More STEC found: Multistate outbreak of Shiga toxin-producing Escherichia coli infections linked to flour

Posted on July 26, 2016 by Douglas Powell

On July 25, 2016, General Mills expanded its recall to include more production dates. A list of all the recalled flours and how to identify them is available on the Advice to Consumers page.

Four more ill people have been reported from two states. The most recent illness started on June 25, 2016.

An infection with another serotype, Shiga toxin-producing Escherichia coli (STEC O26), has been added to this outbreak investigation. STEC O26 was isolated from a sample of General Mills flour (pic, left, from 2011; Sorenne did not eat the flour and awareness of cross-contamination was robust).

One person has developed hemolytic uremic syndrome, a type of kidney failure.

The U.S. Centers for Disease Control, multiple states, and the U.S. Food and Drug Administration(FDA) are investigating a multistate outbreak of Shiga toxin-producing Escherichia coli (STEC) infections.

46 people infected with the outbreak strains of STEC O121 or STEC O26 have been reported from 21 states.

Thirteen ill people have been hospitalized. One person developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Epidemiologic, laboratory, and traceback evidence indicate that flour produced at the General Mills facility in Kansas City, Missouri is a likely source of this outbreak.

Several recalls and recall expansions have been announced as a result of this investigation.

In July 2016, laboratory testing by General Mills and FDA isolated STEC O26 from a sample of General Mills flour. Whole genome sequencing (WGS) showed that the STEC O26 isolated from the flour sample was closely related genetically to isolates from an ill person. The flour tested was not included in the earlier General Mills recalls.

On July 25, 2016, General Mills further expanded its flour recall to include additional lots.

CDC recommends that consumers, restaurants, and retailers do not use, serve, or sell the recalled flours.

Do not eat raw dough or batter, whether made from recalled flour or any other flour. Flour or other ingredients used to make raw dough or batter can be contaminated with STEC and other pathogens.

Consumers should bake all items made with raw dough or batter before eating them. Do not taste raw dough or batter.

Restaurants and retailers should not serve raw dough to customers or allow children and other guests to play with raw dough.

This investigation is ongoing, and we will update the public when more information becomes available.

McDonald’s tries fresh beef ‘An E. coli outbreak waiting to happen’

Posted on July 21, 2016 by Douglas Powell

In 1982, E. coli O157:H7, was found to be responsible for outbreaks of human illness in Oregon and Michigan after customers at McDonald’s outlets ate contaminated hamburgers, the first outbreaks linked to Shiga-toxin producing E. coli.

McDonald’s changed the way it cooked burgers to largely eliminate the human element and instituted E. coli O157 testing of its suppliers and demanded continuous improvement.

Those who don’t know history are doomed to repeat it, or so the saying goes.

Robert Galbraith of Reuters reports that McDonald’s has been testing fresh, never-frozen beef patties at restaurants in Dallas.

Wall Street analysts have applauded the change, but some McDonald’s franchisees say it’s a food-safety disaster waiting to happen.

In a recent survey by Nomura, two dozen franchisees warned that introducing fresh beef patties nationwide would slow down service and expose the chain to new food contamination risks.

“I have major concerns over food safety and our lack of ability to serve a large number of customers quickly,” one franchisee wrote.

Another wrote, “If we do not handle the meat perfectly there is the opportunity for bacterial invasion of our product.”

One operator brought up the E. coli outbreak that affected 14 Chipotle restaurants across the country last fall, sending the chain’s sales plunging by as much as 30%.

“An uncaring employee [could end up] doing something that puts the entire system at risk,” the franchisee wrote. “We are the lightning rod. Chipotle will be a walk in the park if we have an incident.”

McDonald’s has long relied on an extensive network of suppliers who make, freeze, and ship beef patties to its more than 14,000 restaurants in the US.

Expanding the fresh beef test — which is currently limited to 14 restaurants in Dallas — would require big changes to its supply chain. The potential for foodborne illnesses is higher when uncooked meat is kept at a temperature above 40 degrees Fahrenheit, according to the USDA.

At the restaurant level, it would be a “massive learning curve for our managers and crew,” one franchisee wrote. “No doubt the biggest change in McDonald’s history. Would be a huge distraction from our ‘turnaround.'”

In the same survey, many McDonald’s franchisees also acknowledged that fresh beef would help improve the fast-food chain’s public image.

“Faster cook times, juicier product, seared product versus stewed meat,” one franchisee wrote.

Another said, “Many customers perceive unfrozen to be better for you. Perception is everything.”

Twenty-seven domestic franchisees with approximately 199 stores participated in the Nomura survey, representing a small fraction of McDonald’s 14,000 stores in the US.

McDonald’s CEO Steve Easterbrook said last month that there isn’t currently a large enough supply of fresh beef to expand the test nationally but that the company could start expanding it gradually region by region.

Easterbrook said a larger rollout wouldn’t require any major new equipment or expenses for franchisees.

The company just has a few small issues to work out through the test, such as finding the best system for storage and handling of the beef to avoid any cross-contamination of the fresh, uncooked meat with other food items.

“We are trying to figure out the best way to segregate equipment like spatulas and scrapers for the grill,” he said.

Too much Listeria from poor training? Maybe try an augmented reality approach

Posted on June 12, 2016 by Douglas Powell

Listeria monocytogenes is the causative agent of the human illness called listeriosis. The data reported in the last 15 years of scientific literature concerning the relationship between this microorganism and the catering sector showed a permanent presence of the opportunistic pathogen through the years, though with low frequencies.

Even though the pathogenic capacity of L. monocytogenes is practically circumscribed to a few risk categories as pregnant women, newborns and different kinds of immunocompromised people, given its high case-fatality rate this disease represents the second cause of death for foodborne infection in Europe.

As it emerged from the reviewed literature, L. monocytogenes was recovered in many different food categories, which testifies the widespread of the pathogen in the food chain. The main causes of L. monocytogenes presence were poor microbiological quality of raw materials, cross-contamination, inadequate cleaning practices, improper storage temperature, inadequate preparation processes, and a lack in the training of staff on food hygiene.

In particular, cross-contamination of foods can be reduced by hand washing, use of gloves, separation of raw materials from end products, sanitation and disinfection of equipment and food contact surfaces, hence, a structured training program of staff on these practices is essential.

The occurrence of Listeria monocytogenes in mass catering: An overview in the European Union

International Journal of Hospitality Management, Volume 57, August 2016, Pages 9–17, doi:10.1016/j.ijhm.2016.05.005

Andrea Osimani, Francesca Clementi

http://www.sciencedirect.com/science/article/pii/S0278431916300639

Food safety training is utilized in the food industry to provide employees with the needed knowledge on how to prevent foodborne illnesses. However, although there is evidence that current food safety training is effective in increasing employee knowledge, employees’ observed behaviors often do not change and, therefore, the risk of foodborne illness is not decreased. In this review we discuss several motivational theories and propose a unique use of augmented reality for training to increase compliance of employees in regards to safe handling of foods.

Taking food safety to the next level—An augmented reality solution

Journal of Foodservice Business Research

DOI:10.1080/15378020.2016.1185872

Dennis E. Beck, Philip G. Crandall, Corliss A. O’Bryan & Jessica C. Shabatura

http://www.tandfonline.com/doi/abs/10.1080/15378020.2016.1185872

Cross contamination nightmare

Posted on May 23, 2016 by Douglas Powell

From the Retail Hell Underground:

I work for a supermarket in the Fresh Fish department. I actually enjoy the job, most of the time that is, but everyone has horror stories. This was an amusing thing that happened shortly after I started the job.

So we had a sale on Whole Salmon at £4 a kilogram (around $2.50 for a pound, give or take for Americans). It was an incredibly good sale, and whenever the sale is on the department is absolutely rammed with customers. I don’t really mind as the day goes quicker and our sales go through the roof. The vast majority of customers don’t want the Salmon whole as it is, and ask for it filleting, which we are happy to offer and do for them even if it takes a bit longer. I was just about to go for my lunch, but as we had a lot of orders for whole salmon that needed filleting I decided I would stay for longer and help my colleagues get through it. In comes a customer who looks absolutely bewildered, lets call him AB.

Me: Hello Sir, how may I help you today?

AB: The whole salmon, how much is it?

Me: It is on special offer at £4 per kilogramme.

AB: No, how much are THEY?!? I don’t work in kilogrammes. (Despite the fact that the retail sector has been using metric weights for over 30 years and the man didn’t look older than his 50s)

Me: Well it works out at under £2 per pound and they are each individually priced as you can see, they range from between £10 to £16 each depending on which one you want sir.

AB: Give me that one!

Me: Okay sir how would you like it? As it is whole or filleted?

AB: I would like it filleting… quickly please!

Me: I’ll try get through it as soon as I can sir, it shouldn’t take more than 5 minutes. Would you like me to pin bone it?

AB: I SAID FILLETING THANK YOU!!!

Me: No problem, I’ll have it ready for you as soon as possible.

The customer was being irate, but as it was a hot day I didn’t really think much of it as everyone seems to get more aggravated when the sun comes out. I quickly filleted the fish, not bothering to pin bone it as he stated he just wanted it filleting, bagged it up and left it in the back up chiller for when he came back to pick it up. He comes back, I gave it to him and he seemed happy enough. I didn’t think more of it and went for my lunch.

As I came back to the department after my lunch I barely had my apron on when he came rushing back to the department.

AB: There are bones in my fish!

ME: Well yes, you said you didn’t want it pin boning.

AB: CAN YOU REMOVE THEM! I’M NOT EATING MY FISH WITH BLOODY BONES.

ME: Sure thing, but in future when asked if you want it pin boning please reply yes.

AB: (muttering under his breath) …ohh, right.

So I pin bone the fish, but I notice it all crumbled up to the bottom of the bag and it is incredibly wet. My colleague is speaking to the absolutely bewildered customer, and he suddenly bursts out laughing. I’m not really listening to the conversation, but I finish pin-boning the fish and give it back to him and he looks rather embarrassed but thanks me really nicely, like a total mood change.

So I ask my colleague what they were talking about. Supposedly the customer had gone to the customer bathroom after he paid for his shopping, and dropped the salmon in the actual toilet by accident, and he ran the salmon fillets under the water in the sink to clean it as if that would magically get rid of all the bacteria.

This man had just dropped his salmon in the toilet, without telling me, and expected me to handle it again and use a clean surface to de-bone it. Cross contamination nightmare! Me and my colleague had a good chuckle as he got what he deserved.

And that is how I ended up spending the next hour disinfecting the hell out one of our work areas.

How these people manage in daily life is beyond me haha.

15 sickened with E. coli from butcher: Council says no action to be

Posted on May 3, 2016 by Douglas Powell

In June and July, 2015, 15 people were sickened with E. coli O157 from Robinson’s Butchers and Caterers in Billingham, UK.

Yesterday Durham County Council decided it would take no action against the butcher even though cross-contamination was the likely cause.

Stockton Council is continuing its inquiry into the conditions at the Billingham branch which has remained closed since the incident.

Joanne Waller, Durham County Council’s head of environment, health and consumer protection, said: “Officers from Durham County Council’s food safety team took all appropriate enforcement actions during the course of the investigation, to ensure that suitable and effective control measures were put into place by the food business operator at the Wingate premises. Any identified contraventions of food safety law were rectified at the time, and all recommendations were fully implemented without delay. Accordingly, there is no intention to pursue any further formal enforcement action in respect of this incident.”

Some of those affected contracted illness from food supplied by Robinson’s butcher’s to Northfield School in Billingham.

A report by Public Health England’s outbreak control team in December found the outbreak did come from Robinson’s, and said the likely cause was “cross-contamination from raw meat to ready-to-eat food within the Billingham branch and to a lesser degree at the Wingate branch.”

Of the 15 people affected, 10 needed hospital treatment of which seven went on to develop haemolytic uraemic syndrome, a serious condition affecting the kidneys.

One of these was 12-year-old Tia Donaldson, of Billingham, who was left in a critical condition having suffered kidney failure, a series of mini strokes and a dangerously inflamed bowel.

Pork-linked Salmonella outbreak led to 192 confirmed illnesses

Posted on April 14, 2016 by Ben Chapman

It’s MMWR day again. My favorite.

A few years ago we conducted a study in commercial kitchens where we acted as food safety voyeurs and watched 47 food handlers do their job for four days.

We counted and coded all the preparation actions we could see (in some kitchens we had 8 camera angles) and there was whole lot of cross-contamination.

One cross-contamination event per food handler.

Per hour.

The MMWR note from the field detailing a 2015 Salmonella outbreak linked to a Washington State pork processor highlights the impacts of lots of cross-contamination.

A total of 192 confirmed cases were reported from five states; 184 (96%) occurred in Washington (Figure). Patients ranged in age from <1 to 90 years (median = 35 years), and 97 (51%) were female. Among 180 patients for whom information about hospitalization was available, 30 (17%) were hospitalized; no deaths were reported.

On the basis of cases investigated before August 2015, a supplemental questionnaire that went into more detail in addressing meat and livestock exposures was developed. Among 80 patients (42% of all confirmed cases) who were interviewed, 59 (74%) reported eating pork during the 7 days preceding illness. This was significantly higher than the most recently published (2007) Foodborne Diseases Active Surveillance Network (FoodNet) population survey of healthy persons, in which 43% reported eating pork in the week before they were interviewed (p <0.001) (1).

WADOH and PHSKC investigation into the source of pork traced the pork consumed by 35 (59%) of the 59 interviewed patients who reported eating pork back to a U.S. Department of Agriculture’s Food Safety and Inspection Service–inspected pork slaughter establishment in Graham, Washington. During the outbreak period, the establishment distributed whole hogs and pork parts, primarily from five farms in Montana and one in Washington, to Washington, Oregon, and Alaska. Among the 21 interviewed patients who did not report consuming pork before becoming ill, 13 had eaten at one of two restaurants or had shopped at one market where pork from the establishment was served. During June and July 2015, PHSKC inspections of these three facilities identified potential opportunities for cross-contamination of raw pork with other meat and produce, including inadequate employee handwashing and insufficient cleaning and sanitization of food contact surfaces and utensils used for raw meat. Food and environmental sampling by PHSKC at all three facilities yielded the outbreak strains.

There’s a lot of pork cooked and consumed in restaurants across the U.S. daily. And Salmonella in pork is a known issue, but there aren’t reported pork/Salmonella outbreaks every day. My guess is that incoming pork contamination levels were out of the ordinary as well.

Cross-contamination happens in labs too

Posted on April 6, 2016 by Douglas Powell

This paper describes a case of Salmonella cross-contamination in a food laboratory.

In 2012, chocolate bars shipped from Belgium to the USA were prevented from entering the USA because a Salmonella Rissen strain had been isolated from one of the chocolate bars in a Belgian food laboratory. However, a retrospective study of the Salmonella isolates sent from the laboratory to the Belgian National Reference Laboratory for Salmonella revealed that 7 weeks prior, a Salmonella Rissen strain had been isolated from fish meal in the same food laboratory.

The chocolate bars were not expected to be contaminated with Salmonella because the ingredients all tested negative during the production process. Furthermore, because Salmonella Rissen is only rarely isolated from food, it was hypothesized that the two Salmonella Rissen isolates belonged to the same strain and that the second isolation event in this laboratory was caused by cross-contamination.

To confirm this hypothesis, both Salmonella Rissen isolates were fingerprinted using different molecular techniques. To evaluate the discriminatory power of the techniques used, 11 other Salmonella Rissen isolates from different origins were included in the comparison. Pulsed-field gel electrophoresis, repetitive element palindromic PCR and three random amplified polymorphic DNA PCR assays were used.

Repetitive element palindromic PCR and random amplified polymorphic DNA PCR assays were insufficiently discriminatory, whereas pulsed-field gel electrophoresis using the combination of two restriction enzymes showed sufficient discrimination to confirm the hypothesis.

Although cross-contamination in food laboratories are rarely reported, cross-contamination can always occur. Laboratories should therefore always be aware of the possibility of cross-contamination, especially when enrichment is used in the microbiological analysis. Furthermore, it is advised that results showing isolates of the same serotype isolated in a short time frame from unrelated food products should be interpreted carefully and should be confirmed with additional strain typing.

Case report of Salmonella cross-contamination in a food laboratory

10.mar.2016

BMC Research Notes, Volume 9, Number 156, March 2016, Pages 1-4

Rasschaert G, De Reu K, Heyndrickx M, and Herman L

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4787000/

You’ve gotta fight, for your right, to a fair inspection

Posted on March 1, 2016 by Douglas Powell

Pat Ferrier of the Coloradoan writes that restaurants live and die by reputation.

Word of mouth, spread through social circles or social media, can make or break an eatery — especially in a hyper-competitive market like Fort Collins. A negative one-word rating from the county health department can spell disaster.

That’s why the owners of restaurant 415 at 415 Mason St. in Old Town Fort Collins are objecting to the latest in a trio of “inadequate” ratings their eatery has received from the Larimer County Department of Health and Environment.

“We want to be the catalyst for change,” said 415 co-owner Andre Mouton. “The system is severely lacking; it’s broken.”

County health officials periodically examine restaurants and other food-service facilities, looking for factors that can increase the risk of patrons contracting a food-borne illness. Detailed reports on those risk factors are summarized by a risk index that features five ratings: excellent, good, average, marginal and inadequate.

The one-word ratings are published weekly in the Coloradoan. An inadequate rating gives people the impression the restaurant is serving bad food, said Mouton, a veteran restaurateur.

In reality, he said, many of the violations that led to the inadequate rating 415 received in February were administrative in nature, such as not having the proper warning on its menu about consuming raw or undercooked foods, employee drink cups being placed next to clean dishes and a bottle of Windex stored next to clean linens.

According to the complete report from the inspection, 415 received its largest deductions for issues of adequate cooking and potential cross-contamination from equipment, and for hot and cold holding of food. The full inspection is available at noconow.co/415inspect.

Mouton and co-owner Seth Baker admit there are areas in which they can improve, “but our kitchen is one of the cleanest in the city.”

According to the restaurant’s inspection history, 415 has been rated inadequate in each of its last three complete inspections, dating back to October 2013. The restaurant has been docked points for adequate cooking and hot or cold handling in the majority of the eight inspection reports listed on the county website.

Business has unfairly suffered, Baker said. “We strive to be a great place to work,” he said. “We are all local kids and the community is important to us. We are doing everything in our power” to be the best.

Mouton and Baker, however, say they are committed to working to change and improve the county’s 20-year-old inspection rating system.

Each county has a slightly different rating system. Larimer County issues ratings from inadequate to excellent. Weld County gives letter grades from A to F. Industry representatives don’t believe letter grades are fair and prefer more detail be included in reports to the public.

“That could be a double-edged sword,” Devore said. No rating system is perfect but many work pretty well, he said. “The main reason for the rating system is to get some general information out to the public so they can evaluate it.”

Mouton said “it’s not fair to us or other restaurants” to provide a one-word rating, which does not provide a full explanation of violations. “We are not trying to cheat the system. We want to create clarity. We are trying to fix the problem with how things are scored.”

OK, explain those inadequate cooking, hot and cold holding of food and cross-contamination violations.

Cross-contamination makes pork risky

Posted on February 15, 2016 by Douglas Powell

As part of a quantitative microbiological risk assessment (QMRA) food chain model, this article describes a model for the consumer phase for Salmonella-contaminated pork products.

Three pork products were chosen as a proxy for the entire pork product spectrum: pork cuts, minced meat patties, and fermented sausages. For pork cuts cross-contamination is considered the most important process and therefore it is modeled in detail. For minced meat, both cross-contamination and undercooking are the relevant processes. For those commodities bacterial growth during transport and storage is also modeled. Fermented sausages are eaten raw and the production may be defective.

Variability between consumers’ behavior and the impact of variability between production processes at the farm and abattoir are taken into account. Results indicate that Salmonella levels on products may increase significantly during transport and storage. Heating is very efficient at lowering concentrations, yet cross-contamination plays an important role in products that remain contaminated. For fermented sausage it is found that drying is important for Salmonella reduction.

Sensitivity analysis revealed that cross- contamination factors “knife cleaning” and “preparation of a salad” are important parameters for pork cuts. For minced meat cleaning of the board, salad consumption, refrigerator temperature, and storage time were significant.

A QMRA model for Salmonella in pork products during preparation and consumption

Risk Analysis

N. Swart, F. van Leusden and M. J. Nauta

http://onlinelibrary.wiley.com/doi/10.1111/risa.12522/abstract

Cross-contamination: It’s a risk, that no wiping on a chefs’s apron will reduce

Posted on January 3, 2016 by Douglas Powell

Although quantitative studies have revealed that cross-contamination during the washing stage of fresh produce occurs, the importance of cross-contamination in terms of public health relevance has rarely been assessed.

The direct distribution of initially contaminated leafy vegetables to a multitude of servings by cutting and mixing also has not been addressed. The goal of this study was to assess the attribution of both contamination pathways to disease risk. We constructed a transparent and exploratory mathematical model that simulates the dispersion of contamination from a load of leafy greens during industrial washing. The risk of disease was subsequently calculated using a Beta-Poisson dose-response relation.

The results indicate that up to contamination loads of 10⁶ CFU the direct contamination route is more important than the indirect route (i.e., cross-contamination) in terms of number of illnesses. We highlight that the relevance of cross-contamination decreases with more diffuse and uniform contamination, and we infer that prevention of contamination in the field is the most important risk management strategy and that disinfection of washing water can be an additional intervention to tackle potentially high (>10⁶ CFU) point contamination levels.

Public health relevance of cross-contamination in the fresh-cut vegetable industry

Journal of Food Protection, January 2016, No. 1, pp. 4-178, pp. 30-36(7) DOI: http://dx.doi.org/10.4315/0362-028X.JFP-15-272

Jurgen Chardon, Arno Swart, Eric Evers, Eelco Franz

http://www.ingentaconnect.com/content/iafp/jfp/2016/00000079/00000001/art00004

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