Blaming consumers: Cruise ship edition

Jim Walker of Cruise Law News writes the Centers for Disease Control (CDC) reports that there was a gastrointestinal outbreak on the Crown Princess during its recent cruise, from October 25th to November 8, 2017. The Princess cruise ship departed Quebec, Canada on October 25th for a two-week cruise to Canadian and U.S. ports. The cruise ship arrived in Fort Lauderdale, Florida on November 8th and will begin its Caribbean season.

According to the CDC report, 184 passengers and 12 crew members became ill with gastro-like symptoms which included diarrhea.  

During the period from 2010 to the current date, Princess Cruises experienced the most outbreaks on its cruise ships calling on U.S. ports, according to the CDC. Princess reported twenty-one (21) cases to the CDC during this time period.

The Crown Princess alone has suffered through six (6) norovirus outbreaks since 2010 to the present. Before the current GI outbreak, the last norovirus outbreak on the Crown Princess was from January 3 – 18, 2016 and, before that, from October 18 to November 16, 2014. Earlier, there was a norovirus and e-coli outbreak from February 5 to 12, 2014. It also experienced back-to-back norovirus outbreaks from January 29 to February 4, 2012 and February 4 to February 9, 2012.

The cruise line with the second most outbreaks is Holland America Line with 18 cases of GI sicknesses reported to the CDC since 2010. HAL suffered norovirus outbreaks on the Nieuw Amsterdam, and two outbreaks each on the Voendam and the Noordam this year.  

So why is Princess Cruises far more prone to norovirus outbreaks than Carnival cruise lines, for example?

The cruise industry always blames the passengers for bringing the virus aboard, rather than its food handlers, or contaminated food or water. So are Princess Cruises customers the sickest and the least hygienic cruisers around? Are guests of HAL the second most unhygienic cruisers? Do they wash their hands the least of any cruisers? This seems like absurd arguments to make.

Whoever is to blame, the crew members, of course, always pay the price, by having to wipe and scrub and spray everything in sight for long 16+ hour days to try to disinfect a ship longer than three football fields.

Irrespective of the blame-game, don’t call us if you get sick on a cruise. Proving where the virus came from, or that the cruise line was negligent, is virtually impossible to prove, especially since the CDC conducts no epidemiological analysis and sometimes can’t even figure out whether the outbreak is due to norovirus, e-coli or something as exotic as Shigella sonnei or Cyclospora cayetanensis.

For example, The New Zealand Herald reports, a passenger on a cruise ship plagued with a vomiting and diarrhoea bug says he only learnt previous guests had been struck down with the same thing once they set sail.

Sydney man Walter Gibian and his wife Elisabeth left Sydney on October 30 on a 12-day Celebrity Solstice cruise travelling from Sydney to Auckland via the South Island so they could see New Zealand. Gibian had worked in New Zealand in 1980s and loved it so booked the cruise to see the East Coast.

The ship had left Melbourne when the captain announced to guests that passengers on an earlier cruise had norovirus and asked guests to take extra precautions including washing their hands regularly and using hand sanitiser.

any notification before they left and by this time it was too late to do anything about it as they were well on their way to New Zealand.

“It think people should be told and given the option that if you don’t like being exposed to this virus you are allowed to get off. But we found out when we were sea.”

Halfway into the 12-day cruise passengers started falling ill and Elisabeth came down with the bug on Saturday night. She was then isolated to her cabin for 48 hours.

“They (passengers) are sick all right. But of course the ship won’t tell us how many are sick, but my wife got sick on Saturday night. They are taking all sorts of precautions but it is still happening. They keep telling me, they are doing their utmost and they are doing their best but the fact is it is not effective.”

Cutting cantaloupe and blaming consumers: Food safety starts on the farm

In 1998, the U.S. Department of Agriculture very publicly began to urge consumers to use an accurate food thermometer when cooking ground beef patties because research demonstrated that the color of meat is not a reliable indicator of safety.

cantaloupe.half_.sep_.12USDA Under Secretary for Food Safety at the time, Catherine Woteki, said, “Consumers need to know that the only way to be sure a ground beef patty is cooked to a high enough temperature to destroy any harmful bacteria that may be present is to use a thermometer.”

At the time, I said, no one uses a meat thermometer to check the doneness of hamburgers. The idea of picking up a hamburger patty with tongs and inserting the thermometer in sideways was too much effort (others insist the best way to use a tip sensitive digital thermometer is to insert into the middle of the patty at a 45 degree angle).

I was wrong.

Shortly thereafter, I started doing it and discovered, not only was using a meat thermometer fairly easy, it made me a better cook. No more burgers resembling hockey pucks, overcooked to ensure dangerous pathogens were gone. They tasted better.

By May 2000, USDA launched a national consumer campaign to promote the use of food thermometers in the home. The campaign featured an infantile mascot called Thermy who proclaimed, “It’s Safe to Bite When the Temperature is Right.”

Almost two decades later and I have the fervor of a born-again thermometerist, distributing them to friends, one meal at a time.

Sometime in the mid-2000s, in light of on-going outbreaks involving cantaloupe (rock melon) USDA started recommending that consumers wash the exterior to prevent dangerous microorganisms on the surface of the cantaloupe from coming into contact with the inner flesh.

I was not convinced.

And remain unconvinced (see video, below, from 2009).

cantaloupe.salmonella_0.featuredWhat is important that as soon as cantaloupe is chopped or cut in half, it needs to be kept cold (which is why it is disconcerting at markets and megalomarts in Australia and elsewhere to see melons sliced in half, wrapped in plastic and sitting at ambient temperature, which can be a tad warm in Brisbane).

A new study compared two cantaloupe cutting methods and concluded that it’s best to limit contact with pathogens on the farm.

Whole and cut cantaloupes have been implicated as vehicles in foodborne illness outbreaks of norovirus, salmonellosis, and listeriosis. Preparation methods that minimize pathogen transfer from external surfaces to the edible tissue are needed.

Two preparation methods were compared for the transfer of Listeria monocytogenes, Salmonella enterica serovar Typhimurium LT2, murine norovirus, and Tulane virus from inoculated cantaloupe rinds to edible tissueand preparation surfaces.

For the first method, cantaloupes were cut into eighths, and edible tissue was separated from the rind and cubed with the same knife used to open the cantaloupes. For the second method, cantaloupes were scored with a knife around the circumference sufficient to allow manual separation of the cantaloupes into halves. Edible tissue was scooped with a spoon and did not contact the preparation surface touched by the rind. Bacteria and virus were recovered from the rinds, preparation surfaces, and edible tissue and enumerated by culture methods and reverse transcription, quantitative PCR, respectively. Standard plate counts were determined throughout refrigerated storage of cantaloupe tissue.

Cut method 2 yielded approximately 1 log lower recovery of L. monocytogenes and Salmonella Typhimurium from edible tissue, depending on the medium in which the bacteria were inoculated. A slight reduction was observed in murine norovirus recovered from edible tissue by cut method 2. The Tulane virus was detected in approximately half of the sampled cantaloupe tissue and only at very low levels. Aerobic mesophilic colony counts were lower through day 6 of storage for buffered peptone water–inoculated cantaloupes prepared by cut method 2. No differences were observed in environmental contamination as a function of cutting method.

Although small reductions in contamination of edible tissue were observed for cut method 2, the extent of microbial transfer underscores the importance of preventing contamination of whole cantaloupes.

Transfer of pathogens from cantaloupe rind to preparation surfaces and edible tissue as a function of cutting method

Journal of Food Protection®, Number 5, May 2016, pp. 696-889, pp. 764-770(7)

Shearer, Adrienne E. H.; LeStrange, Kyle; Castañeda Saldaña, Rafael; Kniel, Kalmia E.

http://www.ingentaconnect.com/contentone/iafp/jfp/2016/00000079/00000005/art00010

Blaming consumers, New Brunswick edition

If weird things are being said about raw hamburger in Windsor, Ontario, it’s been food safety amateur hour in the public discussion of two apparently separate E. coli O157:H7 outbreaks this summer in New Brunswick.

Two months after an E. coli O157:H7 outbreak that sickened up to 24 people was linked to California Romaine lettuce served at a Jungle Jim’s restaurant in Miramichi, New Brunswick, another outbreak sent two Fredericton teenagers to hospital and sickened at least another two people.

The Daily Gleaner reported that one of those teens, Micaella Boer, was thrilled when the infectious disease specialists at the Saint John Regional Hospital told her she could go home on a 24-hour pass Wednesday. That was some good news.

Unfortunately, the Gleaner felt it necessary to lecture consumers about safe eating practices, saying in a separate editorial that at home, “we have complete control.”

People at home have little to no control over fresh produce – especially lettuce – and a host of other foods such as contaminated peanut butter, spices, deli meats, pet food, frozen pizza, pot pies and so on. Parents and consumers have some responsibility; so does everyone else, farm-to-fork.

Blaming consumers for food safety recalls

According to The Packer, which writes about produce, “recent statements in national media about so-called consumer recall fatigue spurred discussion in the fresh produce and food safety communities, with leaders suggesting consumer complacency is the more prevalent problem.”

So are dangerous microorganisms that consumers have little hope of removing on fresh produce the fault of consumers, not farmers?

Richard Raymond, USDA undersecretary for food safety from 2005-09 told The Packer, “Complacency is a more accurate description of what’s going on with consumers.”

Produce food safety starts on the farm.

Blaming consumers, Australia edition: taxpayer money to make people feel guilty about foodborne illness that wasn’t their fault

Bad food safety information, like bacteria, has no respect for geographic boundaries.

Food safety isn’t simple; people argue about specifics all the time. But failing to acknowledge uncertainties, doubts or errors while making proclamations from on public relations high undermines the credibility of the message and the messenger.

Marnie McKimmie of The West Australian wrote a piece a couple of weeks ago that, in one special synthesis, contains a greatest hits of microbial food safety myths.

Juliana Madden, executive director of the Food Safety Information Council, Australia’s version of the equally tragic FightBac and other consumer education campaigns, shares these gems:

"You can be sloppy peeling the carrots if you are going to bake them, but if you are going to stir fry or have salads then you have to be a lot more careful because that little bit of dirt on the outside can still be there and can contain all sorts of things but particularly E. coli, which is one of the big ones and is just hideously awful.”

Any raw food can be contaminated. An outbreak of E. coli O157:H7 last year in the U.K. sickened 250 and killed one. Best guess was messy handling of raw potatoes and leeks. Carrots are the same. They’re grown in soil. Things poop on soil, and water with poop runs through soil. Careful with those carrot peels.

"The German bean sprouts outbreak was so unfortunate because it was a perfect storm. Those sprouts had actually been treated as properly as they could have been in regards to the regulations but there were two mutations – one made the E.coli a lot more toxic and the other made the E.coli a lot stickier and therefore difficult to wash off."

The contamination was probably in the seed, like in so many other sprouts outbreaks (a table is available at http://bites.ksu.edu/sprouts-associated-outbreaks). No amount of washing would have prevented the outbreak. And mutations happen all the time.

“Always wash pre-washed green vegetables. Despite what the label advises, these must always be washed again at home to reduce the risk of food poisoning from bacteria such as listeria,” warned Sophie Williamson, WA Health Department food unit acting manager.

Researchers concluded in a 2007 review that additional washing of pre-washed salads would increase the food safety risk because of potential cross-contamination in food service and home kitchens. As Don Zink of the U.S. Food and Drug Administration told USA Today last year, bagged lettuce and spinach were already washed in a sanitizing solution at the packing plant and it was probably a lot cleaner than your kitchen. Microorganisms bond to the surface of the food item. "You are not going to rinse them off, it simply won’t happen, they cannot be washed off.”

Or, as I said, All washing might do is "remove the snot that some 3-year-old blew onto the food at the grocery store.” Washing "lowers the pathogen count a little, but not to safe levels if it’s contaminated."

People can have their preferences – back it up with data.

“Bean sprouts. A high-risk food that must be washed thoroughly, Ms Williamson said.”

Again, washing does almost nothing except make people feel good. The U.S National Advisory Committee on Microbiological Criteria for Foods figured this out in 1999.

“Chicken. Still not enough families were ensuring it was cooked until the pink in the middle disappeared and the liquid clear, warned Ms Williamson.”

Color is a terrible indicator. Using a tip-sensitive digital thermometer is the only way to tell if food has reached a safe temperature. Even some Aussies are warming to the idea of thermometers.

Who funds this Food Safety Information Council? See for yourself at foodsafety.asn.au.