Toddler still in hospital after E. coli outbreak linked to raw milk in Minnesota; new outbreak in Washington state

The kids always get it worst.

An outbreak of E. coli O157:H7 linked to consumption of raw milk in Minnesota has felled at least four people, including a toddler who remains hospitalized.

And last night, Washington state officials reported that two recent infections with E. coli O157 have been identified in Washington residents who drank raw, unpasteurized milk. The two cases confirmed this month bring the count of infections this year associated with one Bellingham dairy to eight.

Each year, several dozen people are usually sickened by raw milk in Minnesota. But this is the first outbreak — two or more cases that are linked — in at least 15 years, Health Department officials say.

Assistant state epidemiologist Richard Danila said the Health Department found four cases of E. Coli O157:H7 between May 1 and 21, all of which had the same DNA fingerprint.

Two of those sickened were school-age children, one was a man who was at least 70 years old and the fourth was a toddler. All four were hospitalized: one overnight, two for four days, and one, the toddler, is still in the hospital after being admitted late last week.

Today, the Star-Tribune reports that Michael Hartmann, the organic farmer who produced the implicated raw milk in Minnesota, has for years fought the government’s efforts to regulate him. He last had a license to sell Grade A milk in 2001. He has kicked inspectors off his property, refused to tell a judge his name in court and asserted he is a "natural man" with a constitutional right to raise and sell food without government interference.

Dr. Kirk Smith, supervisor of state Health Department foodborne disease investigations said Thursday that the investigation of his dairy is continuing but said they have little doubt it produced the raw milk containing a deadly strain of E. coli, adding,

"I am concerned that we are going to hear about more cases.” It often takes up to two weeks for cases to surface.

Hartmann declined to talk about the outbreak with a reporter Thursday, other than to say, "It’s all been blown out of proportion."

I doubt the parents of the toddler feel that way.

In Washington, the two new patients say they drank raw milk produced by Jackie’s Jersey Milk in Whatcom County. WSDA has conducted additional testing of the firm’s product, but has not found E. coli in the milk. WSDA continues to work with the farm to review the dairy’s production and product handling practices.

The firm issued a product recall notice in February after WSDA found E. coli during routine sampling of the farm’s raw milk. Soon after the February recall, six patients with E. coli infections reported drinking the dairy’s product. People who were sick said they got the milk at retail stores in King, Snohomish, and Skagit counties.

An updated table of raw-milk related outbreaks is available at
http://bites.ksu.edu/rawmilk

E. coli illnesses traced to raw milk from Minnesota farm

Minnesota Department of Health types have linked three cases of E. coli O157:H7 illness with raw milk from a dairy farm in Gibbon, Minn and are urging anyone who may have recently purchased milk from the Hartmann Dairy Farm, also known as M.O.M.’s, to discard the product and not consume it.

The milk may be labeled organic and consumers may be unaware that the milk has not been pasteurized. In addition, consumers should not eat cheese, ice cream or other dairy products from the farm, which also may have been made from raw, unpasteurized milk.

The Minnesota Department of Health and the Minnesota Department of Agriculture are continuing to investigate a cluster of four E. coli O157:H7 illnesses that all have the same “pulsed field gel electrophoresis” (PFGE) patterns, or DNA fingerprint. Three of the four cases report a link to milk from Hartmann Farm; the fourth case is under investigation. Three of the four people were hospitalized as a result of their illness; one case has developed HUS.

Fox9 reports that Wisconsin nearly passed a bill that would have loosened the restrictions on the sale of raw milk, but Gov. Jim Doyle vetoed the bill, stating,

"I recognize that there are strong feelings on both sides of this matter, but on balance, I must side with the interests of public health and the safety of the dairy industry."

Did the salads at Minnesota church fundraiser spread the norovirus sickening 35?

The Brainerd Dispatch reports that vegetables and baby mixed greens, served at a fundraising event April 25 at a Baxter church, are believed to be linked to a norovirus outbreak that sickened about 35 people.

Doug Schultz, a Minnesota Department of Health spokesperson said laboratory tests confirmed that the norovirus was involved in the outbreak at a New Pathways Inc. fundraiser at Lakewood Evangelical Free Church in Baxter. About 275 people attended the banquet, which was catered by Prairie Bay Restaurant in Baxter. Investigators interviewed about 60 people who attended the banquet and found 35 people who said they became ill.

Schultz said the source of the contamination could not be confirmed. However, state health investigators determined through statistical analysis that the consumption of seasonal vegetables and baby mixed greens served in a salad were associated with the illness.
 

Minn. investigating foodborne outbreak at fundraiser

The Minnesota Department of Health is investigating a report that people got sick from eating the food at a fundraiser held at a church.

The banquet took place Sunday at the Lakewood Evangelical Free Church in Baxter, Minn. The problem was reported Thursday.

The event was a benefit for New Pathways of Brainerd, a group that helps homeless families with children find safe transitional shelter.

The fundraiser was catered by Baxter’s Prairie Bay Restaurant, according to the MDH.

Investigators believe about 275 people were at the event, but it isn’t yet clear how many were exposed or how many became ill. Early signs point to a norovirus as a cause, but that has not been confirmed.
 

Evan Henke: For the Jucy Lucy and stuffed burgers, the food safety jury is still out

Evan Henke, a student at the University of Minnesota School of Public Health (right, sorta as shown), writes in this guest barfblog.com post:

During a recent trip to a Minneapolis restaurant, I ordered what is perhaps Minneapolis’s most significant contribution to the culinary world: the “Jucy Lucy.”

Legend has it that the Lucy, a hamburger with cheese stuffed inside of the beef patty before cooking (right, not exactly as shown), was invented in Minneapolis, although debate still rages as to which burger joint was the first to offer the Lucy to its customers. As I bit into the Lucy, I noticed that the center of the burger was quite undercooked, and I did not notice the use of a thermometer on the nearby grill. I immediately wondered what effect stuffing the cheese inside of the patty had on the survival of foodborne pathogens during the cooking process.

Maybe the added weight of the cheese would better insulate the side of the burger exposed to the surface grill compared to cooking a normal patty of equal thickness without flipping. Maybe any added moisture in the cheese would help kill any pathogen present in the beef, as long as the moisture was present.

But the true food safety implications of stuffing a ground beef patty with cheese or other ingredients are not well documented (left, not exactly as shown). The amounts of fat and water that escape from the cheese during cooking are not documented, and how those amounts affect the survival of foodborne pathogens present in the patty is unclear. It has been documented that E. coli O157:H7 shows increased resistance to heat in patties with higher fat and lower moisture contents[1]. It is possible that the composition of a stuffed burger, depending on the stuffing and fat and moisture content of the ground beef, could favor the survival of foodborne pathogens relative to a burger with no stuffing.

In a world of foods that taste delicious but can be deleterious to your health, the Jucy Lucy and stuffed burgers sizzle in mystery. How the addition of cheese to the center of the patty affects the survival of foodborne pathogens ought to be documented, not just for the health of my fellow Minneapolitans, but for the health of burger eaters everywhere. And of course, thermometer use is recommended whenever preparing ground beef.

The Make Your Own Jucy Lucy video is included below http://heavytable.com/make-your-own-jucy-lucy/. Warning: Conventional safe cooking technique not displayed in video.

Evan Henke is a student at the University of Minnesota School of Public Health pursuing a Master’s degree in Environmental Health. An avid fan of foodborne disease epidemiology and food safety, he spends most of his free time angering his friends with his knowledge of the food chain and careful scrutiny of food safety practices.

1. Ahmed, Nahed M., Donald E. Conner, and Dale L. Huffman. "Heat-Resistance of Escherichia Coli O157:H7 in Meat and Poultry as Affected by Product Composition." Journal of Food Science 60.3 (1995): 606-10.

 

Making Your Own Jucy Lucys from The Heavy Table on Vimeo.

Safest food in the world: Minnesota academic edition

Fewer than one in four consumers now believe the U.S. food supply is safer than it was a year ago, according to new data from the University of Minnesota’s Food Industry Center.

That’s an awkward sentence. But not as awkward as the statement by study co-author Dennis Degeneffe , a research fellow at the center, who told a Minnesota paper that,

Even with low consumer confidence in food safety and intense media scrutiny of recent contaminations, it’s important for consumers to keep in mind that the industry as a whole is safe.

“The truth of the matter is, we have the safest food supply in the world, and it’s probably getting better with technology.”

Tell that to the sick people. And provide some data to back it up.
 

King Nut peanut butter source of national Salmonella outbreak

I didn’t want to engage in any premature e-speculation, but epidemiology usually works. And I still dislike peanut butter. And jazz.

Today, the Minnesota Departments of Agriculture and Health announced that laboratory analyses have confirmed a genetic match between the strains of Salmonella bacteria found in a container of King Nut brand creamy peanut butter and the strains of bacteria associated with 30 illnesses in Minnesota and nearly 400 illnesses around the country.

MDA lab tests conducted last week discovered Salmonella bacteria in a 5-pound package of King Nut peanut butter collected from a long-term care facility associated with one of the reported illnesses.  The Minnesota Department of Agriculture (MDA) and the Minnesota Department of Health (MDH) issued a product advisory on Friday alerting institutions that may have received the product.

MDA and MDH scientists performed additional testing this weekend to verify the connection between the contaminated product and the illnesses.

State officials initially discovered the contaminated product through product testing conducted after MDH epidemiological evidence and an investigation by MDA’s Rapid Response Team implicated King Nut creamy peanut butter as a likely source of Salmonella infections in Minnesota residents.

In the product advisory issued Friday, state officials urged establishments who may have the product on hand to avoid serving it, pending further instructions as the investigation progresses.

King Nut peanut butter is produced by Peanut Corporation of America, of Lynchburg, Va., and is distributed nationally by Ohio-based King Nut Companies. The product was distributed in Minnesota to establishments such as long-term care facilities, hospitals, schools, universities, restaurants, delis, cafeterias and bakeries. King Nut Companies reports that the product is not distributed for retail sale to consumers, and has voluntarily withdrawn the product from distribution.

Salmonella cases in Minn. linked to raw, frozen chicken entrees; at least 14 sick

The Minnesota folks are really good at focusing on raw, frozen, chicken thingies during outbreaks of foodborne illness.

And once again, they’ve cracked the case.

(these aren’t the products implicated, below, right, but an example of the raw and fully cooked products available at retail)

State health and agriculture officials said today that recent cases of salmonellosis in Minnesota have been linked to raw, frozen, breaded and pre-browned, stuffed chicken entrees. The implicated product is Milford Valley Farms Chicken Cordon Bleu and Chicken Kiev. This product is sold at many different grocery store chains.

This is the sixth outbreak of salmonellosis in Minnesota linked to these types of products since 1998. The findings prompted the officials to urge consumers to make sure that all raw poultry products are handled carefully and cooked thoroughly, and to avoid cooking raw chicken products in the microwave because of the risk of undercooking.

Investigators from the Minnesota Department of Health (MDH) determined that 14 cases of Salmonella infection since July 2008 were due to the same strain of Salmonella. The illnesses occurred in both children and adults; six of the cases were hospitalized but have since recovered. …

These types of products previously were marketed as microwaveable. Because of the inherent variability of microwave cooking, using this method to prepare raw frozen product can frequently result in undercooking of the product. Brands of product most commonly available in Minnesota are no longer being marketed as microwaveable. State officials are concerned, however, that consumers are still using microwave ovens for this product, out of habit.

We’ve done some research on this that is making its way through the peer-review process. But this is what was presented at the International Association for Food Protection annual meeting in Aug. 2008.

Abstract

Purpose – This study used a novel video capture system to observe the
food preparation practices of 41 consumers – 21 primary meal preparers
and 20 adolescents – in a mock domestic kitchen using uncooked, frozen,
breaded chicken products, and to determine if differences exist between
consumers’ reported safe food handling practices and actual food
handling behavior as prescribed on current product labels.

Design/methodology/approach – A convenience sample was utilized and all
participants were video-recorded preparing food in one-of-two model
kitchens at Kansas State University. Participants were asked to complete
a survey reporting food handling behaviors that would be typical of
their own home kitchen.

Findings – Differences between self-reported and observed food safety
behaviors were seen across both groups of consumers. Many participants
reported owning a food thermometer (73 per cent) and indicated using one
when cooking raw, breaded chicken entrées (19.5 per cent); however, only
five participants were observed measuring the final internal temperature
with a food thermometer despite instructions on the product packaging to
do so; only three used the thermometer correctly.

Significance – Data collected through direct observation more accurately
reflects consumer food handling behaviors than data collected through
self-reported surveys, and label instructions are rarely followed.

Originality/value – This study contributes to the overall understanding
of consumer behaviors associated with consumers’ intentions and actual
behaviors while preparing meat and poultry products, such as frozen,
uncooked, breaded chicken products.

 

Team Diarrhea cracks the Salmonella case

Amy’s originally from Minnesota. A French professor from Minnesota. That’s part of our shared humor.

So last December during break, we drove to Minnesota, with the dogs, and hung out with some of her extended family.

We also hung out with Team Diarrhea.

That would be the crack investigative unit at the Minnesota Dept of Heath, getting much praise in the past few days over their handling of the Salmonella in whatever-it-is outbreak.

“In less than two weeks, Minnesota Department of Health investigators traced the source of a mysterious salmonella outbreak that had stumped federal health officials for two months and sickened more than 1,200 people in 43 states and Canada.

The culprit: jalapeno peppers.

Federal officials had focused on tomatoes as the source of the salmonella, causing restaurants and stores to pull tomatoes and severely hurting tomato farmers in suspect areas.

While tomatoes haven’t been entirely cleared by federal authorities, attention has now turned to the peppers in what federal officials said was a major break in the case. The story says that a gee-whiz state lab, investigators dubbed "Team Diarrhea" and a unique approach to sleuthing illness contributed to the breakthrough.”

I gave them some Don’t Eat Poop shirts back in December, Hedberg took us to lunch, I came away  thinking, what a great model to do foodborne illness investigations, and to get students doing cool stuff. Guess the rest of the country is now appreciating the insights of Northerners.

Raw frozen chicken thingies — don’t use a microwave

Julie Schmit of USA Today reports that federal food-safety officials are considering whether labels on some frozen chicken products adequately inform consumers that the chicken is raw and provide sufficient cooking instructions.

Minnesota health officials said that stuffed chicken entrees — which look cooked because they’re breaded and prebrowned so that the breading sticks — are blamed for five salmonella outbreaks since 1998 that sickened 71 people.

The latest outbreak, in Minnesota in March, occurred even though the products’ labels changed more than a year ago to more explicitly state that the chicken is uncooked. "

David Goldman, assistant administrator for the U.S. Department of Agriculture, said,

"We’ve done everything we think is appropriate, but if consumer behavior hasn’t changed, we have to deal with that."

Carlota Medus, epidemiologist with the Minnesota Department of Health, said, "They look precooked, plus they are marketed as convenience foods," and that consumers may think the chicken is cooked and only reheat it, which doesn’t kill bacteria.

Of the four consumers sickened in the recent outbreak, two thought the product was precooked. Three used a microwave, even though the label warns not to, Medus says. Conventional oven-cooking is advised because they cook more uniformly than microwaves.

The outbreak was linked to chicken cordon bleu and chicken breast stuffed with cheese from Serenade Foods. Serenade spokeswoman Janelle Deatsman said,

"We think it’s important consumers follow label directions."

Do people read instructions, and are the instructions understood? Are the instructions in multiple languages? Does understanding translate into safe handling behavior?