Tag Archives: Oregon

More raw milk, more kids sick; 3 ill in Oregon

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Oregon health officials say three children under the age of 15 have been hospitalized with E. coli linked to raw milk from a small farm in Clackamas County.

The state Public Health Division said Friday that Foundation Farm has voluntarily stopped distributing milk.

Officials say lab tests confirm that a fourth child also has E. coli but has not been hospitalized. Health officials say other customers of the dairy are reporting recent diarrhea and other symptoms typical of the bacteria.

Grocery stores cannot sell raw, unpasteurized cow’s milk in Oregon. Officials say Foundation Farm distributed to 48 households that were part of a "herd share" — an arrangement in which people own one or more animals from a herd.

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

Going public: Del Monte drops lawsuit against Oregon public health over cantaloupe

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Fresh Del Monte is ending its lawsuit against Oregon health officials who linked a salmonella outbreak to its Guatemalan cantaloupe.

In August, Coral Gables, Fla.-based Del Monte Fresh Produce NA Inc. said it would sue the Oregon Health Authority’s Public Health Division and the agency’s top scientist over how it handled the investigation of the February and March 2011 outbreak that sickened 20 people in the western U.S. and Pennsylvania and Maryland.

Lynne Terry of The Oregonian reported yesterday that Del Monte Fresh Produce said in a letter e-mailed to the state earlier this month that it would not act on its notice to sue William Keene and Oregon Public Health.

"Obviously, it’s a relief for us that that’s withdrawn so now we can focus on the job we’re supposed to do which is to protect the public’s health," said Dr. Katrina Hedberg, state epidemiologist. The tort claim filed last August had gobbled up time of state scientists and lawyers dealing with it, she said.

The claim was unprecedented. State epidemiologists investigate dozens of foodborne illness outbreaks every year and name the culprits to prevent more people from getting sick. No other company has ever filed a suit or threatened to sue Oregon over one of those investigations.

"There have been lots of outbreaks," Hedberg said. "Why some companies choose to work with public health and others want to fight it — I can’t answer that."

Del Monte Fresh Produce wouldn’t either. A spokesman said the company "does not comment on ongoing or closed investigations."

The company’s letter said the withdrawal marked "a show of good faith" in its discussions with Oregon Public Health over food safety. It asked for another meeting with Oregon’s top food safety detectives.

The state agreed to a meeting in Portland.

"I’m not sure why they want it," Hedberg said. "We work with businesses and companies but that does not preclude us from notifying the general public if we find a food item that’s been responsible for an outbreak or cluster of illnesses."

The saga dates to January 2011 when people started getting sick. In March, the company recalled nearly 60,000 whole cantaloupes imported from its facility in Guatemala. The recall notice, published on the Food and Drug Administration website, said the melons could be contaminated with Salmonella Panama, the strain involved in the outbreak.

In July, the FDA imposed an import alert, effectively banning the sale of the Guatemalan melons until the company demonstrated they were safe. Located in Coral Gables, Fla., Del Monte Fresh Produce is a major importer of cantaloupe. A third of its supply comes from Guatemala.

The company, which is not part of the Del Monte Foods conglomerate, responded to the alert by filing suit against the FDA. Then in August, it filed the tort claim against Keene and Oregon Public Health along with a separate ethics complaint against Keene.

The documents said Keene conducted a shoddy investigation. They said he never found salmonella in its cantaloupes but named the company anyway. Del Monte Fresh Produce also blamed Keene for the recall, saying he pushed the FDA to take action.

But Keene was not the only epidemiologist who concluded that Del Monte Fresh Produce was to blame in that outbreak. His peers in Washington state reached the same conclusion.

In September, the FDA lifted its import alert and Oregon’s Government Ethics Commission dismissed the ethics claim against Keene.

At the time, Kirk Smith, epidemiology supervisor for the Minnesota Department of Health, told the Washington Post it’s rare for scientists investigating foodborne illness outbreaks to test the exact food suspected of carrying pathogens. By the time symptoms occur and a foodborne illness is reported and confirmed, the product in question has likely been consumed or has exceeded its shelf-life and been thrown away.

Instead, scientists, like detectives, interview victims, collect data, analyze patterns and match food “fingerprints” to determine the likely source of an outbreak.

“The majority of outbreaks, we don’t have the food to test,” Smith said. “Laboratory confirmation of the food should never be a requisite to implicating a food item as the vehicle of an outbreak.

Epidemiology is actually a much faster and more powerful tool than is laboratory confirmation.”

Redux: On-farm food safety for strawberry growers

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On June 12, 1996, Dr. Richard Schabas, chief medical officer of Ontario (that’s a province in Canada), issued a public health advisory on the presumed link between consumption of California strawberries and an outbreak of diarrheal illness among some 40 people in the Metro Toronto area. The announcement followed a similar statement from the Department of Health and Human Services in Houston, Texas, which was investigating a cluster of 18 cases of cyclospora illness among oil executives.

Turns out it was Guatemalan raspberries, and no one was happy.

The initial, and subsequent, links between cyclospora and strawberries or raspberries in 1996 was based on epidemiology, a statistical association between consumption of a particular food and the onset of disease. The Toronto outbreak was first identified because some 35 guests attending a May 11, 1996 wedding reception developed the same severe, intestinal illness, seven to 10 days after the wedding, and subsequently tested positive for cyclospora. Based on interviews with those stricken, health authorities in Toronto and Texas concluded that California strawberries were the most likely source. However, attempts to remember exactly what one ate two weeks earlier is an extremely difficult task; and larger foods, like strawberries, are recalled more frequently than smaller foods, like raspberries.

By July 18, 1996, the U.S. Centers for Disease Control declared that raspberries from Guatemala — which had been sprayed with pesticides mixed with water that could have been contaminated with sewage containing cyclospora — were the likely source of the cyclospora outbreak, which ultimately sickened about 1,000 people across North America. Guatemalan health authorities and producers vigorously refuted the charges. The California Strawberry Commission estimated it lost $15-20 million in reduced strawberry sales.

The California strawberry growers decided the best way to minimize the effects of an outbreak – real or alleged – was to make sure all their growers knew some food safety basics and there was some verification mechanism. The next time someone said, “I got sick and it was your strawberries,” the growers could at least say, “We don’t think it was us, and here’s everything we do to produce the safest product we can.”

That was essentially the prelude for FDA publishing its 1998 Guidance for Industry: Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables. We had already started down the same path, and took those guidelines, as well as others, and created an on-farm food safety program for all 220 growers producing tomatoes and cucumbers under the Ontario Greenhouse Vegetable Growers banner. And set up a credible verification system.

In Aug. 2011, Oregon health officials confirmed that deer droppings caused an E. coli O157:H7 outbreak traced to strawberries that sickened 14 people and killed one. William Keene, senior epidemiologist with Oregon Public Health, said the outbreak strain turned up in samples from fields in three separate locations.

So, in the same way spinach, lettuce and tomato growers have reinvented their food safety pasts, commissions representing berry growers in Oregon, Washington and California have banded together to promote good food safety practices.

The efforts begin this spring with education and training of growers and farm workers on proper handling of fresh fruit, according to a news release.

The best producers or manufacturers can do is diligently manage and mitigate risks and be able to prove such diligence in the court of public opinion; and they’ll do it before the next outbreak.

2010 E. coli O26 outbreak in Oregon childcare center resulted in no severe illness

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 In the first known outbreak of Escherichia coli O26 in a U.S. child care center, neither severe illness nor a secondary household transmission was reported, according to results presented during the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy.

Data on duration of Shiga-toxin-producing E. coli serotype O26 shedding are limited, but shedding can be prolonged. However, the need for separation of infected children who have this apparently low-virulence infection remains uncertain, according to Mathieu Tourdjman, MD, MPH, CDC Epidemic Intelligence Service Officer with the Oregon Health Authority.

“The study raised more questions than it answered,” Tourdjman said during his presentation. “Child care exclusion policies vary across country. Most frequently, the policy states that children infected with O157 should be excluded until at least two consecutive stool samples are negative. Because limited data on O26 are available for O26 infection, no consensus exists on whether similar exclusion should occur.”

The outbreak of E. coli O26 occurred in an Oregon child care center in October 2010. Children who attended the child care facility were aged in range from 6 weeks to 12 years. They were separated by age into six different classrooms.

According to Tourdjman, infected staff and parents of infected children provided demographic and clinical information. Secondary transmission to household members was assessed by screening stool specimens for Shiga toxin using PCR. Positive isolates were isolated and serotyped. Cases in this particular outbreak were defined as laboratory-confirmed O26 infection among attendees or staff during October 2010.

Results of the study revealed a total of 10 cases of E. coli O26: nine children (median age: 1 year) and one staff member. Patients were in three different classrooms and not clustered. Four patients reported diarrhea, including one with bloody diarrhea, but none of the patients progressed to hemolytic uremic syndrome or required hospitalization.

The findings of the investigation also revealed that duration of shedding ranged from 12 to 46 days (median 25 days), and a lack of secondary transmission to household members.

Tourdjman M. #L1-389. Duration of Shedding and Secondary Transmission of Shiga-Toxin-Producing Escherichia coli O26 During an Outbreak in a Child Care Center:: Oregon, October 2010. Presented at: 51st ICAAC. Sept. 17-20, 2011. Chicago.

More food safety types voice concern about Del Monte’s ‘embarrassing and spurious’ lawsuit

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“I would be the first one to defend any company if the data were incomplete or if the investigation didn’t show an association, but this one almost reminds me of the intimidation lawsuits the tobacco industry has used in the past.”

That’s what Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told Doug Ohlemeier of The Packer regarding Del Monte’s lawsuit targeting Oregon’s top food safety scientist, William Keene.

Michael Doyle, a former Food and Drug Administration advisor who heads the Center for Food Safety at the University of Georgia, said he fears such lawsuits could limit effectiveness of public health messages to consumers.

“One of the most difficult points that epidemiologists have to make is the call as to whether a specific food is a vehicle for an outbreak. If they do this later than sooner, more people could be exposed to the implicated food and made ill. There needs to be a balance because some epidemiologists may be overly aggressive with insufficient information or pulling the trigger too fast. This lawsuit could do more harm than good but it might make epidemiologists more cognizant of the fact that they’re responsible for not only public health, but economic consequences.”

Dennis Christou, Fresh Del Monte’s vice president of marketing, said the suit is necessary to ensure investigations are conducted properly.

“When a product recall is later determined baseless due to a failure to conduct a comprehensive and reliable investigation, the public health is not protected. The investigation must be comprehensive and reliable such that the public can be reasonable confident that the product recall effectively eliminates the threat to consumer safety.”

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

Will Del Monte’s lawsuit against Oregon health succeed in setting poisonous tone for outbreak investigations?

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Del Monte Fresh Produce, a company that recalled its cantaloupes in March after health investigators in several states linked them to a Salmonella Panama outbreak, said yesterday that is plans to sue Oregon Health Authority and, Dr William Keene, one of the nation’s most well-known disease outbreak investigators (right, exactly as shown), claiming that the company’s products were wrongly singled out.

Lisa Schnirring of CIDRAP news at the University of Minnesota interviewed several public health types, who say the company’s suit is unprecedented, and some worry that it may inhibit future foodborne illness investigations.

Lon Kightlinger, MPH, PhD, state epidemiologist with the South Dakota Department of Health, said some of his department’s disease investigations have involved legal tug-of-wars. "Although we do have some worries of legal threats, that does not drive our investigation, but causes us to do a better job," he said.

In Iowa, laws require public health officials to treat the names of entities such as restaurants or companies the same as people, said Patricia Quinlisk, MD, MPH, medical director and state epidemiologist for the Iowa Department of Public Health.

She said that, before going public with names, health officials must discuss the issue with the state attorney general’s office to make sure the action complies with a "necessary for public health" clause. "Thus something like this might have more scrutiny here than other places," she said, adding that she’s never seen a legal threat like Del Monte’s.

Tim Jones, MD, MPH, state epidemiologist for the Tennessee Department of Health, said he’s been bullied and subjected to implied threats in the course of epidemiologic investigations. "I’ve never taken them seriously, and legally I’ve never been worried," he said.

Though Del Monte’s legal threat could create an inhibitory effect, epidemiologists take pride in being able to respond to outbreaks faster and freer than federal agencies, which are often bound by legal restrictions, Jones said.

"Our job is to protect people."

Some measure of immunity is needed for investigators, Jones said. "If anyone in public health is nervous about getting sued, it could be dangerously inhibitory."

It really was Bambi: deer dropping linked to E. coli O157 outbreak on strawberries in Oregon; 1 dead 14 sick

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Oregon health officials confirmed today that deer droppings caused an E. coli outbreak traced to strawberries.

Scientists picked up environmental samples from fields at Jaquith Strawberry Farm in rural Washington County and 10 tested positive for E. coli O157:H7. Of those, six matched the strain that sickened 15 people in Oregon, including one woman who died. The other four were separate strains of E. coli O157:H7.

William Keene, senior epidemiologist with Oregon Public Health, said the outbreak strain turned up in samples from fields in three separate locations.

“It could be one deer that conceivably traveled from one field to another,” Keene said. But he said the positive tests probably indicate that several or perhaps many of the deer around Jaquith’s property carry O157:H7.

But they don’t know for sure because they’ve not done much testing.

A total of seven people were hospitalized in the outbreak and three suffered kidney failure, Keene said.

Blame Bambi: E. coli found in deer droppings in Oregon strawberry patch linked to outbreak; 14 sick, 1 dead

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William Keene, senior epidemiologist with Oregon Public Health, told Lynne Terry of The Oregonian that 10 percent of the samples collected over the weekend from Jaquith Strawberry Farm tested positive for E. coli O157:H7.

Those samples included deer feces, which he initially suspected caused the outbreak. Now it seems certain they were the culprit.

"We’re increasingly confident that we will be able to prove beyond any reasonable doubt that deer were the source of contamination of the strawberries," Keene said.

"It could be there but in such low quantities that you have to collect thousands of samples," he said. "We don’t have the resources to pay for that kind of testing."
Now the lab has to confirm whether the specific strain of the bacteria in the samples matches the strain that sickened the 15 people. Two suffered kidney failure, including an elderly woman in Washington County who died. Two patients are still in the hospital.

That study, published in 1997, marked a big breakthrough. Until then the bacteria had been found in other animals, including horses, dogs and sheep, but scientists had always thought that cattle were responsible for poisoning food with E. coli O157:H7. Keene’s study showed that three samples of deer pellets out of 32 were positive for the bacteria.

Did deer poop kill one and sicken 15 with E. coli O157:H7 in Oregon strawberries?

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My friend Farmer Jeff e-mailed me this morning. He’s not doing so well, but still has fire in his belly and the Oregon strawberry outbreak prompted him to write.

Jeff was a pioneer in fruit and vegetable growing in southern Ontario. I’m sure he got a chuckle when he heard that Monsanto announced last week it was going to start selling a consumer-oriented herbicide-tolerant Bt sweet corn. Jeff was growing, labeling and selling Syngenta’s Bt sweet corn over a decade ago (that’s Jeff, in the white T-shirt and banana pants doing what he loves — talking farming).

But Jeff always had a receptive ear for my microbial food safety rants and he always tried to fit my theories into the practicalities of farm life: especially strawberries.

Jaquith Strawberry Farm in rural Washington County, Oregon is a 35-acre strawberry producer, has been identified as the source of an E. coli O157:H7 that has killed one and sickened 15; four people went to the hospital, including two people who suffered kidney failure.

The farm sold potentially tainted fresh strawberries to buyers who in turn distributed them to roadside stands and farmers markets in Multnomah, Washington, Clackamas, Yamhill and Clatsop counties.

The last of the berries were sold Aug. 1, but health officials are worried that consumers might have stored some of them in the freezer or turned them into uncooked jam.

Anyone who bought strawberries from a stand north of Marion County and as far east as Clackamas County should throw them out. They were sold in unmarked containers without labels.

According to reports in The Oregonian, once it became apparent an outbreak was emerging, epidemiologists kicked into high gear, grilling patients on what they had eaten and where to find a common link. Many said they bought strawberries from a roadside stand.

Next, epidemiologists drove to homes to collect berries from freezers for testing. They quizzed roadside stands where patients had shopped. Those questions turned up Jaquith Strawberry Farm as the likely source of the contamination.

William Keene, senior epidemiologist with Oregon Public Health, suspects the source might be deer he saw roaming through the fields. Scientists took more than 100 soil and other samples from the farm this weekend and sent them to a lab outside Seattle for testing, hoping to confirm the source of E. coli O157:H7.

In the scramble to unravel an E. coli outbreak traced to strawberries, Oregon food safety experts have spent days poring over sales information.

Jaquith Strawberry Farm provided hand-written lists of buyers, sometimes first names only, to food safety specialists. Officials then worked the phones, calling all the people on the list. But the calls didn’t stop there. What they discovered is that the berries sometimes changed hands, traveling from buyer to farmers markets and then to consumers.

And sometimes farmers bought the berries and resold them as their own crop, a practice that is illegal.

"Apparently, it is more common than we thought," said Vance Bybee, head of food safety at Oregon Department of Agriculture.

Deer, like other ruminants, are the natural reservoirs for shiga-toxin producing E. coli like O157:H7 (that’s right, Food Inc. fans, it’s not just feedlot cattle). Deer were the suspected source in the 1996 E. coli O157:H7 in unpasteurized Odwalla juice that sickened 76 and killed a 16-month-old. Deer meat has also been involved in at least two recognized E. coli outbreaks.

My friend Jeff says the pickers should have noticed the deer poop, or at least been aware, and as another farmer friend would suggest, “shoot the f***ers.”

Jeff says agriculture is going backwards.

A table of strawberry-related outbreaks is available at http://bites.ksu.edu/strawberries-related-outbreaks. The overwhelming majority of these outbreaks are related to handling, not growing. But, stuff happens.
 

One dead, 10 sick from E. coli O157:H7 traced to Oregon strawberry farm

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Oregon Public Health officials have identified fresh strawberries from a Newberg, Oregon, farm as the source of a cluster of Escherichia coli O157:H7 infections that sickened at least 10 people last month, including one person who died.

The strawberries were produced last month by Jaquith Strawberry Farm located at 23135 SW Jaquith Road in Newberg. Jaquith finished its strawberry season in late July, and its strawberries are no longer on the market. Jaquith sold its strawberries to buyers who then resold them at roadside stands and farmers’ markets.

Health officials are urging consumers who may have purchased strawberries grown on this farm to throw them out.

Strawberries that have been frozen or made into uncooked jam are of particular concern. Cooking kills E. coli O157:H7 bacteria.

"If you have any strawberries from this producer – frozen, in uncooked jam or any uncooked form – throw them out," says Paul Cieslak, M.D., from Oregon Public Health Division. He says people who have eaten the strawberries, but remain well need take no action. The incubation period for E. coli O157:H7 is typically two to seven days.

Ten people have confirmed an E. coli O157:H7 infection caused by a single strain. These individuals include residents of Washington, Clatsop, and Multnomah counties. Six other people in northwest Oregon also have recently developed an E. coli O157:H7 infection and appear to be part of this outbreak.

Of the confirmed cases, four have been hospitalized, and one elderly woman in Washington County died from kidney failure associated with E. coli O157:H7 infection. There were 12 females and four males among the cases, and their ages ranged from 4 to 85. They fell ill between July 10 and July 29.