Everyone’s got a camera: NY Just Salad mouse edition

NBC New York reports a salad bar blamed its building after up to eight mice were seen running rampant in its midtown location Sunday night, and said the store was closing permanently next month.

“We closed this store for several days to give our team the Thanksgiving holiday off and did not notice the issue in a timely matter. Rodent activity has been a struggle for the concourse area in general,” Just Salad CEO and founder Nick Kenner said in a statement of the Rockefeller Center location.

Kenner added that the brand would moving out of the underground location entirely at the end of December.

Rockefeller Center owner Tishman Speyer did not immediately respond to a request for comment.

The mice were caught on camera by Eli Colon, who had just finished having dinner at a nearby restaurant about 7:30 p.m. when he saw something moving in the Just Salad.

He said he spotted about six to eight mice running and jumping inside the store, which is closed Sundays, and started to film. “When you see this kind of stuff you get very concerned for the health of the people who work there and the people who have lunch there every day,” he said.

In the video, the mice can be seen scampering around behind the counter in the kitchen. Colon has a 3-year-old with allergies so he was particularly concerned about the level of hygiene. sanitary grade of “A” displays mice like that and we were just passing by not searching for mice and those are noticeable. I’m sure there have to be more. Also questions about the standards and processes used by the sanitary organizations that rates these places and how reliable those are.”

Wild boars and zoonoses

Maria Fredriksson-Ahomaa writes in Foodborne Pathogens and Disease that wild boar populations around the world have increased dramatically over past decades. Climate change, generating milder winters with less snow, may affect their spread into northern regions. Wild boars can serve as reservoirs for a number of bacteria, viruses, and parasites, which are transmissible to humans and domestic animals through direct interaction with wild boars, through contaminated food or indirectly through contaminated environment. Disease transmission between wild boars, domestic animals, and humans is an increasing threat to human and animal health, especially in areas with high wild boar densities.

This article reviews important foodborne zoonoses, including bacterial diseases (brucellosis, salmonellosis, tuberculosis, and yersiniosis), parasitic diseases (toxoplasmosis and trichinellosis), and the viral hepatitis E. The focus is on the prevalence of these diseases and the causative microbes in wild boars. The role of wild boars in transmitting these pathogens to humans and livestock is also briefly discussed.

Scientists swallowed LEGOs to find out how long it takes to poop one out

Why use scientists? They could have used any one of my five daughters or three grandsons, whom I am sure have all swallowed Lego at one time or another.

James Chrisman of Thrillist writes an article published in The Journal of Pediatrics and Child Health last week states, on average, the amazing journey of a small yellow plastic head through the human body took 1.71 days. One of these vessels never appeared again, though. It could show up at any day now (they, presumably, won’t be looking for it, so we’ll never know) or maybe, as the blog post suggests, “one day many years from now, a gastroenterologist performing a colonoscopy will find it staring back at him.” 

(For those following up on my recent colonoscopy, which several readers have in private messages, I can say the doc removed a large polyp and two small ones, all were benign, my prostate seems fine and no Lego was found).

As for the concerns this study was meant to address, with regard to kids swallowing these toys, the paper said: “A toy object quickly passes through adult subjects with no complications. This will reassure parents, and the authors advocate that no parent should be expected to search through their child’s feces to prove object retrieval.”

Some objected to the study on Twitter and asserted, “It’s funny and interesting but wrong patient group, single type of FB, tiny sample size. It’s not EBM [evidence-based medicine] and should not change practice.”

To which the authors retorted: “Of course it’s not, it’s a bit of fun in the run up to Xmas.” Consider that the paper used as metrics the Stool Hardness and Transit (SHAT) score and the Found and Retrieved Time (FART) score.

65 sick from E. coli in Romaine lettuce: Collective amnesia for leafy green growers and loads of manure

Maybe CNN is fake news.

When the foodbabe is billed as an expert on microbial contamination of leafy greens and ends up delivering a screed about antimicrobial overuse in livestock as the source of superbugs, I sorta wonder.

But some background.

In sentencing me to jail in 1982, the judge said I had a memory of convenience.

I said I had a memory of not much.

Still don’t.

Spinach and lettuce growers seem to have a memory of not much, given the produce industry’s revisions to the 2006 E. coli O157:H7 outbreak in spinach that killed four and sickened 200.

In October, 1996, a 16-month-old Denver girl drank Smoothie juice manufactured by Odwalla Inc. of Half Moon Bay, California. She died several weeks later; 64 others became ill in several western U.S. states and British Columbia after drinking the same juices, which contained unpasteurized apple cider — and E. coli O157:H7. Investigators believed that some of the apples used to make the cider might have been insufficiently washed after falling to the ground and coming into contact with deer feces.

Almost 10 years later, on Sept. 14, 2006, the U.S. Food and Drug Administration announced that an outbreak of E. coli O157: H7 had killed a 77-year-old woman and sickened 49 others (United States Food and Drug Administration, 2006). The FDA learned from the Centers for Disease Control and Wisconsin health officials that the outbreak may have been linked to the consumption of produce and identified bagged fresh spinach as a possible cause.

In the decade between these two watershed outbreaks, almost 500 outbreaks of foodborne illness involving fresh produce were documented, publicized and led to some changes within the industry, yet what author Malcolm Gladwell would call a tipping point — “a point at which a slow gradual change becomes irreversible and then proceeds with gathering pace” (http://en.wikipedia.org/wiki/Tipping_Point) — in public awareness about produce-associated risks did not happen until the spinach E. coli O157:H7 outbreak in the fall of 2006. At what point did sufficient evidence exist to compel the fresh produce industry to embrace the kind of change the sector has heralded since 2007? And at what point will future evidence be deemed sufficient to initiate change within an industry?

In 1996, following extensive public and political discussions about microbial food safety in meat, the focus shifted to fresh fruits and vegetables, following an outbreak of Cyclospora cayetanesis ultimately linked to Guatemalan raspberries that sickened 1,465 in 21 U.S. states and two Canadian provinces (U.S. Centers for Disease Control and Prevention, 1997), and subsequently Odwalla. That same year, Beuchat (1996) published a review on pathogenic microorganisms in fresh fruits and vegetables and identified numerous pathways of contamination.

By 1997, researchers at CDC were stating that pathogens could contaminate at any point along the fresh produce food chain — at the farm, processing plant, transportation vehicle, retail store or foodservice operation and the home — and that by understanding where potential problems existed, it was possible to develop strategies to reduce risks of contamination. Researchers also reported that the use of pathogen-free water for washing would minimize risk of contamination.

What was absent in this decade of outbreaks, letters from regulators, plans from industry associations and media accounts, was verification that farmers and others in the farm-to-fork food safety system were seriously internalizing the messages about risk, the numbers of sick people, and translating such information into front-line food safety behavioural change.

So why was spinach in 2006 the tipping point?

It shouldn’t have been.

But it lets industry apologists say, how the hell could we known?

Beginning Sept. 14 and continuing until Sept. 20, 2006, the U.S. Food and Drug Administration issued daily news releases that flatly advised consumers “not to eat fresh spinach or fresh spinach-containing products until further notice.”

The agency had never before issued such a broad warning about a commodity, said Robert Brackett, who in 2006 was director of FDA’s Center for Food Safety and Applied Nutritions. Brackett is now vice president and director of the Institute for Food Safety and Health at the Illinois Institute of Technology,

“In this particular case all we knew (was) that it was bagged leafy spinach, but we had no idea whose it was or where it was coming from.

“It was a very scary couple of days because we had all of these serious cases of hemolytic-uremic syndrome popping up and people getting sick, and it was so widespread across the country.”

The Centers for Disease Control and Prevention reported about half of those who were ill were hospitalized during the 2006 spinach E. coli outbreak.

“It was shocking how little confidence that FDA and consumers had in the produce industry at that moment,” said David Gombas, senior vice president of food safety and technology for the Washington, D.C.-based United Fresh Produce Association.

Given the history of outbreaks, the only thing shocking was that the industry continued to expect blind faith.

There were guidelines for growers in 2006, but not a way to make sure growers were following them, said Joe Pezzini, CEO of Ocean Mist Farms, Castroville, Calif.

Convenient.

And now another decade-plus has passed and once again, FDA issued a commodity-wide warning: don’t eat Romaine lettuce (Cos for my Australian friends).

The same huskers and buskers stepped out to make their case, with industry saying OK, maybe we need to be more than a mile away from 100,000 cattle head feedlots that crap into the same water canals used to irrigate leafy greens.

Denny Black, a Manitoba farmer, who grows more than 20,000 heads of Greenleaf and butterhead lettuce at his Neva Farms in Landmark, Man., using hydroponics, a mix of nutrients including calcium and  nitrogen combined with water. The plants, which take about eight weeks to mature from tiny seeds into full grown greens, are grown under artificial lights.

“I think people are looking for an alternative to field grown crops,” Black said.

His method, he claims, could mitigate some risk, since produce can be contaminated with E. coli through the soil, water, animals or improperly composted manure.

Fortunately, Claudia Narvaez, an associate professor in the food science department at the University of Manitoba said, “If the seeds for that lettuce are contaminated with a foodborne pathogen, you can’t, you won’t get rid of it even in a hydroponic production system.”

She added that Black’s controlled environment is only moderately safer compared to soil, depending on the source of the water and whether people follow proper safety procedures when handling the produce.

Keith Warriner of the University of Guelph told CBC he was “shocked” by advice the public got this week from Dr. Jennifer Russell, New Brunswick’s chief medical officer of health, after people got sick from E. coli in Ontario, Quebec and New Brunswick.

Russell advised people to throw away their romaine lettuce. But if they decided to consume the lettuce, she said, they should wash it under cool, running water.

Warriner said washing is too risky.

“We’ve known for years now that washing doesn’t cut it.”

Warriner also told CTV News that romaine lettuce is more susceptible to E. coli contamination partly because of how it’s grown, adding “In our own research, what we found is that E. coli likes romaine lettuce out of all the other lettuces we have.”

Warriner conducted a study that showed romaine lettuce extracts prompted E. coli out of a dormant state, which it can remain in for about a year in soil, and allowed it to flourish.

Romaine’s increased susceptibility comes down to several factors, he said.

The crop is mostly grown in Arizona and California, Warriner said, which is also cattle country. Irrigation water used on romaine fields can become tainted with bacteria from the animals. It doesn’t help that both states are quite hot and romaine lettuce already requires an abundance of water, he said.

But top prize goes to the self-proclaimed foodbabe, she who gets chemicals out of food and managed to secure an interview on CNN (she starts at about 40 seconds in; judge for yourselves).

(Update: the video appears to be removed by CNN, probably due to the Twitter backlash, but here’s the transcript)

I don’t want to give her anymore space for fear it will be associated with credibility: it’s not, that stuff is earned.

Meanwhile, the U.S. Food and Drug Administration says romaine lettuce is now safe to eat following the “purge” of product on the market, and will allow supplies to resume, after grower-shippers agreed to new labeling standards that will include where the lettuce is grown.

The agreement, negotiated by romaine grower-shippers, processors and industry associations, will be the new standard for romaine packed in the U.S. The standards follow an E. coli outbreak linked to 43 illnesses in the U.S. and 22 in Canada, as of Nov. 26.

 “A number of produce associations also have agreed to support this initiative and are recommending that all industry members throughout the supply chain follow this same labeling program,” according to the United Fresh Produce Association, in an e-mail alert to members Nov. 26 sent several hours before the FDA released a statement lifting the advisory that virtually banned romaine in the U.S.

According to the FDA statement, the new labels are voluntary, but its updated message to consumers suggests it’s against shippers’ interest to forego the label:

“Based on discussions with major producers and distributors, romaine lettuce entering the market will now be labeled with a harvest location and a harvest date,” according to the FDA. “Romaine lettuce entering the market can also be labeled as being hydroponically or greenhouse grown. If it does not have this information, you should not eat or use it.”

I like that. It’s what we used with Ontario Greenhouse Vegetable Growers back in 2000 – yes I’m that old – this is a voluntary food safety program, but we have a list of everyone who doesn’t participate and that list will be available to retailers.

Yet why didn’t growers do this for themselves, decades ago, instead of waiting for sick people?

The FDA is advising retailers to display signs about the origin of romaine products when they’re not individually packaged, such as bulk displays of unwrapped heads of romaine.

And kudos to Hansel ‘n Griddle, a small but popular breakfast/lunch chain in the Rutgers area.

In the interest of public health, they texted the following to their customers:

To Our Valued Customer,

Hansel ‘n Griddle has temporarily stopped serving romaine lettuce due to a CDC Food Safety Alert posted on Tuesday, November 20th, 2018 regarding a E. coli outbreak with its source being from romaine lettuce. 

From the CDC website: “The CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak… This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad.”

Below are two links, one to the CDC website, and one to the FDA website, giving details on the E. coli outbreak and more information.

https://www.cdc.gov/ecoli/2018/o157h7-11-18/index.html

https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm626330.htm

 While the CDC has not issued any formal recalls yet, we want to be proactive when it comes to issues regarding food safety and our customers health.

In the meantime, all Hansel ‘n Griddle locations will be substituting romaine lettuce with:

  • Iceberg lettuce in all our salads and wraps
  • Green leaf lettuce on all our paninis, sandwiches and burgers

As always, baby spinach is available for a small upcharge, in place of one of the above lettuce options.

We apologize for any inconvinience this temporary situation may cause

If you have any questions, please feel free to reach out to us atinfo@hanselngriddle.com

Thank you for being a Hansel ‘n Griddle customer.

Best Regards,

The Hansel ‘n Griddle Team

Vanity: Raw egg face masks and risks

Ireland has an egg and a BS problem.

Miranda Larbi of The Irish Sun reports that experts have slammed beauty bloggers who claim that they have the answer to treating wrinkles –  smearing raw egg whites onto their faces.

The DIY hack, they say, is not only is it totally bogus, but it could also spread harmful bacteria.

Putting raw egg on your face has absolutely no benefit for your skin, experts say

Cosmetic surgeon Christopher Inglefield is concerned that raw egg masks will result in Brits getting harrowing bouts of food poisoning due to contamination from the unrefrigerated foodstuff.

Mr Inglefield, founder of the London Bridge Plastic Surgery clinic, warned: “Not only is this ineffective practice, it could potentially spread harmful bacteria, such as Campylobacter and even salmonella if you’re really unlucky.

“You should always wash your hands after handling raw egg.

“If it’s on your face all day then you are potentially contaminating everything and everyone you touch. Just think of the risks.”

Bloggers like Beauty Vixxen, AKA Lizbeth Eguia, have promoted using raw egg as a face mask, but experts warn it’s not safe

5 sick from Salmonella in tahini from Israel

Salmonella in tahini is nothing new.

But is always a reminder that microorganisms don’t care about your lifestyle, your politics, your religion, or your fucking annoyance to proclaim all the allegedly healthy foods you consume as superior – and therefore you are superior — to anything else.

Food porn.

The United States Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC), and state and local partners, is investigating a multistate outbreak of Salmonella Concord illnesses linked to tahini imported from an Israeli manufacturer, Achdut Ltd., located in Ari’el, Israel.

Achdut Ltd. has voluntarily recalled all brands of tahini products manufactured from April 7, 2018 to May 21, 2018 with expiration dates of April 7, 2020 to May 21, 2020.  

The FDA is advising consumers not to eat recalled Achva, Achdut, Soom, S&F, Pepperwood, and Baron’s brand tahini with expiration dates ranging from April 7, 2020 to May 21, 2020. The product lot codes range from 18-097 to 18-141. Consumers should discard the product or return the product to the store for a refund.

Some brands of tahini manufactured by Achdut Ltd. may lack specific dates or may have labels that are written in Hebrew. Consumers who have purchased a tahini product and are uncertain of where the product was manufactured or cannot identify the brand by lot codes or expiration dates should use caution and discard the product or return the food to the store for a refund. More product information and pictures of the recalled product labels can be found in the firm’s recall announcement.

Retailers and restaurants should not use any of the recalled tahini manufactured by Achdut Ltd. at their establishments. Retailers and restaurants should throw the product out. 

Firms that may have used the recalled tahini (either repacked or used as an ingredient in a food without a kill step) should consider recalling their products. Recalls should be reported to your local FDA office. A list of recall coordinators can be found here.

CDC identified five ill people in the U.S. infected with Salmonella Concord that had the same genetic fingerprint as the Salmonella Concord found in tahini sampled at the point of import into the United States. Of the five U.S. cases interviewed, all five reported consuming hummus made with tahini; three people reported eating tahini or hummus made with tahini in a restaurant in the U.S., while the other two people reported consuming tahini or hummus made with tahini during international travel.

30+ sick from Listeria linked to Jerusalem Deli meats in Israel

Outbreak News Today reports that Israeli health officials concluded in a report that more than 30 listeriosis cases were reported to the Ministry of Health, some are severe and include invasive infection and fetus mortality, mostly in the southern region among the Bedouin sector settlements.

In food sampling carried out by the Southern District National Food Services according to information emanating in morbidity incidents investigation, Listeria monocytogenes bacterium has been found in “Jerusalem Deli Pastrami” and the “Jerusalem deli smoked salami” products in the 200 and 400 grams packages by Almadain Food Products Ltd. (Madco) Ltd. The manufacturing date of the products is 08/10/2018 and the expiry date is 07/01/2019.

Can you hear me know? The new holiday tradition: Searching for recalls and outbreak information

Longtime friend of the barfblog.com, Michéle Samarya-Timm, health educator at the Somerset County Department of Health (that’s in New Jersey, represent) writes:

Baking pumpkin pies with Aunt Kay’s secret recipe.  Watching Miracle on 34th Street.  Preparing the dining room with the good china.  Diffusing political conversations at the dinner table. 

Some traditions give a sense of warmth, connection, and continuity, and regularly define a family’s holiday. Unfortunately, there is now a need to add an additional tradition to the season – actively checking for foodborne outbreaks and recalls to prevent folks from getting sick.

 Last week, on Tuesday, November 20th at 2pm, (two days before Thanksgiving), the CDC posted a media statement with advice to consumers, restaurants, and retailers: 

 “CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak.”

 The need to release such a notice, right before a major holiday is an unpropitious scenario.  It was also very concerning in its specificity to consumers, retailers and restaurants:

“Wash and sanitize drawers or shelves in refrigerators where romaine was stored.”

Such an alert is most effective if it reaches the intended audiences.   Folks at my holiday table did not hear about the outbreak.  Neither did many local health departments.

Issuing media releases is one way for public health agencies to reach large groups of people. However, distracted by holiday preparations, travel, shopping, family, football and bad weather this advisory was only partially disseminated to the public. A person had to be following news outlets or social media to receive timely notice. I heard about the recall from the woman next to me while I was getting a haircut – not from the CDC or FDA, or any other federal or state agency.   

 It’s disturbing. The CDC could have sent this info directly to local health departments, or notify them that a news release was issued. This was not the first time as a local public health official that I received delayed – or no – official communication about a national foodborne issue.

Local public health professionals rely on communications systems established by federal and state oversight agencies. Most commonly, if a verified or suspect foodborne contamination or outbreak has occurred, the Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture, or the U.S. Food and Drug Administration (FDA) will ascertain the appropriateness of information release. If this information is deemed credible, notification is forwarded individually or en masse to state departments of health. The states, in turn, push this information down to local regulators. Each step in the process contains elements that may delay the rapid dissemination of outbreak information. The ability and willingness of all stakeholders to quickly and readily share incident particulars with fellow responding agencies can enhance effectiveness and amplify response efforts.

Electronically sending this advisory directly to the nearly 3,000 local health departments in the US would provide the opportunity for hundreds of health inspectors, health educators, epidemiologists and other to reach the hospitals, food banks, schools, mom and pop establishments and local residents who may not have otherwise received the alert. This was a missed opportunity, and hopefully one that didn’t cause additional cases of illness.

As I’ve written before, coordinated communication strategies within and between public health agencies is less robust than it should be. As a result, state and local public health officials may hear about foodborne disease issues first from other sources, such as the media, word of mouth, public complaints, or the food industry.   

 We need to learn how to communicate better with each other.  Local public health shouldn’t have to keep an eye on the news media, Twitter or Facebook for information pertinent to protecting the people in our jurisdictions.  A multitude of electronic portals exist for purposes of interagency  communication, CDC, FDA, and the public health system should collectively define how pertinent information – such as this romaine advisory – rapidly and routinely gets to the grass roots public health workforce. Continuously improving interagency coordination and communication is a goal that is fundamental to increasing the effectiveness of this nation’s food safety systems. I’m putting this out there, because I’m willing to help with the solution. That way, in future years, I can spend my holidays perfecting Aunt Kay’s pie recipe.

This holiday, I’m thankful for public health influencers and amplifiers – like barfblog.com – that act as outbreak aggregators, and push out info to local public health types like me.   

Some background information and recommendations on this topic can be found in:  Getting the message across: an analysis of foodborne outbreak communications between federal, state, and local health agencies   https://calhoun.nps.edu/handle/10945/49379

Sounds like marketing: Food safety culture for economic gain

Research into the connection between organizational effectiveness and culture has been documented since the early nineteen nineties. A connection between economic performance and organizational culture has been established directly linking strong cultural drivers to economic performance in both the finance and retail sectors.

This research proposes a similar association between food safety culture, the measures of maturity and cost of poor quality. Through data collected at five multi-national food companies, this association is explored, and an improved food safety maturity model suggested.

The authors also propose a dynamic model of food safety culture, segmenting it into 4 building blocks: I. Organizational effectiveness, II. Organizational culture norms, III. Working group learned and shared assumptions, and behaviours, and IV. Individual intent and behaviours; and discuss the crucial role of actions between building blocks as part of the pathway to realizing economic gain.

The impact of maturing food safety culture and a pathway to economic gain

19.nov.18

Food Control, https://doi.org/10.1016/j.foodcont.2018.11.041

Lone Jespersen, John Butts, Greg Holler, Jeff Taylor, Dave Harlan, Mansel Griffiths, Carol Wallace

cedirect.com/science/article/pii/S0956713518305863″>https://www.sciencedirect.com/science/article/pii/S0956713518305863

 

 

Turkish military under spotlight as food poisoning and accidental deaths increase

Supplying a safe, nutritious, and increasing local food supply to any military outfit is a challenge.

I was privileged for a few years to provide my thoughts to U.S. military food safety types once or twice a year while at Kansas State University in Manhattan.

I made some lasting friendships, and deeply respect the challenges they faced.

Zulfikar Dogan of Ahval News writes that when the Turkish government issued a series of decrees reshaping the country’s institutions in the aftermath of the July 2016 coup attempt, none of the bodies it set its eye on were more significant than the Turkish Armed Forces.

The radical changes implemented in the military came under the spotlight last week when 21 commando trainees in the western province of Manisa were hospitalised with food poisoning. This followed mass outbreaks of food poisoning in May and June last year, again in training facilities in Manisa, where more than 1,000 soldiers became ill and one died.

Similar cases of mass food poisoning took place in other barracks across the country around the same time. Several government-linked catering companies have already lost their contracts, and the defence minister at the time, Nurettin Canikli, resolved to review catering tenders and introduce a new procurement procedure.

Now, spurred by this month’s poisonings, Özgür Özel, a member of parliament for the main opposition Republican People’s Party (CHP), directed a series of questions in the assembly to Defence Minister Hulusi Akar.

He asked whether the new procurement system described by Canikli last year had been put in place, and for information on the food supply at the Manisa barracks and on the companies involved in catering. He also demanded answers on the last date of inspection at the barracks and on the truth of claims that detachments tasked with checking food had been shut down.

But the ruling Justice and Development Party (AKP) rejected opposition proposals to create a special investigation commission and convene the Committee on National Defence in response to the cases of food poisoning.

After the cases of food poisoning, the Turkish Medical Association released a statement drawing attention to the vacuum left when the military medical institutions were turned over to the Ministry of Health. The association called for these institutions to be reopened and returned to the Turkish Armed Forces.

The Turkish Retired Non-Commissioned Officers Association gave its own statement on the matter, stressing that military doctors were soldiers as well as doctors and that the decrees had made the Turkish Armed Forces the only military in the world that did not have dedicated hospitals and doctors. The association also demanded to know whether private companies would be responsible for catering to Turkey’s troops in wartime.

The points Başbuğ and these associations raise are well illustrated by the response to the cases of mass food poisoning in May and June of last year. Since there was not adequate space in Health Ministry facilities to treat the thousands of poisoned troops, hundreds were forced to receive treatment on stretchers outside hospitals.

Similar scenes were replayed after the food poisoning this month. Handing military decision making to the civilian bureaucracy and dissolving military education and medical institutions has resulted in increased casualties.