Really big nosestretcher alert: leading Toronto hospital says cold cuts, raw fish, OK for expectant mothers

Erin Stadler was at her baby shower in North Carolina in 1997 when she at a piece of brie cheese that was contaminated with listeria. The disease made Stadler and her unborn child deathly ill.

"You don’t think about eating one piece of cheese and almost dying. That’s basically, what happened for both of us," said Stadler.

When Stadler went to the hospital, doctors immediately delivered baby Allison. She was premature at 33 weeks. Allison was in the hospital for two more weeks for additional tests when doctors realized how ill both Erin and Allison were.

Two pregnant women on Virgin Blue Australian flights last year gave birth prematurely after being served listeria-laden chicken wraps.

In the fall of 2008, along with the Maple Leaf listeria-in-deli-meat mess, an outbreak of listeria in cheese in Quebec led to 38 hospitalizations, of which 13 were pregnant and gave birth prematurely. Two adults died and there were 13 perinatal deaths.

A Sept. 2008 report showed that of the 78 residents of the Canadian province of British Columbia who contracted listeriosis in the past six years, 10 per cent were pregnant women whose infections put them at high risk of miscarriage or stillbirth.

The majority — nearly 60 per cent — of pregnant women diagnosed with listeriosis either miscarry or have stillbirths.

The authors wrote,

"Health care providers [want] better information for themselves and resources they could share with pregnant women. … The information provided to pregnant women by health care providers needs to be targeted and clear," and that as a result of the spring survey, BCCDC will start a project to better inform health care providers and their patients about food safety risks during pregnancy.

The U.S. Centers for Disease Control and Prevention (CDC) has estimated approximately 2,500 cases of liisteriosis occur annually in the United States, with about 500 cases resulting in death. In 2000, listeria exposure resulted in a higher rate of hospitalization than any other foodborne pathogen and more than one-third of reported deaths from food pathogens.

CDC has a list of foods to avoid while pregnant: deli meats or cold-cuts top the list. Health Canada has similar advice.

Which makes a report in the April 2010 edition of the journal, Canadian Family Physician, absolutely baffling.

Worse, the report was authored by the Motherisk team at the previously reputable Toronto Hospital for Sick Children.

The authors state, correctly, that the incidence of listeria “among pregnant women remains about 20 times higher compared with the general population,” but go on to state, without any references, that “pregnant women need not avoid soft-ripened cheeses or deli meats, so long as they are consumed in moderation and obtained from reputable stores.”

Here is the actual Q&A as printed in the article:

QUESTION After hearing about outbreaks of illness resulting from Listeria and Salmonella, many of my patients are wondering about the risks of food-borne illnesses during pregnancy and what they can do to reduce their chances of contracting them.

ANSWER Although heating or cooking food is the best way to inactivate food-borne pathogens, improved standards and surveillance have reduced the prevalence of contaminated foods at grocery stores. Therefore, it is no longer necessary for pregnant women to avoid foods like deli meats and soft cheeses (associated with Listeria); soft-cooked eggs (associated with Salmonella); or sushi and sashimi. Regardless of whether seafood is raw or cooked, pregnant women should choose low mercury seafood (eg, salmon and shrimp) over higher mercury varieties (eg, fresh tuna). Pregnant women should ensure that their food is obtained from reputable establishments; stored, handled, and cooked properly; and consumed within a couple of days of purchasing.

I have no idea what the authors mean by a reputable source. I have no idea how this advice got approved and published. How is it that the authors, Carolyn Tam, a graduate student in clinical pharmacology at the University of Toronto, Aida Erebara MD, and Adrienne Einarson RN, assistant director of the Motherisk Program could come up with such terrible food safety advice from the 25-year-old Motherisk program which is designed “to ensure the well-being of mothers and babies, worldwide.”

And they want donations.

Someone has already sent the editor a letter of protest.

Thanks to the barfblog.com reader who sent me the link.

Canada tells old people to cook deli meats two years after 22 died

Almost two years after 22 elderly Canadians died from eating Maple Leaf deli meats, the Canadian government has decided to remind Canadians of the importance of food safety for older adults.

Health Canada and the Canadian Food Inspection Agency tell older Canadians they should separate, clean, chill and cook, and make sure to cook hot dogs and deli meats until they are steaming hot before eating them.

The best the 6-figure bureaucrats who came up with this – and there were many – could do was borrow piping hot from the U.K.?

So is that standard advice now for aged-care facilities across Canada, where the staff dieticians were completely clueless about the potential for deli-meats to be contaminated with listeria? Is this Maple Leaf-sanctioned advice? Will it appear on warning labels for vulnerable populations, including pregnant women?

5 deaths now under review in Ontario listeria probe

Where is the unintentionally funny and still, inexplicably, Minister of Agriculture in Canada, Gerry-death-by-a-1,000-cold-cuts-and-isn’t-my-moustache-awesome Ritz as the latest listeria outbreak unfolds in Canada. He was front and center last time. How about the Canadian Food Inspection Agency? What about the Public Health Agency of Canada or Health Canada?

The Public Health Agency of Canada could not immediately say whether any listeriosis cases in other jurisdictions are under investigation for a link to Siena meats.

Can’t say or won’t say? It’s OK, you can tell me, I’m a doctor.

Canwest News Service reports that the Canadian province of Ontario is left to poke around the latest listeria mess and will now be investigating five listeria deaths for





connections to Siena Meats.

Spokesman Andrew Morrison said the deaths are not linked to two previously recalled meat products from Siena Foods Ltd. which were matched, through a genetic fingerprint, to two non-fatal listeriosis cases in the province, adding,

“It’s important to note that those new products they recalled have a different genetic fingerprint than the first two. Regarding these newly recalled products, Ontario’s investigation is underway to determine any linkages to that.”

A string of reviews into the Maple Leaf listeriosis outbreak showed major gaps in the oversight of Canada’s food system and co-ordination problems with public health officials, including a report by independent investigatory Sheila Weatherill.

In her final report released last July, Weatherill — appointed by the federal government — zeroed in on a “vacuum in senior leadership” among government officials at the Public Health Agency of Canada and the Canadian Food Inspection Agency that caused “confusion and weak decision-making.”

She also called on PHAC to take the communications lead during foodborne illness outbreaks.

Which is why it is notable the apparently poorly named Public Health Agency of Canada has once again zoned out during an outbreak.

Listeria spike in Ontario triggers deaths and hospitalizations – who knew what when?

Robert Cribb of the Toronto Star is reporting tonight that two Ontarians were hospitalized — and another two deaths are being investigated — in relation to a listeria outbreak traced to a Toronto deli meat manufacturer.

Its part of a dramatic spike in listeria cases in Ontario since January that has renewed concerns about the country’s food safety system 18 months after 22 Canadians died in the Maple Leaf tragedy (fiasco – dp).

Packages of prosciutto cotto cooked ham and mild cacciatore salami made by Siena Foods Ltd. have been targeted as a possible cause in the outbreak.

The company’s salami was recalled in December and the ham was recalled early Friday. Both were sold to delis, grocery stores, specialty food stores and supermarkets after January 11.

“We are using a variety of different methods to … prevent any further exposure to this product by the public,” said

Siena officials did not respond to interview requests Friday.

Since January, the province has had 14 confirmed listeria cases (six in Toronto) — well beyond the eight that is typically expected for this point in the year, said Dr. Arlene King, Ontario’s chief medical officer of health.

Two Torontonians were sickened by a strain of the pathogen that matches with the Siena meat, hospitalized and are now recovering, she said. At least seven people across the province have been hospitalized since January from listeria.

Two Ontarians died during the same time the tainted Siena meat was in the marketplace, she confirmed. But provincial officials are still investigating whether there is a direct connection between those deaths and the company’s products.

Rick Holley, a microbiologist and food safety expert at the University of Manitoba and a consultant with the Canadian Food Inspection Agency (CFIA) said,

“I haven’t seen improvement. We haven’t seen any reduction, in my view, of the risk. We’re not doing foodborne illness surveillance the way we should. I’m not encouraged that, materially, we’ve got the kind of buy-in by industry we need to move forward with confidence.”

Doug Powell, a Canadian food safety expert at Kansas State University, said,

“There’s clearly some bad stuff going at that plant. I would like (health officials) to be clear about what they know, what they don’t know and what they’re doing about it. I don’t know how these Canadian health types are allowed to operate the way they do and not say anything.”

Timeline:
December 21, 2009: The CFIA recalls Siera salami
March 3: The ministry began a detailed investigation with local health units to identify source of the illness
March 5: The ministry released an “enhanced surveillance directive” to health units to identify any other cases
March 9: The ministry was notified of the test results of food samples taken from one of the two cases of hospitalized victims. The genetic fingerprint from the prosciutto was an exact match to the salami and a sample taken from one of the infected people.
March 11: The CFIA recalls Siera cooked ham