Tag Archives: Foodborne Illness

Norovirus, salmonella cause bulk of known US foodborne illness; meat, produce primary vehicles

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The US. Centers for Disease Control reported today that in 2008, 1,034 foodborne disease outbreaks were reported, which resulted in 23,152 cases of illness, 1,276 hospitalizations, and 22 deaths. Among the 479 outbreaks with a laboratory-confirmed single etiologic agent reported, norovirus was the most common, accounting for 49% of outbreaks and 46% of illnesses. Salmonella was the second most common, accounting for 23% of outbreaks and 31% of illnesses. Among the 218 outbreaks attributed to a food vehicle with ingredients from only one of 17 defined food commodities, the top commodities to which outbreaks were attributed were poultry (15%), beef (14%), and finfish (14%), whereas the top commodities to which outbreak-related illnesses were attributed were fruits and nuts (24%), vine-stalk vegetables (23%), and beef (13%).

Since 1992, CDC has defined a foodborne disease outbreak as the occurrence of two or more similar illnesses resulting from ingestion of a common food. State, local, and territorial health department officials use a standard, Internet-based form to voluntarily submit reports of foodborne outbreaks to CDC. An online toolkit of clinical and laboratory information is available to support investigation and reporting of outbreaks.

The number (1,034) of outbreaks was 10% lower than the annual average reported (1,151) for 2003–2007, and the number of outbreak-related illnesses was 5% lower (23,152 versus 24,400).

Of the total number of outbreak-related foodborne illnesses, 1,276 (6%) resulted in hospitalization. Salmonella was the most common cause of outbreak-related hospitalizations, causing 62% of hospitalizations reported, followed by Shiga toxin–producing Escherichia coli (STEC) (17%) and norovirus (7%). Outbreaks caused by Clostridium botulinum resulted in the highest proportion of persons hospitalized (90%), followed by Listeria outbreaks (76%). Among the 22 deaths associated with foodborne disease outbreaks in 2008, 20 were attributed to bacterial etiologies (13 Salmonella, three Listeria monocytogenes, three STEC [two O157, one O111], one Staphylococcus), one to norovirus, and one to a mycotoxin.

Among the 868 outbreaks with a known single setting where food was consumed, 52% resulted from food consumed in a restaurant or deli, 15% in a private home, and the remainder in other locations.

Ref: Surveillance for foodborne disease outbreaks — United States, 2008. Morbidity and Mortality Weekly Report, September 9, 2011 / 60(35); 1197-1202.

Bad food safety reporting I. Would your home kitchen fail a food safety inspection? Mine would

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There has been a proliferation of terrible food safety reporting, especially nonsensical stories targeting the home as the overall number 1 super-duper source of foodborne illness.

The most recent round started with a study published in the U.S. Centers for Disease Control weekly report on Sept. 3, 2010, by the folks in Los Angeles who popularized letter grades for displaying the results of restaurant inspections. This time they used the same criteria to grade home kitchens, and concluded “at least one in seven home kitchens would flunk the kind of health inspection commonly administered to restaurants.”

So what? Based on the way the study was done, my kitchen would fail.

The problem with many of the results garnered from the L.A. study is that home kitchens where food is prepared for a few family members and friends are not restaurants where food is prepared daily for thousands of strangers: the risk is amplified, and so are the required precautions.

The results are based not on actual inspections, but  an Internet quiz taken by about 13,000 adults. So it’s the same self-reported nonsense, and only by people who surf the Intertubes, and could be bothered to take the quiz.

Direct video observation is a far more reliable indicator of human behavior in the kitchen, and yes, people make mistakes all the time, especially me.

But how those mistakes are defined can really mess up the results; food safety is not simple, so basing scores on answers to 45 questions could be erroneous and magnify the error rate.

I went through the survey and spotted some possibly problematic questions, depending on how the answers were scored and weighted (that information is apparently not available to mere mortals).

Q. I cook meat thoroughly until the juices are clear, not bloody.

I cook meat until it reaches the safe temperature endpoint as verified by a tip-sensitive digital thermometer. Color is a lousy indicator of meat food safety. Do I lose points?

Q. I defrost frozen foods by either storing them inside the refrigerator, under cold running water, using a microwave oven, or during the cooking process.

I would never defrost under cold running water because that is a microbial cross-contamination disaster and is not recommended by the federal government. Do I lose points?

Q. I check to make sure that there are no foreign objects such as glass, hair, etc., in my food.

I pay attention. I don’t specifically check for glass or hair using my special glass and hair goggles. Do I lose points?

Q. I thoroughly rinse my fruits and vegetables before cooking or eating them.

Depends. If it’s pre-washed bagged salad, I do not rewash because scientists have said the re-washing process is more likely to cross-contaminate the greens with whatever crap was previously in my sink. The paper is in Food Protection Trends and available here. Do I lose points?

Q. I always have soap and paper towels available for hand washing.

At home I use tea towels and go through a couple a day, ensuring they are routinely washed and cleaned. Do I lose points?

Q. I remove all jewelry from my hands and maintain my fingernails trimmed before I prepare foods.

No. I’m not a sandwich artist making subs for thousands. I’m preparing food for my family. Do I lose points?

The authors conclude, “Use of interactive, online learning tools such as the Food Safety Quiz can be used to promote home food safety in the community” but provide no evidence to support this claim, and state in the next sentence, “further research is needed to evaluate and improve the program content and to assess its effect on changing food handling and preparation practices in the home kitchen.”

The study was crap. Worse, blaming people is a lousy motivator for behavior change, if that was indeed the goal.

The Associated Press, and every other story about the study stated, “experts believe the bulk of food poisonings are unreported illnesses from food prepared at home.”

Experts believe foodborne illness has multiple causes from multiple sources. Casey Jacob and I tried to contribute to the public conversation about foodborne illness, where it happens and who’s to blame, with the appropriately titled paper, Where Does Foodborne Illness Happen—in the Home, at Foodservice, or Elsewhere—and Does It Matter? in the journal, Foodborne Pathogens and Disease. The paper has been published online ahead of print. We conclude, ??While some occurrences of foodborne illness result from unsafe practices during final preparation or serving at the site where food was consumed, others are consequences of receiving contaminated food from a supplier, or both. Data gathered on instances of contamination that lead to illness make greater contributions to the development of programs that reduce the risk of foodborne illnesses, than data or assumptions that describe locations where contaminated food is consumed. The abstract is below:

Foodservice professionals, politicians, and the media are often cited making claims as to which locations most often expose consumers to foodborne pathogens. Many times, it is implied that most foodborne illnesses originate from food consumed where dishes are prepared to order, such as restaurants or in private homes. The manner in which the question is posed and answered frequently reveals a speculative bias that either favors homemade or foodservice meals as the most common source of foodborne pathogens. Many answers have little or no scientific grounding, while others use data compiled by passive surveillance systems. Current surveillance systems focus on the place where food is consumed rather than the point where food is contaminated. Rather than focusing on the location of consumption—and blaming consumers and others—analysis of the steps leading to foodborne illness should center on the causes of contamination in a complex farm-to-fork food safety system.

Campylobacter, most common foodborne illness, peaks in May in Wales

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Campylobacter is the most commonly reported bacterial cause of diarrhea in Wales and the rest of the UK, but telatively little is known about it.

And for some unknown reason, campylobacter cases show a marked seasonal trend with peaks in the late spring – around the third week of May – and again in the autumn.

Last year there were more than 3,300 confirmed cases of campylobacter in Wales – the highest number and rate since 2001. To date this year there have been more than 300.

The Food Standards Agency’s last survey of campylobacter and salmonella in chicken on sale in the UK, which was published in October, found campylobacter was present in 65% of the samples of chicken tested. Salmonella was detected in 6% of samples.

Andrew Wadge, the FSA’s director of food safety, told the Western Mail,

“It is obvious more needs to be done to get these levels down and we need to continue working with poultry producers and retailers to make this happen.

“Other countries like New Zealand and Denmark have managed to do so, we need to emulate that progress in the UK.”

Hasn’t hit this lawyer yet — no references but lots of rhetoric

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When I first met Amy in 2005, I tried to impress her with some mixed tapes – because I’m a total nerd – of music like Weezer, and the Tragically Hip and Neil Young, and Blue Rodeo.

The later is a Toronto-based band I’ve seen many times, but not as many as Chapman, who has sortofa cult thing going on with them.

Amy really likes the 1993 Blue Rodeo song, Hasn’t Hit Me Yet, for its evocative nature –I agree the band hit their peak on this album – and it applies to yet another food industry lawyer type who just doesn’t seem to get it.

One of the Defending Food Safety lawyerly dudes – they represent companies – said today that current statistics confirm that approximately 70 percent (sic) of all food-borne (sic) illnesses (or, about 50 million illnesses annually) have nothing to do with the underlying safety of food. Rather, the majority of illnesses are caused by contamination where food products are prepared. As a result, if consumers and those who handle foods simply wash their hands, and prepare foods appropriately, most food-borne (sic) illness can be eradicated.

Reference?

There is none. This is a rhetorical rather than an actual argument based on data.

The dude also says,

“… in most instances, (foodborne illness can) be virtually eliminated in the kitchen.”

People who believe this stuff are stuck in 1993.

Sloan slams lawyers again

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Americans don’t get The Tragically Hip, but they seem to like the pop-oriented tunes of Nova Scotia’s Sloan when introduced – although no one down here has heard of them.

The 1996 Sloan song, Autobiography, often comes to mind when I read dribble from the blog, Defending Food Safety, written by some lawyers somewhere.

When you find you’re a conformer
Take pride and swallow whole
But if you’re trying to climb the ladder
Don’t let people walk over you
Because that’s just what they’ll do

The latest swallow had to do with an entry that begins,

“It’s no secret that virtually all foods are safe if handled properly. Indeed, according to FDA, most food-borne (sic) illnesses are avoidable if consumers follow proper food handling techniques. This is true whether consumers are shopping for products, transporting them home or preparing them in their kitchen."

I’m not sure what consumers have to do with contaminated peanut butter, pet food, pot pies, frozen pizzas, bagged spinach, carrot juice, lettuce, tomatoes, canned chili sauce, hot peppers and white pepper.

And I’m not sure where such lawyerly assertions about the source of foodborne illness come from – we’ve written a peer-reviewed article about where foodborne illness happens and argue it’s the wrong question.

Nosestretcher alert: how much foodborne illness is the fault of home cooks?

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Does the majority of foodborne illness really happen in the home?

The statement is repeatedly repeated, but usually with no supporting data.

A story most recently proclaimed, “More than 50 percent of foodborne illnesses come from food prepared in the home.”

There was no reference.

The stats that have been reported in peer-reviewed journals are all over the place: anywhere from 15-90 per cent of foodborne illness apparently happens in the home.

So if a consumer ate bagged spinach in fall 2006 at home, would that mean they possibly got sick at home, or that the contamination originated on the farm and there was little consumers could do?

Casey Jacob and I attempted to tackle this question in the journal, Foodborne Pathogens and Disease, and concluded,






“Rather than focusing on the location of consumption—and blaming consumers and others—analysis of the steps leading to foodborne illness should center on the causes of contamination in a complex farm-to-fork food safety system.”

Robert Tauxe of the U.S. Centers for Disease Control noted in a recent talk there have been 10 new food vehicles indentified in multistate outbreaks of foodborne illness since 2006: bagged spinach, carrot juice, peanut butter, broccoli powder on a snack food, dog food, pot pies, canned chili sauce, hot peppers, white pepper and raw cookie dough.

Few, if any of these have to do with consumers.
 

“it’s not food poisoning, it’s likely norovirus.” Um, sometimes they are the same

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According to the Dumfries & Galloway Standard (UK), a Dumfries hotel has temporarily shut after 20 patrons who ate there complained of illnesses.

Owner Aileen McGhie told the Standard she was not ordered to close the three-star hotel, and took the decision to do so herself in a bid to clean the premises from top to bottom.

She said: “A few people fell ill last week after being a guest or a diner at the hotel and we are still waiting for test results. I called environmental health myself and it is assumed it is an outbreak of the Norovirus. Rumours that it is food poisoning are completely false.

Um, Aileen, sometimes they are the same thing. While cruiseships and hospitals get a lot of press for norovirus, the majority of reported norovirus outbreaks are associated with foodservice settings or events, and have higher attack rates than other settings. While the difference between classical food poisoning might matter to you, many of the control measures are the same (reducing cross-contamination, good personal hygiene, doing a good job at cleaning up barf).

Owner Aiellen McGhie went on to say:

“Twenty people is not actually a high number considering the hundreds of people we had in the hotel that week." 

It’s possible that one dish or food handler is implicated in — my guess is that not everyone ate everything on the menu. Foodborne illness cases are also consistently under reported and might contribute to the "low numbers".  And it probably doesn’t matter to the barfing customers.

Fast food workers: Wash your hands

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I have been sick the past few days. I am not sure what caused it, where I contracted the illness, but I am sick. In my mind, this reiterates the need for everyone to wash his or her hands.

A recent study co-authored by William Burkhardt, a food virologist and microbiologist with the U.S. Food and Drug Administration (FDA),  explains that more than half of food service workers do not wash their hands before returning to work.

In an article by the Quad-City Times, foodborne illnesses can happen anywhere and they are easy to transmit:

Norovirus, hepatitis A and E. coli, another gastrointestinal infection, are the most common food-borne illnesses involving restaurants, Burkhardt said. Norovirus, like hepatitis A, is spread by fecal matter on food products that are then ingested by unaware patrons. However, the hepatitis A symptoms might not show up for 10-14 days while those with norovirus know much more quickly, in as little as 12 hours after ingestion.

Those who ingest the hepatitis A virus need only a few particles to eventually become ill, according to the microbiologist. "Oftentimes, a hundred million of these viral particles are present in a gram of fecal material," he said.

Even a small piece of fecal matter on a person’s hand can transmit the germs, especially to salads, uncooked food items or in ice. The virus is killed during proper cooking.

To prevent the spread of foodborne illness food service workers should abide by proper handwashing and proper glove usage.

Fantasy cycling and fantasy eating during the Tour de France

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I’ve been following the Tour de France since 2002 when I discovered my former classmate (and 4th grade crush) Levi Leipheimer was competing. Last year I boycotted the race when team Astana was not allowed in the Tour, but this year I kicked it into high gear and even started playing fantasy cycling. (Nerdy, I know.) Leipheimer broke his wrist on Thursday, and, unfortunately, had to leave the race. But his teammates race on, and racing requires amazing sustenance.

According to the New York Times article, “Five-star tour cuisine for guys who eat and ride” the men on the tour require 5000 to 8000 calories a day.

Eating that much demands enticement and Team Garmin-Slipstream (the team of my fantasy cyclists Farrar, Wiggins and Zabriskie) has its own chef, American Sean Fowler. Fowler works with the team’s physiologist to keep the guys feeling good and their bowels running smoothly. Juliet Macur writes:

Every day at the Tour, Fowler cooks exclusively for Garmin’s nine riders, to the chagrin of team management. (…)

On a typical morning, they will gather their cooking gear and take it to the motor home in which they follow the race. They make sure to arrive early at the team’s next hotel, to inspect the kitchen.

If it is not up to Sean Fowler’s standards for cleanliness, which has happened a few times at this Tour, he will cook in the motor home. He takes precautions to keep the riders safe from food poisoning or other gastrointestinal problems, which could be devastating to their performance. In his motor home, he wields utensils and pots and pans like a careful samurai because the space is cramped.

Although Leipheimer’s out, as of this morning my fantasy team still has four of the top ten riders. Let’s hope none of the others are injured or downed with foodborne illness.

Local is not safer

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Spring has sprung in Kansas. We all worked in the yard yesterday, and after a couple of cool nights later in the week, the first leafy greens will be going into the garden.

With spring comes the mantra, local is safer.

The idea food that is grown and consumed locally is somehow safer than other food, either because it contacts fewer hands or any outbreaks would be contained, is sorta soothing, like a mild hallucinogen, and has absolutely no basis in reality.

Foodborne illness is vastly underreported — it’s known as the burden of reporting foodborne illness. Someone has to get sick enough to go to a doctor, go to a doctor that is bright enough to order the right test, live in a state that has the known foodborne illnesses as a reportable disease, and then it gets registered by the feds. For every known case of foodborne illness, there are 10 -300 other cases, depending on the severity of the bug.

Most foodborne illness is never detected. It’s almost never the last meal someone ate, or whatever other mythologies are out there. A stool sample linked with some epidemiology or food testing is required to make associations with specific foods.

Robert Brackett, senior vice president of the Grocery Manufacturers Association, and a darn fine scientist, told USA Today most foodborne illnesses don’t get noticed because not enough people get sick to alert officials that an outbreak is underway. Undetected outbreaks are more likely with "local" products delivered in small quantities and sold in a small area.

Comparing local with all that other food brings in more tenuous links and numerous erroneous assumptions. To accurately compare local and other food, a database would have to somehow be constructed so that a comparison of illnesses on a per capita meal or even ingredient basis could be made.

But the absence of data doesn’t stop doctrine. JoLynn Montgomery, director of the Michigan Center for Public Health Preparedness at the University of Michigan told the Detroit Free Press today that one solution that is catching on is buying locally grown foods.

"The less distance the food has to travel, the fewer people who touch the food, the less risk you have.”

Local can be microbiologically safe. But repeating ‘local’ while in some sorta peyote buzz doesn’t take care of the dangerous bugs. So wherever food is purchased or even grown, ask some questions:

• how are pathogenic microorganisms managed;
• is wash and irrigation water tested for dangerous bacteria;

• how is fresh produce protected from animal poop;
• what kind of soil amendments are being used and are they microbiologically safe; and,
• are you or your suppliers practicing great handwashing?

That’s a start.