Tag Archives: Pregnant

Impact of listeria on infants in B.C. documented

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A new report shows 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.

In a case described in the current B.C. Medical Journal, a pregnant woman in her 30s went to a Lower Mainland hospital complaining of a stiff neck, fever, back pain and headache. After arriving, she delivered a stillborn baby at 21 weeks gestation.

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.

It’s a national embarrassment that statistics on listeriosis in Canada are either not available or hopelessly unreliable. Further, the call to action probably never would have gotten noticed were it not for the 24 deaths and dozens of illnesses in the Maple Leaf listeria outbreak. Pregnant women and other at-risk populations deserve better.
 

Maple Leaf listeria plant to re-open, creates new food safety position, questions remain

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Three weeks after the Maple Leaf financial dude told the markets the plant would reopen, the Maple Leaf listeria plant is about to reopen and produce deli-meats.

The company has videos, a long list of food safety enhancements they are adopting, and has created the position of ‘chief food safety officer.’

Guess I thought a $5 billion a year company would already have one of those. But that’s one of the things I find most challenging – how to compel everyone from maintenance crews to CEOs that food safety matters, especially in the absence of an outbreak. Now there’s an outbreak, 24 suspected or confirmed dead, 56 ill.

"Throughout this incident we have steadfastly placed consumers’ interests first" said Michael McCain, president and CEO of Maple Leaf Foods.

That remains to be seen as more is uncovered about why there were delays and lousy notification as news of the outbreak initially trickled out. But yes, once the problem became publicly apparent, the company acted in great fashion.

The Canadian Medical Association Journal yesterday called for a full public inquiry. Not necessary, and a waste of taxpayers money. A few Bill Marler lawsuits would reveal far more about who knew what when.

Or people could do their jobs:

• Maple Leaf in conjunction with the various public authorities should provide a full public accounting of who knew what when and what was done to find out more;

• some sort of warning system about the risk of listeriosis in foods must be developed for at-risk populations – especially pregnant women and the elderly because they are the ones who get sick and die; and,

• make all data of listeria testing in plants public so others in the industry can improve and consumer confidence can be enhanced with data not just words.

Pregnant woman miscarries because of listeria in Quebec cheese

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Public health officials in Quebec say a pregnant woman in the province has lost her baby, possibly because of listeriosis.

Officials are still awaiting test results to confirm whether the woman who lost her baby was infected with the bacteria, said Dr. Horatio Arruda, Quebec’s director of public health protection.

She didn’t lose the baby. It’s not like she misplaced the baby somewhere. The baby died because of listeria. Pregnant women should not eat a whole bunch of refrigerated ready-to-eat foods, but in the rush to promote raw milk cheese and food porn, those in charge forgot to remind those who are vulnerable of the risks.

Max Dubois, the owner of L’Échoppe des Fromages in St. Lambert, wants to know who will compensate him for the $40,000 worth of cheese inspectors seized and destroyed from his store on Saturday.

"Why could they not have organized a voluntary recall, as they do in France. Each cheese would have been sent away for analysis. We would have better been able to trace the spread of the bacteria. But now all the evidence has been destroyed. We’ll never know if it was spread through a distributor, or on the paper it was wrapped in, or in some other way."

Uh, France is no better. Here is the latest French cheese recall due to listeria.

Microbiologist Jacques Goulet, a cheese specialist in the food science department at Université Laval, says he, too, believes the government over-reacted.

"Listeria is present everywhere. But for most people, the risk posed by listeriosis is very low. Healthy people are rarely affected by the bacteria," he said, noting that the annual average of listeriosis cases in Quebec is about 50. (The public health department reported 63 cases in 2007 and 49 in 2006.).

Way to cite statistics. The people who got sick are real people who thought they were eating safe food.
 

Listeria in cheese from Toronto shop sickened pregnant woman

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On Aug. 29, 2008, Ping Chiu, owner of Cheese Magic in Kensington Market, had to throw out $1,000 worth of cheese and wasn’t happy about it.

"According to the health inspector, it was listeria. Although I was told by two big cheese suppliers that it can’t be listeria."

It was listeria.

“Health officials confirmed Tuesday that product sold at a popular Kensington Market cheese shop was the source of the listeria bacterium that sickened a pregnant customer.

“Cheese Magic at 182 Baldwin St. was closed down last week after a regular customer fell ill after contracting listeriosis. Health inspectors also claim they found cat and mouse droppings in a food area of the store, mould growth inside a walk-in cooler, and products stored at incorrect temperatures.

“The business has since reopened after inspectors found it had met all safety requirements when they revisited the shop.”

For some bizarre reason, Dr. Barbara Yaffe, an Associate Medical Officer of Health for Toronto Public Health, felt it necessary to downplay the risk of listeria, especially for pregnant women, rather than shout it from the rooftops.

“Keep in mind that the risk from listeriosis is low for healthy individuals. Those most at risk of developing serious illness are pregnant women, the elderly, and those with weak immune systems."

Thanks. My pregnant wife will keep that in mind. So will the pregnant woman who got sick. At some point Canadian health types will have an honest discussion with consumers at risk without worrying if they will offend industry.
 

Seven pregnant women among 14 sickened with listeria from Quebec cheese

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In 2004, I spent a week at a cottage with a couple of my children in Eastern Ontario near Sandbanks Provincial Park on Lake Ontario. Lovely spot.

One rainy day, we toured around and ended up at a cheese shop. They produced the cheese in the factory at the back, and had a charming market outlet that seemed to trap tourists like bees on sap.

Upon entering the store, a sign declared, “HACCP – A food safety program; Hazard Analysis Critical Control Pont.” Cool. I asked one of the staff what it meant. She said she didn’t know.

But beside the HACCP proclamation was a sign that read, “Public bathroom is out of order; for your convenience there is a blue Johnny on the spot behind the building (sic).”

And here it is (left). Note the lack of handwashing facilities or sanitizer. I watched people go to the porta potty and then come into the cheese shop and do what people do at quaint cheese shops: stick their unwashed hands into shared samples of curds (that’s one of my daughters looking disgusted in the middle, right, not because of the practice, but because I have to take pictures and be a food safety geek everywhere we go).

HACCP really doesn’t mean much unless there is a culture of food safety amongst the employees and everyone involved in making a product, like cheese or deli meat.

Best as I can figure, there is a separate outbreak of listeria in Quebec, in which one has died and 14 have been sickened. Eleven different types of cheese have been recalled, and many of them appear to be raw milk cheese, which the Quebec government recently approved for sale.

While merchants are complaining about the crackdown and lost sales, what seems to have been lost in the coverage is that seven pregnant women – four confirmed, three suspected – have developed listeriosis and three gave birth prematurely.

Sylvie Thibault, a customer sampling some of the free cheeses at La Fromagerie Atwater yesterday, said she’s not worried, stating,
 
"I have started to double-check what cheese I buy. But I won’t stop eating the food I love because of a little scare."

Joe Schwarcz, director of McGill University’s Office for Science and Society, said,
 
"We need to put this in perspective," adding it’s important "not to have people think every time they bite into a piece of brie, they’re risking death."

Wow. I wouldn’t want to be pregnant in Quebec. So, Quebec government (Canada has no real authority in Quebec), given the number of pregnant women who have been sickened, any efforts to highlight the risks of listeria in certain foods to at-risk populations? Or is it just a silly little scare?

The recalled products from Fromagerie Medard are: Le Rang des Iles, Le 14 Arpents, Les Petits Vieux, Le Gedeon, Le Medard, Le Couventine, Le Cabrouet and Les Cailles, all with best-before dates between July 12 and Sept. 6. Products pulled off shelves from Fromagerie Table Ronde are: Le Fleurdelyse, Le Fou de Roi and Le Rassembleu with best-before dates after July 14.

Last week, cheeses manufactured by Fromages La Chaudiere were recalled because of salmonella, blamed for the death of an elderly person in the Chaudiere Appalaches region and 90 illnesses across Quebec.
 

Maple Leaf identifies likely source of listeria contamination at plant

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Maple Leaf Foods continues its textbook risk communication, being the first to publicly provide information about the source of the listeria contamination that has killed 19 and sickened dozens.

But is it enough?

“After careful study of the records, the physical plant and product test results received from the Canadian Food Inspection Agency (CFIA), internal and external experts have concluded that the most likely source was a possible collection point for bacteria located deep inside the mechanical operations of two slicing machines on lines 8 and 9. Rigorous sanitization of this equipment was completed on a daily basis in accordance with or exceeding the equipment manufacturer’s recommendations. However, upon full disassembly, areas were found where bacteria may accumulate deep inside the slicing machines and avoid the sanitization process. There were also other environmental factors, not on product contact surfaces, that may have contributed to the contamination.

"We deeply regret this incident and the impact it has had on people’s lives," said Michael McCain, President and CEO. "We have the highest food safety standards and we have worked around the clock and left no stone unturned to identify the root cause and eliminate the source of this contamination. Throughout this crisis we have done whatever it takes to place our consumers’ interests and public health first. It’s now up to us to earn back your confidence."

Concerns with slicing machines are hardly new regarding listeria. The company has taken some good steps, but can do more:

• Release the results of the 3,000 listeria swabs your company takes every year to provide some data, some meaning, to your claims that public health is your top priority?

• Support some kind of point-of-sale initiative – warning labels or otherwise – to explicitly warn pregnant women and immunocomprimized Canadians that, as you say, listeria is so widespread in the environment, that vulnerable people should not eat your products, unless they are heated or some other kill step is employed.

Should deli meats be on the menu for pregnant women and at medical care facilities?

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After four kids, I was familiar with the look.

“How long have you been pregnant,” I asked the thirty-something as we filled our plates during the catered lunch at a meeting in 2000 in Ottawa.

“About six weeks.”

The American media had been filled with coverage of listeria after the 1998-1999 Sara Lee Bil Mar hot dog outbreak in which 80 were sickened, 15 killed and  at least 6 pregnant women had miscarriages. Risk assessments had been conducted, people were talking about warning labels, and especially, the risks to pregnant women.

There was no such public discussion in Canada.

So as I watched the pregnant PhD load up on smoked salmon, cold cuts and soft cheese for lunch, I wondered, do I say something?

One of the biggest risks in pregnancy is protein deficiency. What if smoked salmon, cold cuts and soft cheeses were this woman’s biggest source of protein? (Turns out they were.)

Another big risk factor is stress. I didn’t want to freak her out. Besides, who the hell am I to say anything?

We sat together during lunch and chatted about babies, her aspirations and how she was feeling. Eventually I introduced the subject of listeria by talking about a risk assessment that had recently been published by the U.S. Food and Drug Administration, and that maybe she would be interested in looking at the results. I felt sorta goofy.

Eight years later, I don’t feel so goofy. Instead I’m frustrated at the lack of awareness, not only amongst pregnant women but amongst the elderly, other immunocompromised individuals, and the institutions and professionals that are supposed to look out for others.

Most of the now 12 confirmed and 6 suspected deaths related to Maple Leaf deli meats were consumed in places like nursing homes.

The Ontario Association of Non-Profit Homes and Services for Seniors, an umbrella group, was unaware of the recommendation that immunocompromised avoid deli meats to reduce the risk of listeria, unless they are thoroughly heated.

Association executive director Donna Rubin said,

"We’ve contacted dietitians that have long-standing experience in our homes and they’ve never been warned about listeriosis or deli meats being a huge issue or that they should be avoided.”

An Ontario Health Ministry spokesman said it has no specific policy against serving sliced meats in nursing homes, and Health Canada officials said banning certain foods from seniors homes is not in its jurisdiction. Health Canada has never recommended health facilities stop serving deli meats, noting that hospitals are a provincial responsibility.

In Calgary, two nursing home operators, Carewest and Bethany Care Society, confirmed some of their facilities serve cold meats.

Janice Kennedy, a Bethany spokeswoman, said,

"If public health says not to serve cold cuts to seniors, then we wouldn’t. We’re still meeting requirements."

It all sounds bureaucratic to me, as the death toll increases.

And the pregnant woman? When I saw her at another meeting a couple of months later, she thanked me for providing her with information about listeria and risky foods for pregnant mothers.
 

Botulism, babies and bad advice

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Amy and I don’t really disagree about much. But we can each get moody and self-absorbed and go after each other. Especially at the end of 20-hour drives. That’s about how long it takes to go from Manhattan (Kansas) to Guelph (Ontario) and at the end of one epic journey back from Guelph two years ago, tired and driving through Kansas City with a trailer full of my crap that I just had to have in Kansas, Amy decided to entertain herself by asking me, who are you to publish an opinion, or something like that.

I’ve always thought that academic-types had a responsibility to share their knowledge in a compelling manner with the public, rather than just complain about people’s opinions of things scientific and otherwise. But really, who the hell am I? Why should anyone listen? Or care?

I questioned myself for a couple of months and didn’t do much public stuf. Then I got over it. But I still question myself and try to do my homework.

I’m not so sure about Dr. Dave in the video below.

This is from some mommy television show in Canada that Ben sent me. It’s called, The Mom Show. In the clip below, Dr. Dave, appears to have no clue about botulism in babies less than a year old.

Clostridium botulinum can cause sickness in very young children, and infants under the age of 1 years old are most at risk. Honey may contain Clostridium botulinum spores that can grow in the digestive tract of children less than one-year-old because their digestive system is less acidic. The bacteria produces toxin in the body and can cause severe illness. Even pasteurized honey can contain botulism spores and should be not be given to children under the age of 12 months.

The advice is clear: do not give any honey to children less than one-year-old.

But maybe I don’t know what I’m talking about.

 

Maple Leaf’s McCain has the communication goods; now show us the data

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Maple Leaf president Michael McCain told the media today that,

“I once again wish to express my deepest personal sympathies to those Canadians who have been affected by this tragedy. While this is the most unfortunate of events possible, I absolutely do not believe that this is a failure of the Canadian food safety system or the regulators.

“Certainly knowing that there is a desire to assign blame, I want to reiterate that the buck stops right here.

“As I’ve said before, Maple Leaf Foods is 23,000 people who live in a culture of food safety. We have an unwavering commitment to keep our food safe, and we have excellent systems and processes in place. But this week it’s our best efforts that failed, not the regulators or the Canadian food safety system.”

Good for McCain. He runs a company with world-class aspirations, so he’s not weaseling away from the spotlight.

And he unshackled the company of any political or bureaucratic commentary – which has been fairly hopeless all along.

But if McCain is going to step up, he’s also going to get some questions,

McCain says, “a comprehensive study done at the University of Regina gave Canada one of five superior ratings out of 17 top-tier OECD countries in a world review of food safety. This highlights that Listeria is a particularly challenging bacteria for the entire food industry to manage, including the United States and Europe, simply because it is pervasive."

That study was fairly challenged and has not been published in a peer-reviewed journal. Don’t cite shit.

And you didn’t address any of the tough issues.

Will you release the results of the 3,000 listeria swabs your company takes every year to provide some data, some meaning, to your claims that public health is your top priority?

 Will you back some kind of point-of-sale initiative – warning labels or otherwise – to explicitly warn pregnant women and immunocomprimized Canadians that, as you say, listeria is so widespread in the environment, that vulnerable people should not eat your products.

Michael McCain, you’ve taken some great first steps and gone way beyond what government has done. The sooner you lose them the better; they’re deadweight and not very good hockey players. They don’t lose their jobs, and they don’t lose sleep about falling stock prices. 

Me, Ben, Amy and the rest of our team are here to help you actually implement that culture of food safety you and your folks are so fond of citing. We’ve noticed you liked the pictures of recalled products idea. We’re not just armchair quarterbacks, and we’re just an e-mail away.
 

15 dead in Canadian listeria outbreak; government messages turn from bizarre to banal

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Michael McCain, president and CEO of Maple Leaf Foods, when it comes to the communication and building trust aspects of what must be your listeria nightmare, stay away from government.

Shortly after the first death was announced last Wednesday, Aug. 20, 2008, various politicians and bureaucrats said the surveillance system was working. Robert Clarke, the assistant deputy minister of the Public Health Agency of Canada, said Friday that the government’s actions in this case were quite rapid and an illustration of success.

I’ve been harping ever since that it’s impossible to tell from the various public statements who became sick when, and whether the system really worked or not. If you’re going to brag about how the system is working, you have to provide dates for onset of illness and deaths.

Today I got some company.

Toronto’s Globe and Mail wrote in an editorial that officials claiming surveillance success, “doth self-praise too much, too soon.

“Did the surveillance system work? No independent voice has said so yet, and it is hard to see why Mr. Clement’s or Mr. Clarke’s word should be taken at face value. The two-year-old Public Health Agency, which reports to Mr. Clement, has yet to distinguish itself for independence. And everyone – government health officials and the company involved, Maple Leaf Foods Inc. – considered it enough that the first warning of possible contamination went out to distributors, not the public. For four days, the loop was closed. Whether that was the right or the wrong approach, it does not do much for the public’s confidence in Canada’s food-safety system.”

Columnist Tom Brodbeck of the Winnipeg Sun wrote that,

“Federal Health Minister Tony Clement says the recent tainted meat outbreak that killed six people and caused at least 14 more serious illnesses is a shining example of how well Canada’s food inspection system works.

Pardon? …

“If this is what Clement calls a success story, I’d hate to see what he considers a system failure. … I don’t think six deaths and 14 serious illnesses is anything to be proud of.”

These comments about success are even more bizarre and appalling now that the confirmed and probable death toll has been raised to 15.

So this afternoon, Dr. David Butler-Jones, MD, Chief Public Health Officer (that’s a lot of capitals), who had previously lauded the success of the surveillance system,  wrote in a press release that,

“As Canada’s Chief Public Health Officer, I want to update Canadians on the state of the ongoing listeriosis outbreak.”

He really seems to enjoy that title; and he then proceeded to provide less than no information.

“We are all understandably concerned whenever we hear that something as precious as the food we eat may pose a danger. Years of effort to ensure safe and secure food supplies have allowed us to be confident in what we eat. …

“While not everything is preventable, fortunately there are some simple steps that can be taken to reduce the risk of illness for ourselves and our families. There are the usual things we should always be doing, like washing hands, storing and cooking food properly, washing fruits and vegetables well, and avoiding unpasteurized milk and milk products. …

“Canadians should be confident that the Government of Canada, through the
Public Health Agency of Canada, Health Canada and the Canadian Food
Inspection Agency, is working closely with all provinces, territories, and with Maple Leaf Foods to respond to this outbreak and protect the public’s health.

“We can never be completely immune to the risk of contaminations and outbreaks, even with the best food safety system in the world. That is why we operate surveillance and other systems to identify potential outbreaks and do the detective work that helps us to find the cause and stop further problems. And what we learn from each experience helps us to improve the system further.”

As Napoleon Dynamite sorta  said, “That’s like, the worst thing I’ve ever seen.”

Why should Canadians have any confidence when the public servants at all these agencies with their six-figure salaries can’t provide basic information like who got sick when? How arrogant is it to tell someone they should be confident in an alphabet soup of agencies, in the absence of any data or statements that inspire confidence?

Ben sent me a sports headline regarding the Olympics, which also fits for food safety: Canada remains happily mediocre.

That’s me and Ben, above right, not exactly as pictured.

And here’s me with a clean shirt talking to CBC News.