Les Nessman explains how to talk about continuing leafy green outbreaks

A romaine lettuce task force was organized by the industry in December to help prevent future outbreaks, said Jennifer McEntire, vice president of food safety and technology for the United Fresh Produce Association.

The task force has representation from all types of growing operations from different growing regions, she said.

One primary focus of the task force is preventing outbreaks by looking at root cause analysis, she said.

A table of leafy green-related outbreaks – at least 80 since 1995 – is available here.

But Les Nessman gets to the heart of this political process — in 1978:

UK family still waiting for answers one year after E. coli poisoning

The Yorkshire Post reports parents of two boys who be­came se­ri­ously ill af­ter con­tract­ing E.coli 0157 sus­pected to be from beef burg­ers are still wait­ing for an­swers from su­per­mar­ket gi­ant Sains­bury’s more than a year later.

Al­fie and Oliver Maude, then seven and three, from Rich­mond, North York­shire, came down with up­set stom­achs two days af­ter eat­ing the Taste the Dif­fer­ence Aberdeen An­gus burg­ers in Oc­to­ber 2017. Al­fie was ad­mit­ted to Dar­ling­ton hos­pi­tal two days later with ex­cru­ci­at­ing stom­ach pain and se­vere de­hy­dra­tion.

He was then rushed to New­cas­tle hos­pi­tal for dial­y­sis be­cause his kid­neys were fail­ing. Both boys had de­vel­oped a se­ri­ous con­di­tion, hae­molytic uremic syn­drome, al­though Oliver did not re­quire dial­y­sis.

Both will have to un­dergo reg­u­lar check-ups well into adult­hood to keep an eye on their kid­neys.

Mother Vicci Maude said she and hus­band Steve were be­sides them­selves with worry as their boys “puffed up and turned yel­low”. She said: “When the con­sul­tant came in she said some chil­dren don’t sur­vive this – ob­vi­ously it was the hard­est thing I’ve ever had to hear. They still find it very stress­ful hav­ing to go back to hos­pi­tal and hav­ing blood tests. I just feel they (Sains­bury’s) need to take some re­spon­sibiity.”

It’s explained by shit in irrigation water: Santa Barbara farm first fingered with outbreak strain of E coli O157 in Romaine lettuce that sickened 59 in US, 28 in Canada: Tumble those dice

Welcome to Washington, D.C., Frank, and government PR.

On Nov. 20, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention warned the American public of a multi-state outbreak of E. coli O157:H7 linked to romaine lettuce and advised against eating any romaine lettuce on the market at that time.

According to FDA Commissioner Scott Gottlieb, M.D. and FDA Deputy Commissioner Frank Yiannas, we  have new results to report from this investigation tracing the source of the contamination to at least one specific farm. Based on these and other new findings, we’re updating our recommendations for the romaine lettuce industry and consumers.
Today, we’re announcing that we’ve identified a positive sample result for the outbreak strain in the sediment of a local irrigation reservoir used by a single farm owned and operated by Adam Bros. Farms in Santa Barbara County.

The FDA will be sending investigators back to this farm for further sampling. It’s important to note that although this is an important piece of information, the finding on this farm doesn’t explain all illnesses and our traceback investigation will continue as we narrow down what commonalities this farm may have with other farms that are part of our investigation. While the analysis of the strain found in the people who got ill and the sediment in one of this farm’s water sources is a genetic match, our traceback work suggests that additional romaine lettuce shipped from other farms could also likely be implicated in the outbreak. Therefore, the water from the reservoir on this single farm doesn’t fully explain what the common source of the contamination. We are continuing to investigate what commonalities there could be from multiple farms in the region that could explain this finding in the water, and potentially the ultimate source of the outbreak.

As of Dec. 13, our investigation yielded records from five restaurants in four different states that have identified 11 different distributors, nine different growers, and eight different farms as potential sources of contaminated romaine lettuce. Currently, no single establishment is in common across the investigated supply chains. This indicates that although we have identified a positive sample from one farm to date, the outbreak may not be explained by a single farm, grower, harvester, or distributor.

At the same time, the U.S. Centers for Disease Control updated its warning to advise U.S. consumers to not eat and retailers and restaurants not serve or sell any romaine lettuce harvested from certain counties in the Central Coastal growing regions of northern and central California. If you do not know where the romaine is from, do not eat it.

  • Some romaine lettuce products are now labeled with a harvest location by region. Consumers, restaurants, and retailers should check bags or boxes of romaine lettuce for a label indicating where the lettuce was harvested.
      • Do not buy, serve, sell, or eat romaine lettuce from the following California counties: Monterey, San Benito, and Santa Barbara.
      • If the romaine lettuce is not labeled with a harvest growing region and county, do not buy, serve, sell, or eat it.
      • The Public Health Agency of Canada has identified ill people infected with the same DNA fingerprint of E. coliO157:H7 bacteria in Canada.

Own it: Gossip goes away

I knew I wouldn’t get into rehab Friday morning because I had been drinking at 3 a.m. in a vain attempt to go back to sleep.

Gotta blow zero to get into rehab, which I’ll do Monday.

But, as I said to one of my rehab buddies, whose life has spun out of control, yet he got 90% in the law courses he has taken, own it. Don’t be ashamed.

He said, I read your blog and it seems you had a falling out with Ben.

I said I’ve had a falling out with my wife of 13 years every week (she’s at hockey practice, 6 a.m. in Brisbane).

Ben, about the same.

Bad wiring.

Or, the people you are closest with and feel vulnerable enough to share your fears, are the ones to lash out at.

The produce industry needs a similar self-reckoning.

Candice Choi of APwrites that after repeated food poisoning outbreaks linked to romaine lettuce, the produce industry is confronting the failure of its own safety measures in preventing contaminations.

The E. coli outbreak announced just before Thanksgiving follows one in the spring that sickened more than 200 people and killed five, and another last year that sickened 25 and killed one. No deaths have been reported in the latest outbreak, but the dozens of illnesses highlight the challenge of eliminating risk for vegetables grown in open fields and eaten raw, the role of nearby cattle operations that produce huge volumes of manure and the delay of stricter federal food safety regulations.

A contested aspect of the regulation, for example, would require testing irrigation water for E. coli. The Food and Drug Administration put the measure on hold when the produce industry said such tests wouldn’t necessarily help prevent outbreaks. Additional regulations on sanitation for workers and equipment — other potential sources of contamination — only recently started being implemented.

We’ve been saying the same thing for over 20 years.

And Scotland: Study could explain higher rates of E. coli O157 infection

A subtype of E. coli O157 found in cattle may be responsible for higher rates of severe human infection in Scotland, report suggests.

E. coli O157 is a bacterium carried by cattle, which can cause life-threatening human infections when it enters the food chain. Scientists found that cattle in Scotland have a higher level of a subtype of E. coli O157 – PT21/28, which is known to cause more severe human infection.

It may be that local exposure to this particular subtype is a potential factor for the rates of people infected by E. coli O157 in Scotland being around three times higher than in England and Wales.

Researchers used Whole Genome Sequencing (WGS) to define which specific subtypes of E. coli caused an outbreak. For example, data obtained from WGS helped to understand whether a human infection is likely to have arisen from local farm animals or by a strain present in imported food or as a consequence of travel abroad.

The team have also combined WGS data with machine learning to predict which subtypes of E. coli O157 pose the greatest threat to human health.

The research also trialed a vaccine, developed to limit E. coli O157 excretion from and transmission between cattle. Results indicated that the vaccine may be effective in reducing human exposure and infection from E. coli O157.

However, before a vaccine can be made available, further work is needed to assess if it is practical and works in field situations.  Modelling by collaborators at Glasgow University indicates the vaccine would be an effective public health intervention.

The research, undertaken by a consortium of scientists led by The Roslin Institute, University of Edinburgh, the Moredun Research Institute, Scotland’s Rural College, University of Glasgow, Public Health England, NHS Lothian & United States Department of Agriculture (USDA) shows that the overall prevalence of E. coli O157 in cattle is similar across Great Britain, and has remained relatively consistent in Scotland over the last decade.

Food Standards Scotland and the Food Standards Agency published the results of this four-year project in a new report.

The study was a successful collaboration bringing together scientists in multiple disciplines to understand how common E. coli O157 is across farms in Great Britain and then sequencing approaches are used to determine how these bacteria relate to the ones causing human infections.

Strains present in Scottish cattle are more likely to be associated with serious illness in humans, possibly explaining the higher incidence of E. coli O157 infections in Scotland compared to England & Wales.

Phages be sexing up E. coli O157 in England and Wales

We used whole-genome sequencing to investigate the evolutionary context of an emerging highly pathogenic strain of Shiga toxin–producing Escherichia coli (STEC) O157:H7 in England and Wales. A timed phylogeny of sublineage IIb revealed that the emerging clone evolved from a STEC O157:H7 stx-negative ancestor ≈10 years ago after acquisition of a bacteriophage encoding Shiga toxin (stx) 2a, which in turn had evolved from a stx2c progenitor ≈20 years ago. Infection with the stx2a clone was a significant risk factor for bloody diarrhea (OR 4.61, 95% CI 2.24–9.48; p<0.001), compared with infection with other strains within sublineage IIb. Clinical symptoms of cases infected with sublineage IIb stx2c and stx-negative clones were comparable, despite the loss of stx2c. Our analysis highlighted the highly dynamic nature of STEC O157:H7 Stx-encoding bacteriophages and revealed the evolutionary history of a highly pathogenic clone emerging within sublineage IIb, a sublineage not previously associated with severe clinical symptoms.

Highly pathogenic clone of shiga toxin-producing Escherichia coli O157:H7, England and Wales, December 2018

Emerging Infectious Diseases vol. 24 no. 12

Lisa Byrne, Timothy Dallman, Natalie Adams, Amy Mikhail, Noel McCarthy, and Claire Jenkins

https://wwwnc.cdc.gov/eid/article/24/12/18-0409_article

Corn-stuff may increase E. coli O157 in cattle

Inclusion of distillers’ grains (DGs) has been associated with
increased prevalence of Escherichia coli O157:H7 in cattle housed in
research settings. Our objective was to quantify the relationship
between inclusion of DGs in commercial feedlot rations and the burden
of E. coli O157.

A convenience sample of 10 feedlots was enrolled based on DG use in finishing diets; 1 cohort included 5 feedlots in which DGs were greater than 15% of the dietary dry matter and the other cohort consisted of 5 feedlots at a concentration less than 8%. 

Sampling occurred at each feedlot on four occasions at ∼6-week
intervals. At each feedlot visit, 4 pens of cattle within 3 weeks of
slaughter were selected and 24 freshly voided fecal pats were sampled.

Ten-gram samples were enriched in 90 mL of modified tryptic soy broth with novobiocin (20 mg/L) for 14 h at 42°C. Enrichments were subjected to immunomagnetic separation, plating onto chromogenic agar with novobiocin (5 mg/L) and potassium tellurite (2.5 mg/L), incubation for 18 h at 37°C, and latex agglutination of morphologically typical colonies. E. coli O157 was recovered from 16.7% of 3840 samples.

Adjusted prevalence was 14.3% after controlling for within-feedlot and
within-pen clustering. Prevalence during each sampling period was
19.9% (round 1), 21.0% (round 2), 14.1% (round 3), and 11.7% (round
4). Prevalence varied between cohorts, but this difference varied over
time (p = 0.06). Among those with greater than 15% of the diet as DGs, prevalence was greater than those with less than 8% inclusion for all rounds of sampling (p < 0.01). Averaged across time, prevalence was 23.9% and 9.4% for those with greater than 15% and those with less than 8% of DGs, respectively. While observational, these data provide real-world support of reports of increased E. coli O157:H7 burden associated with DG use in cattle diets.

Corn-based distillers’ grains in diets for feedlot cattle are associated with the burden of Escherichia coli O157 in feces

Foodborne Pathogens and Disease 15:298-405

Evan Chaney, Rebecca Maloney, Bradley J. Johnson, J. Chance Brooks, Mindy M. Brashears, and Guy H. Loneragan.

Walkerton E. coli O157 pain lingers after 18+ years

It’s the helicopters.

We live near the publically-funded Princess Alexandria hospital.

A helicopter flies over our house a couple of times a day bringing some victim from the outback or the coast.

The state of Queensland is really, really big.

It reminds me of my Walkerton-resident friend, Jim, and what he went through in the aftermath of the E.coli O157 outbreak in drinking water that killed seven and sickened 2,500 in the town of Walkerton, population 5,000.

Jim knew that every helicopter was someone dead or dying being flown to the medical center in London, Ontario (that’s in Canada, like Walkerton).

I think of Jim and the victims every time a chopper goes past.