Going public: The hepatitis A case that wasn’t

Posted on October 15, 2016 by Ben Chapman

When there is a chance to protect public health you gotta go public with all the info you have, when you have it. Sometimes new information arises that changes things and makes it look like officials got it wrong – when they didn’t.

Last week, according to The Chronicle, a food handler tested positive for hep A – and it turned out to be a false positive.

A reported case of Hepatitis A at the Chehalis Shop’n Kart last week has been ruled a false positive by county health officials, meaning a worker in the store’s bakery was not infected and baked goods they handled were not contaminated.

An initial press release from the Lewis County Public Health and Social Services last week said a bakery worker tested positive for the virus, which causes an acute liver infection.

But a release issued Friday said this test was a false positive, meaning there was never an infection or risk to customers.

Shop’n Kart owner Darris McDaniel said the containment procedure cost his store thousands of dollars in product they threw away, while also damaging its reputation.

“In the future, if anything would happen again, we would ask for another test right away, because this sent up a lot of bad signals for our business when in fact it wasn’t true,” he said. “We did take the proper steps and acted very quickly.”

Does that going public default apply to the leafy greens cone of silence? Arizona restaurant sued over Salmonella outbreak

Posted on October 3, 2016 by Douglas Powell

Alejandro Barahona and Ken Alltucker of AZ Central report a Phoenix resident filed a lawsuit against Texas-based Pappas Restaurants Inc. that claims she contracted salmonella last month after eating at the chain’s Phoenix restaurant.

The Maricopa County Department of Public Health confirmed there was an investigation of a salmonella outbreak at Pappadeaux Seafood Kitchen of Phoenix.

The outbreak is over and the county health department is closing its investigation, said Jeanene Fowler, a department spokeswoman.

Because final paperwork that details the outbreak has not been completed, Fowler said, county officials could not confirm the number of people who became ill after eating at the popular seafood restaurant, at 11051 N. Black Canyon Highway.

A manager at Pappadeaux in Phoenix said he could not discuss the outbreak, referring Republic inquiries to the chain’s headquarters in Houston. Officials at the chain’s headquarters did not respond to phone messages and email questions about the county’s investigation or the lawsuit.

Pappas Restaurants has not yet answered the lawsuit, which was filed last Friday at U.S. District Court in Phoenix.

The lawsuit states that on Aug. 14, Phoenix resident Shaina Robinson ate shrimp, tilapia and crab cakes at Pappadeaux Seafood Kitchen of Phoenix. The lawsuit states that two days later, Robinson became “violently ill” with stomach illness. Four days later, she sought treatment at a Scottsdale hospital.

She spent five days at the hospital and tested positive for a strain of salmonella, according to the lawsuit.

She missed two weeks of work and “incurred significant medical bills as a direct and proximate cause of her salmonella infection contracted at Pappadeaux Seafood Resturant,” the lawsuit states.

Robinson is seeking restitution for irreparable emotional distress, medical expenses, bodily injuries, suffering and permanent impairment, among other claims.

The county health department often does not publicly announce restaurants tied to an outbreak unless officials believe it can help prevent people from becoming sick, Fowler said.

She said part of the issue is timing. County health and environmental services inspectors must confirm that an outbreak is ongoing and public disclosure could prevent people from getting sick. Inspectors also must verify an outbreak is tied to a specific restaurant and not a supplier that delivered tainted food to different establishments.

“We don’t wanted to put (restaurants) out of business for something that may have nothing to do with the business,” Fowler said. “We are trying to take that into account.”

But Fowler said that completed reports, whether it’s a routine inspection or investigation of a foodborne illness, are available for public inspection.

“We get hundreds and hundreds of these each year,” Fowler said, referring to foodborne-illness complaints.

Attorney Ryan Osterholm said he believes county health officials should aggressively notify the public during outbreaks.

“The public deserves to know,” Osterholm said. “There should be transparency in anything unless there is a compelling reason not to. … The baseline should be transparency.”

Going public – Not: Michigan state epidemiologist didn’t publicly report Flint-area disease outbreak

Posted on September 29, 2016 by Douglas Powell

Jeff Karoub of the Boston Globe reports Michigan’s former state epidemiologist acknowledged in a plea deal Wednesday that she was aware of dozens of cases of Legionnaires’ disease in the Flint area around the same time the city changed its water source, but that she didn’t report it to the general public.

Corrine Miller, the former director of disease control and prevention at the Michigan Department of Health and Human Services, faced three charges stemming from the investigation into Flint’s lead-contaminated water crisis. She pleaded no contest to a misdemeanor of willful neglect of duty in exchange for prosecutors dropping felony misconduct and conspiracy charges.

Flint switched from Detroit’s water system to the Flint River to save money in 2014. But tests later showed that the river water was improperly treated and coursed through aging pipes and fixtures, releasing toxic lead.

The plea agreement states that Miller was aware of the Legionnaires’ cases in 2014, and reported to someone identified only as ‘‘Suspect 2’’ that the outbreak ‘‘was related to the switch in the water source’’ after compiling data about the illness in Genesee County. No explanation is given in the plea deal as to why the cases weren’t publicly reported.

A definitive connection between the corrosive river water and Legionnaires’ has not been made, but many experts believe it probably was the cause.

Going public: Missoula edition

Posted on September 16, 2016 by Ben Chapman

The Missoula City-County Health Department is following the mantra of share what you know, what you don’t know and be available for questions following a possible hepatitis A exposure in Missoula, Montana.

According to KPAX, A food handler at a local retailer, the Good Food Store, was confirmed to be ill with the virus and may have exposed thousands of shoppers over the past month.

Missoula City-County Health Department officer Ellen Leahy says while the food service employee was excluded from work during most of the time that they had symptoms, there is a potential for customer exposure because Hepatitis A can be spread before a person has symptoms – before they know they are infectious or ill.

To address this possibility, the health department is issuing this public notice in conjunction with the Good Food Store, where the employee’s job included preparing foods for the self-serve salad bar. Ready-to-eat-foods such as those found on a salad bar won’t be cooked or washed by the consumer prior to eating and can be a vehicle for contamination.

Leahy says the Good Food Store followed proper sick employee exclusion rules and has excellent policies, practices, and facilities for food handling and hand washing.

The Missoula City-County Health Department recommends the following courses of action:

• If you ate food from the self-serve salad bar at the Good Food Store between August 15 and September 13, please be alert for symptoms of Hepatitis A.

• If you ate food from the self-serve salad bar at the Good Food Store within the past two weeks and have not been previously immunized for Hepatitis A, an immunization given within two weeks of exposure may protect you from getting the disease. Please come to the health department or contact your health care provider as soon as possible to discuss immunization options.

• If you did not eat food from the self-serve salad bar at the Good Food Store, no action is recommended at this time.

Contact the Missoula City-County Health Department at (406) 258-3500 if you have questions or concerns about Hepatitis A.

KPAX.com | Continuous News | Missoula & Western Montana

Child dies from E. coli O157 in Scotland linked to blue cheese

Posted on September 6, 2016 by Douglas Powell

Is there a way to mediate the values between protecting public health and protecting business?

My suggestion would be the company stop asserting that testing found nothing – because that means shit – and Food Safety Scotland get the legal plug out of its ass and go public with whatever information they have.

So while the Scottish company at the centre of an E. coli O157 recall related to its raw milk Dunsyre blue cheese continues to say it’s innocent, and Food Standards Scotland isn’t talking, maybe this will help focus the participants on what matters.

A child has died following the outbreak of E. coli O157 in Scotland, one of 20 confirmed cases of infection – detected between 2 and 15 July – 11 of whom had received hospital treatment.

Health officials are investigating possible links to Dunsyre blue cheese, which is made with unpasteurised milk.

South Lanarkshire-based Errington Cheese, which makes Dunsyre blue, said last month that testing had shown it to be “completely clear of E. coli O157”.

Health Protection Scotland said that epidemiological investigations had “identified Dunsyre Blue cheese as the most likely cause of the outbreak”.

It added: “Despite extensive investigation, including looking for other possible food sources, no other link to a majority of cases could be established.”

Testing don’t prove shit.

Dr Alison Smith-Palmer, from Health Protection Scotland’s Incident Management Team (IMT), said: “On behalf of the IMT, I would like to take this opportunity to extend our deepest sympathies to the family of the child who has died.

“Our thoughts are with them at this time and we ask that their privacy be respected.

“All confirmed cases became unwell prior to the end of July. As there have been no new cases since then the IMT will now stand down and work to produce its final report.”

It is understood that the final report could take up to six months to produce.

In a statement issued last month on its website, Errington Cheese said its own tests had shown the product to be clear of the bug.

“All our testing, covering a period of almost six months from 21 March to date, is completely clear of E. coli O157,” the statement said.

“All authority testing is negative for E. coli O157. All customer testing for E. coli O157 is negative. All farm testing for E. coli O157 is negative.”

The statement added: “From what we can gather all cases had an onset of symptoms between 1st -15th July (2 week period).

“However, our cheese was available over a 8/9 week period.

“From this we conclude that the outbreak was more likely to have been caused by something with a shorter shelf-life or not by a food at all.”

Epi works but needs to be stronger than ‘some people ate the cheese ’ Cheese firm in Scotland linked to E. coli outbreak threatens legal action

Posted on August 29, 2016 by Douglas Powell

Victoria Weldon of Herald Scotland writes that a cheese firm at the centre of an E.coli outbreak is threatening legal action to prevent a ban on sales of its popular delicacy.

Dunsyre Blue, a mould ripened, gourmet cheese from Lanarkshire, is suspected of being the source of last month’s outbreak which struck down 16 people, hospitalising two.

Makers Errington Cheese were initially forced to recall two batches but claim they have now been ordered to halt all sales or face enforcement action.

It follows fresh tests carried out by FSS identifying genes that, while not confirmation of E.coli, indicate a “presumptive positive” result for naturally occurring bacteria strains.

Company founder Humphrey Errington claims the ban is “unprecedented” and argues that scientific evidence suggests presumptive positive results are notoriously inconclusive, adding, “The behaviour of FSS is monstrous. They blamed our cheese for this outbreak in the absence of any hard evidence and have refused to share with us details of their investigation. We had independent tests carried out two weeks ago that showed the suspected batches of cheese were not contaminated. We shared these results with FSS and they said nothing to restore public trust in the product.”

Errington said the ban on Dunsyre Blue, which accounts for about two-thirds of the company’s revenue, was a “catastrophe” and revealed that his lawyers will decide today whether or not to take legal action.

“I’m afraid I can see this ending up in the courts,” he told the Sunday Times.

Dunsyre Blue is characterised by its chunky blue-green moulds and is favoured by the Queen and Michelin-starred restaurants, including an eaterie run by renowned chef Andrew Fairlie at Gleneagles resort in Perthshire.

It became the focus of the health scare after 14 people in Scotland and two in England were struck down with E.coli in July, suffering stomach cramps, diarrhoea, vomiting and fever.

By the end of the month, health officials announced that Dunsyre Blue was the most likely cause of the outbreak.

However, questions are now being asked over the strength of evidence linking the cheese to the outbreak.

Hugh Pennington, professor of bacteriology at the University of Aberdeen, said: “I don’t know if Dunsyre Blue was the cause or not, but if you’re going to accuse Errington’s cheese of being the vector of the outbreak, then without further ado effectively destroy his business, then I think you should have stronger evidence than just ‘some people ate the cheese’.”

A spokesman for FSS said that all victims had been contaminated with the same strain of E.coli O157 and that “there is a strong link with certain batches [C22 and D14] of Dunsyre Blue cheese”.

He added: “Dunsyre Blue cheese remains the most likely source of this outbreak, with confirmed cases becoming unwell between July 2 and 15. It would not be appropriate to respond in more detail as investigations have not yet concluded.”

Going public: London, Ontario (that’s in Canada) version after Salmonella spike

Posted on August 27, 2016 by Douglas Powell

Rather than waiting until all the facts were in and all the linkages solid, the Middlesex-London Health Unit on Friday decided to do something which has now become radical: it shared what they knew about a spike in Salmonella illnesses, said what they were doing to find out more, and implied that when they find out more, you’ll hear it from health-types first.

Good job.

Jennifer O’Brien of the London Free-Press reports that 14 reported cases of Salmonella in a week — compared to a monthly August average of nine — has mystified health inspectors who couldn’t find a “common thread” among those affected.

Stephen Turner, director of environmental health and infectious diseases said, “We look for relationships — common restaurants, grocery stores, a common workplace . . . whether they’ve purchased a common product. We haven’t found that. That is why it’s raised our eyebrows so we are investigating diligently.”

The next step for the health unit is to contact each infected person and find out information that might explain how they became infected, he said.

The 14 people who were infected between Aug. 18 and Friday included males and females who range in age and live in various neighbourhoods across London.

They all reported typical symptoms associated with salmonella — diarrhea, vomiting and fever, said Turner, adding the health unit would like anyone experiencing such symptoms to report them.

Going public, Colorado-style: 16 sick with Salmonella at Oscar’s of Breckenridge

Posted on August 9, 2016 by Douglas Powell

Kaeli Subberwal of Summit Daily reports that 16 employees and patrons at a popular Breckenridge taco bar came down with Salmonella poisoning in July. This outbreak led Summit County health officials to shut down the restaurant until the issue was addressed — a process that took six days.

Morgan Stovall had been working at Oscar’s of Breckenridge for only three shifts when the health inspectors arrived.

“I guess we knew we were getting a health inspection,” she said, “but we thought they would just come in and make sure we were using gloves and everything; but that health inspector came in with someone higher up who deals with outbreaks.”

The health inspection on July 15 was prompted by three cases of salmonella that were reported to the state health department after Oscar’s patrons went to their medical providers and were diagnosed with the foodborne illness.

“The only common exposure among the three confirmed illnesses is consuming food at Oscar’s restaurant during the week before becoming ill. Specifically, ill persons visited Oscar’s on July 1 and July 4,” read a letter from the Colorado Department of Public Health and Environment to Amy Wineland, the director of Summit County Public Health.

Though Oscar’s is back in business, some workers are still suffering the consequences of the outbreak.

“It’s been nearly 3 weeks, and I’m still testing positive,” employee Brittany Doyne wrote in an email. “I feel I should be compensated for all 3 of my jobs, not just Oscar’s. I’m missing out on thousands of dollars I would have earned had Oscar’s not gotten me sick. Nearly all of what little savings I have is gone now.”

How the sick employees are being compensated while out of work is unclear.

Going public: Schumer wants FDA’s food recall process overhauled

Posted on August 1, 2016 by Douglas Powell

Maybe Chuck Schumer is eyeing a career in comedy like his somewhat related cousin, Amy.

Chuck says federal regulators are too slow getting bad food off the shelves.

The New York Democrat is calling for the U.S. Food and Drug Administration to review its recall process from top to bottom to determine if it’s doing enough to prevent contamination-related food illnesses.

The action follows a preliminary report by the Office of Inspector General for the U.S. Department of Health and Human Services suggesting the FDA has taken far too long to initiate food recalls.

Schumer notes that a 21-state E. coli outbreak linked to tainted flour began in December but the recall wasn’t issued until May.

Whole genome sequencing takes time. So does any foodborne illness investigation, especially ones that are now leading the world in linking together previously unconnected victims and food vehicles.

A better approach might be a standardized guide for going public, so everyone knows the rules, even if they don’t agree with them.

Going public: Maine wants to limit what you can know about disease outbreaks

Posted on July 23, 2016 by Douglas Powell

Joe Lawlor of the Portland Press Herald reports the Maine Center for Disease Control and Prevention is proposing a rule change that would allow it to more easily withhold information on the locations of outbreaks of communicable diseases like measles, chicken pox and pertussis.

A rule is the same as a regulation, would have legal force behind it and implements an agency’s interpretation of a law.

Contacted Wednesday, CDC spokesman John Martins said the agency does not comment on pending rule changes.

The proposal comes a year after the Portland Press Herald filed a lawsuit in July 2015, when the Maine CDC denied the newspaper’s request for information about chicken pox outbreaks at three schools and a day-care facility during the 2014-15 school year. An outbreak is defined by the Maine CDC as a place where there are three or more cases of an infectious disease.

In a settlement agreement, the information was released to the Press Herald in October 2015, and the newspaper published the outbreak locations.

There were 84 chicken pox cases at Maine schools in 2014-15. Of those cases, 57 affected unvaccinated or undervaccinated children, according to CDC data.

In another case where public health advocates criticized the CDC for being unnecessarily secretive, the agency refused in 2014 to name the restaurant where a hepatitis A outbreak had occurred.

The Maine agency’s policy runs counter to recommendations by public health experts, who say that knowing where outbreaks occur is beneficial to the public health because some people – including infants, the elderly and those with compromised immune systems – are more susceptible to communicable diseases.

The CDC argued when denying the newspaper’s request last year that releasing the school names could jeopardize personal privacy because “indirect information” about the outbreaks could result in the public being able to identify people who had fallen ill.

But Sigmund Schutz, the Press Herald’s attorney, countered that the newspaper was not requesting personal information, and state law did not permit the CDC to deny the request.

Schutz said the new rule, if adopted, also would be in conflict with state open records laws, which do not give the agency latitude to deny requests based on unlikely scenarios that an individual could be identified.

Schutz said the newspaper will be lodging official comments objecting to the proposed rule. The public comment period ends Monday.

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