Tag Archives: Pregnant

Canada issues new listeria policy; not sure what changes

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My fingerprints arrived in Ottawa (that’s in Canada) about a month ago for a travel-related security check. I know this because they signed when they received the package by courier.

I checked on the status of the paperwork a week ago and was told, in doublespeak, by writing,

“Given the information sent, the application has not reached our system at this time. Due to our quality control process, this does not mean that they are not in the building.”

Maybe all Canadian government-types go to the same communication classes, because a couple of days ago, Health Canada issued a press release about updates to its listeria control policy.

Health Canada has completed its update of the 2004 policy on Listeria monocytogenes in Ready-to-Eat (RTE) foods, in view of enhancing the control of Listeria in high-risk foods. The purpose of this policy is to provide guidance to stakeholders regarding verification and control, as well as regulatory oversight and compliance activities of RTE foods with respect to their potential to support the growth of Listeria monocytogenes.

The Canadian "Policy on Listeria monocytogenes in ready-to-eat foods" (hereafter referred to as the Listeria policy) is based on Good Manufacturing Practices1 (GMPs) and the principles of HACCP (Hazard Analysis Critical Control Point). This policy was developed using a health risk assessment (HRA) approach and uses as its foundation a combination of inspection, environmental sampling and end-product testing to verify control of Listeria monocytogenes in ready-to-eat (RTE) foods. Focus is given to environmental verification and control, especially in post-lethality areas, as applicable. This policy applies to RTE food sold in Canada, produced both domestically and imported. The present policy revises and replaces the Policy on Listeria monocytogenes in ready-to-eat foods dated October 4, 2004.

How this will mean fewer sick and dead people, like the 23 who died in the 2008 Maple Leaf listeria mess, is not addressed. However the Health Canada types did say, “There is an increased focus on outreach with the federal/provincial/territorial community to increase awareness of the risks of foodborne listeriosis and to provide guidance on how to reduce the risks of acquiring listeriosis to personnel in institutions where high-risk people may be exposed.”

How this outreach will be conducted and evaluated is not discussed. No mention of labels or public availability of testing data. But read it yourself and decide.

But when I tried to read the original I had to submit a request, and received the following:

“Thank you for contacting Health Canada. Your message has been received. We will get back to you as soon as possible.”

The document eventually arrived.
 

Language a ‘risk factor’ for listeria in Australia

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Focusing on the language needs of expectant mothers and enhancing food safety in hospitals could reduce cases of foodborne illness caused by listeria.

Australian researchers report in the current Epidemiology and Infection that of 136 cases of listeriosis in Australia between Nov. 2001 and Dec. 2004, 40 per cent of cases with prior hospitalization were exposed to high-risk foods during hospitalization; consumption of camembert cheese was an additional risk factor.

Of the 19 perinatal cases — defined as illness in a pregnant woman, fetal loss, or illness in a baby aged less than 3 months with isolation of L. monocytogenes from at least one of the maternofetal pair — living in a household where a language other than English (LOTE) was spoken was the primary risk factor associated with listeriosis.

The numbers are small, but the researchers have identified a persistent problem – providing information is nice, but what if the target can’t read or understand (in this case) English?

“The Food Standards Australia and New Zealand (FSANZ) website only provides a brochure on listeriosis and food in English. Languages used in State and Territory brochures vary widely with some only including English while others provide up to 14 languages other than English.

“This study identified that listeriosis prevention messages need to be disseminated in multiple languages and primary-care practitioners should ensure that patients from households speaking a LOTE receive counselling on listeriosis prevention.”

Which sounds nice, but since hospitals are serving high-risk foods to others at risk, maybe the medical community is a limited source of information. And just because a brochure is in another language doesn’t mean anyone will read it or act upon the information. That requires far more rigorous evaluation in terms of information needs, delivery, messages and accuracy. The morons at Toronto Sick Kids hospital told moms-to-be that cold-cuts and raw fish were OK (they’re not).

As the authors conclude,

“The effectiveness of the implementation of the new food safety programs for food service to vulnerable persons should be carefully evaluated to ensure optimal protection of this group.”

A national case-control study of risk factors for listeriosis in Australia
30.apr.10
Epidemiology and Infection (2011), 139: 437-445
C.B. Dalton, T.D. Merritt, L.E. Unicomb, M.D. Kirk, R.J. Stafford, K. Lalor and the OzFoodNet Working Group
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8013904
Abstract
Listeriosis is a foodborne disease associated with significant mortality. This study attempts to identify risk factors for sporadic listeriosis in Australia. Information on underlying illnesses was obtained from cases’ treating doctors and other risk factors were elicited from the patient or a surrogate. We attempted to recruit two controls per case matched on age and primary underlying immune condition. Between November 2001 and December 2004 we recruited 136 cases and 97 controls. Of perinatal cases, living in a household where a language other than English was spoken was the main risk factor associated with listeriosis (OR 11·3, 95% CI 1·5–undefined). Of non-perinatal cases we identified the following risk factors for listeriosis: prior hospitalization (OR 4·3, 95% CI 1·0–18·3), use of gastric acid inhibitors (OR 9·4, 95% CI 2·4–37·4), and consumption of camembert (OR 4·7, 95% CI 1·1–20·6). Forty percent of cases with prior hospitalization were exposed to high-risk foods during hospitalization.
 

Bureaucrats babbling: Health Canada blames consumers

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Health Canada said today while telling pregnant women to be especially careful about the 11 million cases of foodborne illness that strike Canadians each year that,

“Many of these illnesses could be prevented by following proper food handling and preparation techniques.”

Please, please, oh please. Show us mortals the data on which that statement is based?

And since Health Canada advises pregnant women to “make sure to cook hot dogs and deli meats until they are steaming hot before eating them,” please, please, oh please, stand up and say the advice provided by the Toronto Hospital for Sick Children Motherrisk program is complete nonsense.
 

Pregnancy optional foods – Australian style

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There are morons dispensing advice at Toronto’s Hospital for Sick Kids. I have no idea why they get paid to tell pregnant women, “it is no longer necessary for pregnant women to avoid foods like deli meats and soft cheeses soft-cooked eggs or sushi and sashimi.”

I have no idea how this advice got approved and published. How is it that the authors, Carolyn Tam, a graduate student in clinical pharmacology at the University of Toronto, Aida Erebara MD, and Adrienne Einarson RN, assistant director of the Motherisk Program could come up with such terrible food safety advice from the 25-year-old Motherisk program which is designed “to ensure the well-being of mothers and babies, worldwide.”

And they want donations.

Jane Calvert, a formerly pregnant journalist in Melbourne, Australia, who recently gave birth to a healthy daughter, is much more incisive and intelligent than the tax-supported staff at Toronto’s Sick Kid’s.

Calvert asks in The Age today, at what point did fine dining become more tolerant of gluten intolerants than it did of pregnant women? Go to any decent digs and you’re sure to see dishes containing substances that affect celiacs clearly marked. But asking what meals could potentially kill your unborn child seems a much greater imposition.

She suggests a Three Point Pregnancy Policy

1. Label your pregnancy-safe dishes. Remember there are almost three months during which pregnant women may not be able to ask questions, for fear of revealing their status.

2. Ensure your staff are educated, ready and able to answer questions about potential risks and can do it in a way that’s not condescending.

3. Provide a menu with choice. Try to make sure there are at least three safe pregnancy options that don’t involve having to murder a meat dish that really should be served rare.

All good points. The folks at Toronto Sick Kid’s hospital should either provide references for their recommendations or retract the article. Or just go away. It’s embarrassing.

Really big nosestretcher alert: leading Toronto hospital says cold cuts, raw fish, OK for expectant mothers

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Erin Stadler was at her baby shower in North Carolina in 1997 when she at a piece of brie cheese that was contaminated with listeria. The disease made Stadler and her unborn child deathly ill.

"You don’t think about eating one piece of cheese and almost dying. That’s basically, what happened for both of us," said Stadler.

When Stadler went to the hospital, doctors immediately delivered baby Allison. She was premature at 33 weeks. Allison was in the hospital for two more weeks for additional tests when doctors realized how ill both Erin and Allison were.

Two pregnant women on Virgin Blue Australian flights last year gave birth prematurely after being served listeria-laden chicken wraps.

In the fall of 2008, along with the Maple Leaf listeria-in-deli-meat mess, an outbreak of listeria in cheese in Quebec led to 38 hospitalizations, of which 13 were pregnant and gave birth prematurely. Two adults died and there were 13 perinatal deaths.

A Sept. 2008 report showed that of the 78 residents of the Canadian province of British Columbia who contracted listeriosis in the past six years, 10 per cent were pregnant women whose infections put them at high risk of miscarriage or stillbirth.

The majority — nearly 60 per cent — of pregnant women diagnosed with listeriosis either miscarry or have stillbirths.

The authors wrote,

"Health care providers [want] better information for themselves and resources they could share with pregnant women. … The information provided to pregnant women by health care providers needs to be targeted and clear," and that as a result of the spring survey, BCCDC will start a project to better inform health care providers and their patients about food safety risks during pregnancy.

The U.S. Centers for Disease Control and Prevention (CDC) has estimated approximately 2,500 cases of liisteriosis occur annually in the United States, with about 500 cases resulting in death. In 2000, listeria exposure resulted in a higher rate of hospitalization than any other foodborne pathogen and more than one-third of reported deaths from food pathogens.

CDC has a list of foods to avoid while pregnant: deli meats or cold-cuts top the list. Health Canada has similar advice.

Which makes a report in the April 2010 edition of the journal, Canadian Family Physician, absolutely baffling.

Worse, the report was authored by the Motherisk team at the previously reputable Toronto Hospital for Sick Children.

The authors state, correctly, that the incidence of listeria “among pregnant women remains about 20 times higher compared with the general population,” but go on to state, without any references, that “pregnant women need not avoid soft-ripened cheeses or deli meats, so long as they are consumed in moderation and obtained from reputable stores.”

Here is the actual Q&A as printed in the article:

QUESTION After hearing about outbreaks of illness resulting from Listeria and Salmonella, many of my patients are wondering about the risks of food-borne illnesses during pregnancy and what they can do to reduce their chances of contracting them.

ANSWER Although heating or cooking food is the best way to inactivate food-borne pathogens, improved standards and surveillance have reduced the prevalence of contaminated foods at grocery stores. Therefore, it is no longer necessary for pregnant women to avoid foods like deli meats and soft cheeses (associated with Listeria); soft-cooked eggs (associated with Salmonella); or sushi and sashimi. Regardless of whether seafood is raw or cooked, pregnant women should choose low mercury seafood (eg, salmon and shrimp) over higher mercury varieties (eg, fresh tuna). Pregnant women should ensure that their food is obtained from reputable establishments; stored, handled, and cooked properly; and consumed within a couple of days of purchasing.

I have no idea what the authors mean by a reputable source. I have no idea how this advice got approved and published. How is it that the authors, Carolyn Tam, a graduate student in clinical pharmacology at the University of Toronto, Aida Erebara MD, and Adrienne Einarson RN, assistant director of the Motherisk Program could come up with such terrible food safety advice from the 25-year-old Motherisk program which is designed “to ensure the well-being of mothers and babies, worldwide.”

And they want donations.

Someone has already sent the editor a letter of protest.

Thanks to the barfblog.com reader who sent me the link.

Maple Leaf makes lemon-scented food safety pledge

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Maple Leaf Foods, the folks who made deli-meats that killed 23 Canadians in 2008, issued a public food safety pledge yesterday.

Fearless and empathetic leader Michael McCain, speaking on behalf of the 23,500 employees of Maple Leaf Foods, said

“We have spent the last 18 months seeking the advice of the best experts in the world (and in many cases hiring them), examined every one of our previous practices, made significant improvements in all areas of food safety – testing, training and sanitization – and worked with industry and government to raise the bar.”

Maybe. But you’ve retained the worst public relations advisors and it’s going to take a lot of lemons to cleanse the stench on this pledge. Below are all the components of the frat-boy type pledge (thank you sir, may I have another) exactly as it appeared, even though it’s far too wordy, with some editorial comments from me.

*We commit to becoming a global leader in food safety. Our Chief Food Safety Officer will lead the implementation of best practices in sanitation, testing, technologies, product formulations and manufacturing, and has the authority to stop production at any plant where he believes there may be a risk to food safety.”

Awesome. Will those test results be made public?

*We commit to building a strong culture of food safety, with high performance teams, through continuous training, education and communicating results. Our people are encouraged and expected to act on any food safety concern they may have to improve our food safety practices."

Communicating results, like making listeria test results public?

Public availability of food safety testing data underpins efforts to convince a skeptical public that a product is microbiologically safe.

Yes, testing has limitations, just like restaurant inspections, but the goal should be to figure out how best to make that information available – rather than saying people can’t have it or handle it.

On Dec. 31, 2009, Beef Products Inc. took a fairly public hit when the N.Y. Times questioned the efficacy of the company’s use of ammonia as an antimicrobial treatment for ground beef.

BPI founder and chairman Eldon Roth announced in February at the National Meat Association’s annual conference that the company will post on its Web site 100 per cent of its results from the processor’s testing for E. coli O157:H7 and salmonella.

"We’re going to be 100 percent transparent," Roth told Meatingplace in an interview following the announcement. … We’re not promising to be perfect, but I will promise that we will be better.”

That’s how it’s done.

*We commit to following the highest standard of testing and analysis to identify potential risk. Any test that raises food safety concerns will result in immediate quarantine, with no products leaving the plant until the Company (why is this capitalized? Is Maple Leaf its own nation-state? — dp) and government regulatory authorities are confident that the food is safe."

Test and hold. Sorta standard.

*We commit to setting and meeting high standards and measuring our performance against the Global Food Safety Initiative standards through independent audits which will also allow us to continuously improve."

Rather than relying on some auditor waltzing through the plant now and then, why not be able to prove how ab fab Maple Leaf is at this food safety thing. Borrow a page from Cargill (and activists around the world) and install your own video cameras to have data to support food safety pledges.

In April 2009, Cargill Beef announced it had implemented a third-party video-auditing system that would operate 24 hours a day at its U.S. beef plants to enhance the company’s animal welfare protection systems. All of Cargill’s U.S. plants were expected to have the program in place by the end of 2009.

In Feb. 2010, Cargill announced its expanded remote video auditing program will monitor food-safety procedures within its 10 beef-harvest facilities in North America.

Mike Siemens, Cargill leader of animal welfare and husbandry, said,

“The early results with our animal welfare program have been terrific and we’re excited to get all the facilities up-and-running on the program. Cargill has been able to use the RVA technology to help increase an already superior compliance rate at its plants to an even higher level. In addition to the positive results on compliance rates, we have observed healthy competition among plants on performance scores, as well as a general theme of collaboration among plants on how to attack specific operational challenges. The ability to share data and video easily is extremely valuable.”

Angie Siemens, Cargill technical services vice president for food safety and quality, said,

“We’re working to eliminate the opportunity for cross-contamination. We want to have the right steps at the beginning of our process to enhance the efficacy of our intervention technologies later in the process. The major objective of the video auditing application is to design a ground-breaking program that can further reduce the E. coli and Salmonella contamination.”

*We commit to openly sharing our knowledge with industry, government and consumers, so we can learn from them and they can learn from us, in pursuit of better food safety at every step of preparation."

Your knowledge isn’t required. Data would be more meaningful. So would warning labels of some sort, especially for at-risk populations. Florida-based supermarket Publix places all of its deli-cut meats into a plastic bag that says:??

“The Publix Deli is committed to the highest quality fresh cold cuts & cheeses.
Therefore we recommend all cold cuts are best if used within three days of purchase.
And all cheese items are best if used within four days of purchase.”

*We commit to placing public interest and consumers first, by behaving in the most responsible and transparent way possible if there is ever a breach in our food safety system.”

Is that why Maple Leaf and the Canadian Food Inspection Agency set aside epidemiology and waited for confirmatory testing in an unopened package before issuing any public warning, even though local health units had already established a link with Maple Leaf products?

Maple Leaf seems to be suffering from a common affliction that strikes many institutions in decline – they believe their own PR. Actions speak so much louder than words. From the beginning in Aug. 2008, Maple Leaf should have:

• come clean on who knew what when regarding listeria testing;

• made listeria test results public;

• provided warning labels on deli meats for at-risk populations, like pregnant women and all those old people that unnecessarily died; and,

• marketed food safety efforts at retail so consumers can choose.

How long is that deli meat in the window good for? Listeria version

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Listeria is a problem. And it’s not going away.

That stood out for me in the 2009 FoodNet data, providing a snapshot of foodborne barf across the U.S.

I told Elizabeth Weise in today’s The USA Today that the 19 per cent annual increase in listeriosis is in part due to the length of time people keep deli meats in refrigerators.

"Sliced deli meat is only good for two to three days." Listeria is particularly dangerous to pregnant women, young children and the elderly. It’s "a huge problem. Thirty percent of the people who get it die.

The U.S. Department of Agriculture is working on a risk assessment of deli meats, says David Goldman of the USDA’s Food Safety Inspection Service.

Those risk assessments have been around since at least 2000.

Several papers published in the latest issue of the Journal of Food Protection show that deli meats sliced – fresh – at the counter are more dangerous than the stuff bought in packages.

Endrikat, et al. note that deli meat was ranked as the highest-risk ready-to-eat food vehicle of Listeria monocytogenes within the 2003 U.S. Food and Drug Administration and U.S. Department of Agriculture, Food Safety and Inspection Service risk assessment (see, those risk assessments have been done).

“A sensitivity analysis, assessing the effect of the model’s consumer storage time and shelf life assumptions, found that even if retail-sliced deli meats were stored for a quarter of the time prepackaged deli meats were stored, retail-sliced product is 1.7 times more likely to result in death from listeriosis.”

The stuff people buy in packages is safer, because of the antimicrobials approved for use in the U.S. and because those slicers are really hard to clean.

I like that the Publix supermarket chain labels their deli meats to inform consumers that the stuff doesn’t last forever.

“The Publix Deli is committed to the highest quality fresh cold cuts & cheeses?. Therefore we recommend all cold cuts are best if used within three days of purchase?. And all cheese items are best if used within four days of purchase.”

The provision of such information did not require Congressional hearings and did not require some hopelessly-flawed consumer education campaign; it required a food safety type to say, this is important, let’s do it.

Quebec cheesemakers complain about inspection, want taxpayers to pay for it

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Being married to someone who teaches French can be useful when I run across a story that has listeria and fromage in it, but can’t make out anything else. Amy thought it was of interest so assigned it to her translation class.

In fall 2008, there was a couple of outbreaks of listeria in cheese in Quebec that led to 38 hospitalizations, of which 13 were pregnant and gave birth prematurely. Two adults died and there were 13 perinatal deaths.?

The Quebec government cracked down, especially on makers of cheese from raw milk.

Last week, Le Soleil reported the Quebec Ministry of Agriculture, Fisheries and Food (MAPAQ) is ready to take on the costs of analysis of all artisanal cheeses for one more year in order to ensure they contain no pathogens.

The screening and prevention project was put in place for one year in October 2008 at the end of the listeria crisis. Every month, MAPAQ inspectors visited cheesemakers in order to detect the Listeria monocytogenes, E. coli, Salmonella, and Staphyloccocus aureus. The goal is to reassure consumers of the quality of Québécois cheeses and to guide cheesemakers towards self-testing. The bill was estimated at $1 million.

The artisanal cheesemakers have denounced the omnipresence of inspectors in their premises since the beginning of the listeria crisis, judging that inspectors don’t know their reality and are proving to be excessively zealous.

NC mom wants tougher food regulations after listeria in cheese caused illness

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Erin Stadler was at her baby shower when she at a piece of brie cheese that was contaminated with Listeria. The disease made Stadler and her unborn child deathly ill.

"You don’t think about eating one piece of cheese and almost dying. That’s basically, what happened for both of us," said Stadler.

The disease came as a surprise to Stadler in 1997 because up until her baby shower, she had a normal, healthy pregnancy. However, shortly after the party, she began to feel the symptoms of the disease.

When Stadler went to the hospital, doctors immediately delivered baby Allison. She was premature at 33 weeks and weighed just 4 pounds, 33 ounces. Allison was in the hospital for two more weeks for additional tests when doctors realized how ill both Erin and Allison were.

Stadler will be traveling to Washington D.C. next week to talk with senators about passing tougher food regulations. Allison, now a healthy 13-years-old girl will travel to Washington with her mom to discuss a proposed bill called S-510.

Mothers, babies in Oregon infected with listeria from Mexican-style cheese

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This is why listeria matters, especially to pregnant women and others who may be immunocompromised.

Two Oregon mothers have been sickened by listeria after eating tainted Mexican-style cheese made in Yakima, causing their babies to be born with a serious illness.

Another person got sick as well in Washington state after eating Queso Fresco made by Queseria Bendita in Yakima. The firm’s three cheeses, including Requeson and Panela, are being recalled.

William Keene, senior epidemiologist with the Public Health Division, said,

“All of these people were hospitalized. No one has died but with five people we’re lucky. … Queso fresco is a recurrent source of problems because it’s made with raw milk and often under poor conditions.”