Jimmy Johns: The E. coli gift that keeps on giving

The U.S. Centers for Disease Control reports that as of April 22, 2020, this outbreak linked to clover sprouts appears to be over.

51 people infected with the outbreak strain of E. coli O103 were reported from 10 states.

3 people were hospitalized. No deaths were reported.

Epidemiologic, traceback, and laboratory evidence indicated that clover sprouts were the source of this outbreak.

On March 16, 2020, Chicago Indoor Garden recalled external icon all products containing red clover sprouts. More information about this recall is available on the FDA website.external icon

Jimmy John’s LLC reported that all of its restaurants stopped serving clover sprouts on February 24, 2020.

People usually get sick from Shiga toxin-producing E. coli (STEC) 1 to 10 days (average of 3 to 4 days) after swallowing the germ.

Symptoms vary, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Some people may have a fever, which usually is not very high (less than 101˚F/38.5˚C).

Some people with a STEC infection may get a type of kidney failure called hemolytic uremic syndrome (HUS).

Antibiotics are not recommended for patients with suspected E. coli infections until diagnostic testing can be performed and E. coli infection is ruled out. Some studies have shown that administering antibiotics to patients with E. coli infections might increase their risk of developing HUS, and a benefit of treatment has not been clearly demonstrated.

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of E. coli O103 infections linked to clover sprouts.

Public health investigators used the PulseNet system to identify illnesses that were part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on E. coli bacteria isolated from ill people by using a standardized laboratory and data analysis method called whole genome sequencing (WGS). CDC PulseNet manages a national database of these sequences that are used to identify possible outbreaks. WGS gives investigators detailed information about the bacteria causing illness. In this investigation, WGS showed that bacteria isolated from ill people were closely related genetically. This means that people in this outbreak were likely to share a common source of infection.

A total of 51 people infected with the outbreak strain of E. coli O103 were reported from 10 states. A list of the states and the number of cases in each can be found on the Map of Reported Cases.

Illnesses started on dates ranging from January 6, 2020, to March 15, 2020. Ill people ranged in age from 1 to 79 years, with a median age of 29 years. Fifty-five percent of ill people were female. Of 41 ill people with information available, 3 were hospitalized and no deaths were reported.

WGS analysis of isolates from 39 ill people was performed; the isolate from 1 ill person predicted antibiotic resistance to streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole, and 38 isolates from ill people did not show evidence of antibiotic resistance. Standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is currently underway. These findings do not affect treatment guidance since antibiotics are not recommended for patients with STEC O103 infections.

Investigation of the Outbreak

Epidemiologic, traceback, and laboratory evidence indicated that clover sprouts were the source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures they had in the week before their illness started. Eighteen (56%) of 32 people interviewed reported eating sprouts. This percentage is significantly higher than results from a survey pdf icon[PDF – 787 KB] of healthy people in which 8% reported eating sprouts in the week before they were interviewed.

Seventeen (63%) of 27 people interviewed reported eating sprouts at a Jimmy John’s restaurant. Jimmy John’s LLC reported that all of their restaurants stopped serving clover sprouts on February 24, 2020. Clover sprouts are no longer available at Jimmy John’s restaurants.

Additionally, FDA identified the outbreak strain of E. coli O103 in samples of Chicago Indoor Garden products that contain sprouts. On March 16, 2020, Chicago Indoor Garden recalledexternal icon all products containing red clover sprouts.

FDA’s traceback investigationexternal icon showed that a common seed lot was used to grow both the sprouts recalled by Chicago Indoor Garden and sprouts that were served at some Jimmy John’s locations. The same seed lot was also used to grow sprouts linked to an outbreakexternal icon of the same strain of E. coli O103 infections in 2019.

As of April 22, 2020, this outbreak appears to be over.

Jimmy Johns get’s a warning letter from FDA

This warning letter from FDA to Jimmy John’s about continuous use of sprouts is unique. I’ve never seen anything quite like it. 5 outbreaks, at least 88 illnesses, all linked to sprouts, should lead to something different. The old approach doesn’t seem to be working.

Here’s my favorite part: “In May 2012, a meeting was held with FDA at your request. During that meeting, you expressed that you would offer only clover sprouts, and to only source clover sprouts from [redacted] suppliers.

Since that corrective action, your firm has been implicated in three additional sprout-related outbreaks. Documents from traceback investigations conducted by FDA, states and local partners demonstrate that in addition to [redacted] sprouts, Jimmy John’s restaurants are using multiple other sources of sprouts.”

Going to other suppliers, hell keeping sprouts on the menu and then taunting with sassy posters (Skull. Crossbones. Eat at your own risk. Nudge. Nudge.), was a brazen move by JJ’s. and not really in line with what their CEO James North said following one of those outbreaks: “Food safety and the welfare of our customers are our top priorities and not negotiable in our business.”

Yesterday North sent a statement to USA Today after receiving the warning letter that said the sprouts have been removed from restaurants. “This removal was out of an abundance of caution and was not initiated by any known, immediate threat,” North said.

Abundance of caution is the stupidest term in food safety risk communication.

Jimmy Johns linked to sprout outbreak again

I can’t remember if this is outbreak number 3 or 4 (oops, it’s number 5 according to the Chicago Tribune) but Jimmy Johns, the sub folks, have been linked to a bunch of salmonellosis illnesses through sprouts again.

I wonder if their PR folks regret this sprout marketing ploy (right, exactly as shown) from a few years ago. Skull. Crossbones. Eat at your own risk. Nudge. Nudge. Say no more.

Yeah. And there are illnesses again.

“Food safety and the welfare of our customers are our top priorities and not negotiable in our business,” said James North, Jimmy John’s President and CEO, in a news release, adding the company is working with the various agencies in the investigation.

Here’s a table of over 75 sprout-related outbreaks going back to 1973. We’ll add this one when there are more details.

Nudge. Nudge.

 

The crap Americans eat: Jimmy Johns and Chipotle, together at last

It was a food safety juxtaposition in Scottsdale, Arizona I couldn’t help but photograph.

jimmy.johns.chipotle.mar.16Jimmy Johns and its sprout-laden subs, Chipotle and its mystery E. coli and Salmonella and Norovirus.

Jimmy Johns was empty; Chipotle, not so much.

If Chipotle Mexican Grill can convince Americans that a 1,000 calorie diarrhea burrito is healthy, and that their co-CEOs deserve $13 million each, they can pretty much do what they want.

chipotle.scottsdale.mar.16

People are sick: Jimmy Johns in Utah closed for health violations

As Fox News is to Jon Stewart, Jimmy John’s is to food safety types: the gift that keeps on giving.

jimmy.john's.sproutsA Jimmy Johns – they make those sandwiches popular on university campuses — in Utah was, according to health types, closed for an imminent health hazard in response to a foodborne illnesses outbreak and ongoing illness connected to this establishment and the following violations:

  1. Food employees worked in the establishment while ill.
  2. An employee did not wash hands when changing gloves.
  3. An employee removed a loaf of bread from the pan with bare hands.
  4. Fresh bread is being stored on the dirty dish drain board.
  5. An employee beverage is stored next to establishment food in the walk in cooler.
  6. The vent in the walk in cooler is not properly repaired to be easily cleanable.
  7. Fan covers in the walk-in cooler are dirty.
  8. Food equipment is not being air dried before being nested together.
  9. The mop is not hung to air dry.
  10. Bread sticks in the walk in freezer are not covered to prevent contamination.
  11. Food is being stored on the floor.

9 sickened with E. coli O157 in Oct. 2013 linked to imported cucumbers served at Jimmy John’s in Denver

I’m sure university departmental meetings across the U.S. continue to chomp down on catered Jimmy John’s sandwiches, even though they have a terrible food safety record:

cucumber282 sick from Norovirus in Garden City, Kansas, in 2014;

29 sick from E. coli O26 on clover sprouts in early 2012; and,

140 sick from Salmonella on alfalfa sprouts in 2011.

Now, the Colorado Department of Public Health & Environment reports that in Oct. 2013, an outbreak of E. coli O157:H7 sickened nine people, including 1 probable case and 8 laboratory-confirmed cases with matching pulsed-field gel electrophoresis (PFGE) and multiple-locus variable number tandem repeat analysis (MLVA) patterns from E. coli O157:H7 isolated from stool.

All 9 cases reported eating sandwiches at Denver-area Jimmy John’s locations in early October 2013. The outbreak investigation consisted of case finding and interviews, 2 separate case-control studies, environmental investigations, produce traceback, and laboratory testing.

348sThe results of this investigation indicate that consumption of Jimmy John’s sandwiches containing cucumbers imported from Mexico was the likely cause of the outbreak. To our knowledge, this is the first E. coli O157:H7 outbreak associated with cucumbers reported in the United States. Public health and food safety officials should be aware that cucumbers may be contaminated with E. coli O157:H7, which could cause sporadic E. coli O157:H7 infections as well as outbreaks. As of the date of this report, no other cases of E. coli O157:H7 with the PFGE pattern combination seen in this outbreak were reported in Colorado. 

Someone sued because they wanted raw sprouts on their Jimmy John’s sandwich? Maybe they work at Kansas State University

Lee Schafer of the Star Tribune wrote in mid-Oct (yes, I’m playing catch-up, taxes and hockey and pumpkins are a bitch) about an announcement of a proposed class-action settlement to readers who somehow suspect they got cheated out of some alfalfa sprouts by the sandwich shop Jimmy John’s.

sprout.apple_.aug_.141In the case of Starks v. Jimmy John’s LLC et al., filed in Los Angeles Superior Court, a customer claimed that Jimmy John’s did not put alfalfa sprouts on her sandwich. The notice of proposed settlement said “sandwiches,” plural, so that suggests it happened to her more than once.

Since alfalfa sprouts were advertised on the menu, there was a problem.

In a subsequent court filing, the customer alleged interference with contract, intentional misrepresentation, negligent misrepresentation, fraud, violation of California’s False Advertising Act and so on.

Jimmy John’s has agreed to “cease and desist from advertising or otherwise representing” to sell sandwiches with sprouts and then not put them on the sandwich, and it agreed make a charitable donation of at least $100,000.

The vouchers issued to customers can only add up to a maximum of $725,000, less the actual costs of the settlement administration, which are estimated at $15,000.

So, if you ordered a sandwich with sprouts from February 2012 through July 21, 2014, and didn’t get sprouts, then you may fill out a form, send it in and get the $1.40.

jimmy.johns_.sprouts2-300x225The lead plaintiff is to get $5,000 in addition to her $1.40 voucher. The plaintiffs’ attorneys are to receive $370,000 in fees and expenses. That’s cash, incidentally, not 264,286 vouchers for a pickle or chips at Jimmy John’s.

Meanwhile, business was brisk Friday at a Jimmy John’s in downtown Minneapolis. There were several sandwiches like the Totally Tuna and Turkey Tom listed with “sprouts* optional” with the asterisk leading to a menu warning that eating raw or undercooked sprouts poses a health risk.

Jimmy John’s has become the poster child for raw sprouts in the U.S. with numerous outbreaks; WalMart and Kroger no longer sell raw sprouts; much of food service stopped years ago.

We document at least 55 sprout-associated outbreaks occurring worldwide affecting a total of 15,233 people since 1988. A comprehensive table of sprout-related outbreaks can be found at https://barfblog.com/wp-content/uploads/2014/08/Sprout-associated-outbreaks-8-1-14.xlsx.

Sprouts present a unique food safety challenge compared to other fresh produce, as the sprouting process provides optimal conditions for the growth and proliferation of pathogenic bacteria. The sprout industry, regulatory agencies, and the academic community have been collaborating to improve the microbiological safety of raw sprouts, including the implementation of Good Manufacturing Practices (GMP), establishing guidelines for safe sprout production, and chemical disinfection of seed prior to sprouting. However, guidelines and best practices are only as good as their implementation. The consumption of raw sprouts is considered high-risk, especially for young, elderly and immuno-compromised persons.

From November 2010 into 2011, an outbreak linked to raw sprouts in the U.S. and involving sandwich franchise Jimmy John’s sickened 140 people. This was the third sprout related outbreak involving this franchise, yet the owner of the Montana Jimmy John’s outlet, Dan Stevens, expressed confidence in his sprouts claiming that because the sprouts were locally grown they would not be contaminated. By the end of December 2010 a sprout supplier, Tiny Greens Farm, was implicated in the outbreak. Jimmy John’s owner, John Liautaud, responded by stating the sandwich chain would replace alfalfa sprouts with clover sprouts since they were allegedly easier to clean. However, a week earlier a separate outbreak had been identified in Washington and Oregon in which eight people were infected with Salmonella after eating sandwiches containing clover sprouts from a Jimmy John’s restaurant. This retailer was apparently not aware of the risks associated with sprouts, or even outbreaks associated with his franchisees.

sprout.santa_.barf_.xmas_1-300x254In late December, 2011, less than one year after making the switch to clover sprouts, Jimmy John’s was linked to another sprout related outbreak, this time it was E.coli O26 in clover sprouts. In February 2012, sandwich franchise Jimmy John’s announced they were permanently removing raw clover sprouts from their menus. As of April 2012, the outbreak had affected 29 people across 11 states. Founder and chief executive, John Liautaud, attempted to appease upset customers through Facebook stating, “a lot of folks dig my sprouts, but I will only serve the best of the best. Sprouts were inconsistent and inconsistency does not equal the best.” He also informed them the franchise was testing snow pea shoots in a Campaign, Illinois store, although there is no mention regarding the “consistency” or safety of this choice.

Despite the frequent need for sprout-based risk communication, messaging with industry and public stakeholders has been limited in effectiveness. In spite of widespread media coverage of sprout-related outbreaks, improved production guidelines, and public health enforcement actions, awareness of risk remains low. Producers, food service and government agencies need to provide consistent, evidence-based messages and, more importantly, actions. Information regarding sprout-related risks and food safety concerns should be available and accurately presented to producers, retailers and consumers in a manner that relies on scientific data and clear communications.

The would-be food safety gurus at Kansas State still order Jimmy John’s with sprouts for their various really important meetings.

Erdozain, M.S., Allen, K.J., Morley, K.A. and Powell, D.A. 2012. Failures in sprouts-related risk communication. Food Control. 10.1016/j.foodcont.2012.08.022

http://www.sciencedirect.com/science/article/pii/S0956713512004707?v=s5

Abstract

Nutritional and perceived health benefits have contributed to the increasing popularity of raw sprouted seed products. In the past two decades, sprouted seeds have been arecurring food safety concern, with at least 55 documented foodborne outbreaks affecting more than 15,000 people. A compilation of selected publications was used to yield an analysis of the evolving safety and risk communication related to raw sprouts, including microbiological safety, efforts to improve production practices, and effectiveness of communication prior to, during, and after sprout-related outbreaks. Scientific investigation and media coverage of sprout-related outbreaks has led to improved production guidelines and public health enforcement actions, yet continued outbreaks call into question the effectiveness of risk management strategies and producer compliance. Raw sprouts remain a high-risk product and avoidance or thorough cooking are the only ways that consumers can reduce risk; even thorough cooking messages fail to acknowledge the risk of cross-contamination. Risk communication messages have been inconsistent over time with Canadian and U.S. governments finally aligning their messages in the past five years, telling consumers to avoid sprouts. Yet consumer and industry awareness of risk remains low. To minimize health risks linked to the consumption of sprout products, local and national public health agencies, restaurants, retailers and producers need validated, consistent and repeated risk messaging through a variety of sources.

Epidemiology don’t matter; sprout grower says FDA’s E. coli tests are negative

From the epidemiology-doesn’t-count files, Idaho sprout grower Dave Scharf, owner of Evergreen Fresh Sprouts, says, “I have a clear conscious knowing my product is not what made people sick” after the Food and Drug Administration notified him that samples of his sprouts from a Jimmy John’s restaurant and seed at his growing operation did not test positive for the E. coli O121 that has sickened at least 10 people.

sprouts.sandwichThe negative test results don’t mean Scharf’s sprouts were not the cause of the illnesses, said Seattle food safety attorney Bill Marler, who is handling a case for Idaho resident Honey Sayler.

“It is not unusual for some samples to test negative,” Marler said June 2. “There are many different ways to prove a foodborne illness case and epidemiological (investigations) are admissible.”

Scharf said the FDA staff did not say when the remainder of test results are expected. He said his business is operating at about 50% capacity because of lagging orders.

“People are just running scared because of this,” Scharf said.

After all the sprout-related outbreaks, people are not scared, they’re being sensible.

A table of sprout-related outbreaks is available at: http://bites.ksu.edu/sprouts-associated-outbreaks

Epi doesn’t count; my sprouts are safe

From the continual trashing of the power of epidemiology files, David Scharf, owner of Evergreen Fresh Sprouts, implicated in an E. coli O121 outbreak that has sickened at least 10 people, said state health officials jumped the gun pointing the finger at his business.

“I find that it is very ambiguous to say that my product is bad,” Scharf told The Spokesman-Review.

jimmy.john's.sproutsHe said he tests his sprouts before they leave the warehouse and also tests the spent water, according to federal rules. “I have documentation stating my sprouts are good.”

Officials should keep quiet until they know for certain what the source of the infection is, Scharf added.

“It’s kind of sad that we’re going to put the cart before the horse, really,” he said.

I test and hold product for E. coli and salmonella before I ship. Until they show me a test result I’m not recalling anything.”

Evergreen was singled out in similar investigation in 2011 when the Food and Drug Administration demanded it voluntarily recall products as a salmonella outbreak unfolded, sickening 25 people in five states. Test results showed no bacteria was found in the Evergreen produce at that time, but the FDA stuck by its conclusion the business was the origin of the outbreak.

The clover sprouts suspected in the current E. coli O121 outbreak were eaten in sandwiches at Jimmy John’s Gourmet Sandwiches in King and Spokane counties, two Pita Pit locations in Spokane County, and Daanen’s Deli and a Jimmy John’s in Kootenai County, Washington state health officials said. The restaurants voluntarily suspended serving sprouts, officials said.

10 sick from E. coli O121 outbreak linked to raw clover sprouts; Jimmy John’s again linked; keep eating those sandwiches, Kansas State

The late great Bill Keene predicted this when Jimmy John’s switched to clover sprouts.

An outbreak linked to raw sprouts in the U.S. that sickened 140 people occurred between November 2010 into 2011, involving sandwich franchise, Jimmy John’s. The owner of the Montana Jimmy John’s outlet, Dan Stevens, expressed confidence in his sprouts claiming that because the sprouts were locally grown they would not be contaminated, although the source of the contaminated sprouts had not yet been identified. By the end of December 2010 a sprout supplier, Tiny Greens Farm, was implicated in the outbreak. Jimmy John’s owner, John Liautaud, responded by stating the sandwich chain would replace alfalfa sprouts with clover sprouts since they were allegedly easier to clean. However, a week earlier a separate outbreak had been identified in Washington and Oregon in which eight people were infected with salmonella after eating sandwiches containing clover sprouts from a Jimmy John’s restaurant. This retailer was apparently not aware of the risks associated with sprouts, or even outbreaks associated with his franchisees.

amy.sprouts.guelph.05Now it has happened again.

Washington state health officials are warning consumers not to eat raw clover sprouts from an Idaho producer that have been linked to an outbreak of E. coli infections in the Northwest.

The sprouts have been linked to seven confirmed and three probable cases of E. coli O121 illnesses in Washington and Idaho.

Five of those patients were hospitalized; there have been no deaths.

Results from initial investigations indicate a strong link to eating raw clover sprouts produced by Evergreen Fresh Sprouts, LLC of Idaho.

Sprouts were eaten in sandwiches at several food establishments including Jimmy John’s Gourmet Sandwiches locations in King and Spokane counties, as well as two Pita Pit locations in Spokane County, and Daanen’s Deli as well as a Jimmy John’s location in Kootenai County.

The restaurants where the cases reported eating raw clover sprouts have voluntarily suspended serving sprouts.

The producer also distributed sprouts around the northwest to other restaurants, as well as retail grocery stores where consumers may buy them for home consumption.