Tag Archives: Pregnant

Should deli meats carry warning labels?

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Warning labels are a lousy risk management strategy, but the outbreak of listeria in Canada which has killed at least 12 and sickened dozens has had lots of lousy aspects.  So why not?

A story that is running across Canada this morning says,

With pregnant women and the elderly especially at risk from Listeria, the Canadian Food Inspection Agency needs to step up efforts to alert people to the hazard — perhaps going so far as to put warning labels on deli products — said University of Guelph adjunct professor Doug Powell.

What? Guess that was some stretch at Canadian content. I’m an associate professor of food safety at Kansas State University.  If I’m adjunct at Guelph, I want access to all the money that was provided to deliver news and is instead being used as some sort of room renovation fund by a department chair I never met.

The opinion piece that ran in the Toronto Star this morning was more accurate.

Michael McCain delivered a powerful and compelling apology over the weekend as authorities confirmed Maple Leaf deli meats were the likely source of food-borne illness that has killed at least six and sickened dozens.

Outbreaks of food and water-borne illness are far too common. The World Health Organization estimates that up to 30 per cent of people in so-called developed countries will suffer each and every year. That’s a lot of sick people.

But the current listeria outbreak turns statistics into stories, and challenges a company like Maple Leaf, with world-class aspirations, to do better.

The first case of listeriosis apparently surfaced in late June. Why it took the various health authorities so long to make a link remains to be uncovered.

For now, the Canadian Food Inspection Agency, Health Canada and others are providing little in the way of details regarding who knew what when.

The authorities are, however, proving unjustifiably adept at praising themselves for the speed with which they responded to the outbreak.

Two months after the first case is not an early-warning system. The political barbs that have been tossed around – which provide no insight on managing listeria – are simply embarrassing given the loss of life and illness.

McCain and Maple Leaf are better than this, and can be better:

• Issue pictures of the recalled products:

Telling people to look for products that contain the stamp "Establishment (EST) 97B" puts too much of a burden on people who just wanted to go shopping, not do homework. The U.S. Food and Drug Administration realized this, and last year started including pictures on their recall notices for products deemed to be high health risks.

Pictures aren’t superficial, they are good communication. It’s difficult for even PhD-types to wade through nine pages of recalled products, and pictures can make the connection for those who don’t always know what brands they buy.

• Warn pregnant women and others at risk from listeria in deli meats:

My wife is six months pregnant and she hasn’t had deli meats or smoked salmon or other refrigerated, ready-to-eat foods for six months.

That’s because, as Michael McCain says, the bacterium listeria is fairly much everywhere, difficult to control, and grows in the refrigerator. It also causes stillbirths in pregnant women, who are about 20 times more likely to contract the bug than other adults.

The banter in Canada about government or industry taking the lead on food inspection, whether food should be produced in large or small places, is misguided at best and more likely, political opportunism.

Long before the current outbreak, the advice from the Canadian government about listeria was mushy:

"Although the risk of listeriosis associated with foods from deli counters, such as sliced packaged meat and poultry products, is relatively low, pregnant women and immunosuppressed persons may choose to avoid these foods."

The advice from the U.S. Centers for Disease Control is clear: Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated.

It has been documented that many pregnant women are not aware of the risks associated with consuming refrigerated, ready-to-eat foods like cold cuts.

Don’t expect the bureaucrats in the Canadian government to do anything. If Michael McCain and Maple Leaf are truly concerned with public health, they could at a minimum put warning labels on their products. Maybe near the "(EST) 97B."

• Make your listeria data public:

Maple Leaf Foods spokesperson Linda Smith told CTV Newsnet Friday, officials at the plant are "… constantly looking for it (listeria), constantly swabbing and looking for it."

Smith said the equipment at the plant is sanitized every day and officials take about 3,000 swabs per year. The plant also has a microbiologist on site.

"This plant has an excellent food safety record, excellent inspection record, excellent external auditors. We’ll never know exactly how it got here."

But you do have 3,000 samples per year. If Maple Leaf really wants to restore public confidence, release the listeria data. How many positives does the Toronto plant see in a year? Were there positives leading up to the initial Aug. 17 recall? If there were no positives, why not? What is the protocol when a positive is discovered?

Consumers can handle more, not less information about the food they eat.

Maple Leaf Foods has the unfortunate opportunity to set new standards for consumer confidence.

Douglas Powell of Brantford is an associate professor of food safety at Kansas State University.

12 dead, 26 confirmed ill, 29 more suspected in Canadian listeria outbreak

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I was talking with my mom yesterday. Her and dad live in Brantford, Ontario, Canada, and she asked if I was busy with the listeria outbreak. I asked her if she was concerned at all, and she says she doesn’t buy deli meat – her, and more often, dad, will cook a roast or a ham and eat leftovers.

At that point, I realized I had become my parents. I do buy the occasional shaved turkey breast, and lots of smoked salmon, but it’s been nothing but roasts and birds fillets for the past six months of Amy’s pregnancy.

Others in Canada aren’t so sure what to do.

Ken Barnett of Ajax, Ontario, said that in the future, he and his wife are sticking to salads and salmon for lunch. I wonder if he knows smoked salmon is another one of those refrigerated, ready-to-eat foods that can harbor listeria.

“We’ve sort of made a decision not to buy any cold meats for the time being.”

Meanwhile, health types announced this afternoon that the number of dead in the Maple Leaf listeria outbreak has risen to six confirmed and six more suspected deaths, along with 26 confirmed illnesses and another 29 suspected ill.

Meat types this afternoon said the Canadian meat supply was among the safest in the world, and that,

“Canadian consumers should be assured that Canada’s meat supply is recognized amongst the safest in the world.”

The release went on to describe all the money that has been invested in the meat system and that consumers needed to do their part. I’m sure none of this was reassuring to the dead and sick, especially since these are ready-to-eat products.

Medical types on Vancouver Island received a letter warning them to be on the lookout for patients with symptoms of listeria. Shouldn’t this have happened two months ago when the first cases were reported?

And an academic type, my buddy Rick Holley at the University of Manitoba, said he wasn’t surprised to learn of the listeria outbreak since Canada’s tracking of food-related illnesses is inadequate, and that,

"I am constantly troubled by the lack of surveillance information on foodborne and waterborne illnesses in Canada.”

 

Michael McCain of Maple Leaf: Should pregnant women eat deli meats?

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There’s been an outbreak of babies amongst the food safety stalwarts in my lab. Katija delivered in June, Ben’s gonna be a daddy next month, and me, trying to keep up with the cool kids, at the end of November.

Michael McCain, the president and CEO of Maple Leaf Foods, seems sincere enough. He said yesterday that listeria is "pervasive" adding that,

"It (Listeria) is virtually impossible to eradicate in its entirety. It exists in plants, in supermarkets, potentially in your kitchen.”

That’s true. And deli meats and other refrigerated ready-to-eat foods like smoked salmon are particularly good sources of listeria.

Back in May, U.K. environmental health officers from 42 local authorities purchased 1,127 samples of sliced-at-the-counter cooked meats from food retailers including butchers, delicatessens, market stalls and supermarkets.

Laboratory tests found that 15 per cent of the samples were contaminated with low numbers of listeria on the day of purchase, while 7.3 per cent were contaminated with Listeria monocytogenes, the more serious form of listeria.

Although these were within European Food Safety Standards, when the contaminated samples were tested again after storage for 48 hours in a refrigerator, the L. monocytogenes in some of the contaminated samples had multiplied to unsafe levels.

In July, 2008, health types in Ireland warned pregnant women to avoid ready-to-eat, refrigerated and processed foods, such as soft cheeses, cold cuts of meat, pates and smoked fish after an increase in pregnancy-related listeriosis.

A Dec. 2007 review of listeria in pregnancy states,

“One of the most important changes during pregnancy is the down-regulation of the cellular immune system. Because the fetus is genetically different from the mother, the body treats it as a graft. To prevent the maternal immune system from rejecting the fetus, cell-mediated immunity must therefore be suppressed during pregnancy. This is favored by high levels of progesterone. However, reduced cell-mediated immune function leads to increased susceptibility of the woman and her fetus to infections by intracellular pathogens such as Listeria monocytogenes. That is why pregnant women are 20 times more at risk of contracting listeriosis than are other healthy adults. Pregnant women account for 30% of all cases of listeriosis and 60% of cases among persons 10 to 40 years of age.

“Typically, systemic infection occurs most frequently after ingestion of food contaminated with L monocytogenes. The bacteria cross the mucosal barrier of the intestine, probably aided by active endocytosis of organisms by epithelial cells. Once in the bloodstream, bacteria spread to different sites, but they have a particular affinity for the central nervous system or placenta. While circulating, the bacteria are internalized by macrophages and other plasma cells and are thereafter spread cell-to-cell through phagocytosis. As a result, antibodies, complement, and neutrophils become unable to protect the host.”

And that’s why 6-months pregnant Amy hasn’t touched a deli product in over six months. But most women don’t know this. Neither do a lot of doctors or health professionals. During one of our prenatal visits, I asked the aid if there were any foods pregnant Amy should be avoiding.

She said, “no, not really.”

I specifically asked about deli meats.

She said, “Get the deli meat from the counter cause it’s fresher than the pre-packaged stuff.”

She didn’t know about listeria. Most people don’t. Researchers reported in the Australian and New Zealand Journal of Health that in a survey of 586 women attending antenatal clinics in one private and two major public hospitals in New South Wales between April and November 2006, more than half received no information on preventing Listeria.

So, Michael McCain, I know what I’d tell my wife or any other pregnant woman. What would you tell a pregnant woman about deli meats? Would you be willing to put a health advisory on the back of the package?

Pregnant humans and cats can co-mingle

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My friend and OK hockey player Scott Weese seems to be having fun with his Worms and Germs blog. It’s a great resource for pet ownership, especially aspects of zoonotic disease.

Yesterday, Scott asked, are pregnancy and cats compatible? Amy, who’s six months pregnant, and I share our Manhattan home with two dogs and two cats (the cats are from Walkerton, Ontario, and made the trip to Kansas with me). Scott writes, and I didn’t know about the 24-hour infectious bit, that,

“Cats are the only animal species that can spread Toxoplasma in their stool. Shedding rates in cats are quite low, but can be higher in cats that go outside, hunt or are fed raw meat. However, it takes 24 hours or more for Toxoplasma in stool to be infectious (that means that fresh stool cannot spread Toxoplasma). That key point greatly reduces the risk of transmission from cats.”

Sure, if you clean the litter box regularly. That’s Amy with Crystal (right).
 

McCain apologizes for Maple Leaf listeria; excellent risk communication, will the management of the risk stand scrutiny?

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If your products kill and sicken people, it’s a good idea to say sorry. Many people think that saying sorry is an admission of guilt and will be used in court. Lawyer Bill Marler says that is not the case. To me, saying sorry is an expression of empathy. It’s a basic human response.

Michael McCain, president and CEO of Maple Leaf Foods, took not only to the airwaves but to the Intertubes to convey his empathy and resolve at fixing the listeria situation. It’s an excellent piece of risk communication.

But communicating effectively about risks like listeria is never enough. Eventually, journalists and juries will start asking some tough questions about who knew what when. The Odwalla 1996 outbreak of E. coli O157:H7 in unpasteurized juice was also textbook risk communication, but the company was eventually revealed to have cut corners and ignored warning signs.

This is a tough situation that I wouldn’t wish on anyone. Oh, and the critics who say that food produced locally would result in fewer illnesses are statistically challenged: to make a fair comparison between small and big producers, the number of illnesses per meals consumed is the true measure, and no one has offered that up; further, outbreaks involving local producers may never get picked up by the surveillance system.; and the big folks have the resources to invest in food safety. McCain says Maple Leaf has a culture of food safety. Maybe. The evidence will be laid out over the weeks and months to come.

 If you go to the youtube post, you can see the comments, which already include,

“I just had further look at your recent earnings for the last quarter….if you are truly sorry, the families of those who lost loved ones should never have to work another day in their life. Whether you pay the victim’s families the millions of dollars that you can afford or not will tell if you are truly sorry.”

There will be more harsh words. McCain and Maple Leaf deserve praise for their risk communication efforts: how the risk was managed – who knew what when and what actions were taken – remains to be seen.
 

Maple Leaf cold-cuts confirmed as listeria source in Canada: at least 5 dead, dozens ill

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Canwest News Service is first out of the block, citing a senior government official as saying Saturday that testing has confirmed that an outbreak of listeriosis that has claimed at least four lives – and probably several more — across Canada has now been positively linked to processed meats produced at Maple Leaf Consumer Foods.

Earlier Saturday, the Public Health Agency of Canada upped to 21 the number of cases of a deadly listeriosis outbreak that have been confirmed so far in four provinces. The agency said in a statement that 16 of the cases were found in Ontario, three in British Columbia, and one each in Saskatchewan and in Quebec.
Three deaths in Ontario – St. Catharines, Hamilton and Waterloo – have been officially tied to the deadly strain of the food-borne listeria bacterium, and a fourth death on Vancouver Island has also been attributed to the strain.

The public health agency also said a further 30 suspected cases remain under investigation. Of those, 14 are in Ontario, eight are in Quebec, four are in Alberta and two each are in B.C. and Saskatchewan.

So, with the positive ID, will Canadian politicians and bureaucrats keep smugly bragging about their wonderful system for foodborne disease surveillance?

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. Those dates have not been provided. Take a look at the updates from the U.S. Centers for Disease Control concerning the Salmonella Saintpaul outbreak and compare that with what comes out of various Canadian agencies. There is no comparison.

Tell the public what you know, what you don’t know, and what you’re doing to find out more.
 

Seven deaths, dozens of illness investigated in Canadian listeria outbreak: pregnant women reminded of risks

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My wife is six months pregnant and she hasn’t had deli meats or smoked salmon or other refrigerated, ready-to-eat foods for six months.

That’s because the bacterium listeria is fairly much everywhere, difficult to control, and grows in the refrigerator. It also causes stillbirths in pregnant women, who are about 20 times more likely to contract the bug than other adults.

The banter in Canada about government or industry taking the lead on food inspection, whether food should be produced in large or small places, is misguided at best and more likely, political opportunism.

There’s a lot of sick people out there and more to be uncovered. Listeria happens, but why did it take the Canadian authorities and industry seven weeks to issue advisories?

It seems part of a pattern of don’t ask, don’t tell, at least until it’s obvious to a whole bunch of others; there are questions about who knew what when.

Epidemiology, the association of something with disease – in this case, deli meats from Maple Leaf – was strong enough for the B.C. Centre For Disease Control to announce a link and a warning, while Ontario stayed mum. Why the difference? These folks are all PhDs in something, what’s going on?

Long before the current outbreak, the advice from the Canadian government about listeria was mushy:

“Although the risk of listeriosis associated with foods from deli counters, such as sliced packaged meat and poultry products, is relatively low, pregnant women and immunosuppressed persons may choose to avoid these foods.”

The advice from the U.S. Centers for Disease Control is clear: Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated.

It has been documented that many pregnant women are not aware of the risks associated with consuming refrigerated, ready-to-eat foods like cold cuts.

Whatever the outcome of the Canadian listeria outbreak, it’s time for Canadian bureaucrats to stop dancing and provide straight advice to consumers. Other countries do it.

5 deaths, 38 illnesses being investigated in Canadian listeria outbreak; sub spokesthingy says consumers are ‘hypochrondriacs’

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It’s been a bizarre day, answering questions about the U.S. moving ahead with approvals for irradiation on some leafy greens, and Canada moving backwards – really backwards – into political grandstanding while people suffer in an expanding listeria outbreak.

The latest news is that five deaths are now being investigated and dozens of illnesses. If you watch some of the media clips you’ll see that undeserved Canadian smugness shining through – ‘we figured this listeria thing out really fast, it took the Americans six months to figure out salmonella in jalapenos’(Maureen Taylor of CBC pokes some big holes in that theory).

My message was the same: Listeria is a dangerous bug, this is a serious outbreak, there were some serious shortcomings in informing the public and six-months pregnant Amy wouldn’t touch a cold-cut or other refrigerated ready-to-eat food whether it was inspected by government or industry or me.

No one was really interested in the sick people or potential risk.

I did a live interview with CBC Newsworld, the 24 hour news channel that is sometimes referred to as Wallyworld. The producer called to do a pre-interview and asked,

“What are your impressions of this listeria outbreak in Canada.”

I said,

“I’m sorry, I don’t do impressions.”

When it came time to do the CBC National News interview, I was chatting with the reporter, and she said I was in Kansas City, and I said,

“Manhattan. Kansas. Kansas State University.”

“Oh, right.”

“Not University of Kansas. Kansas State. People care about that shit down here. I’m from Ontario, I don’t’ get it, but they really care .”

“And they should. Yeah. Kansas State.”

On CBC National News, it said, ‘Doug Powell, University of Kansas.’

Sigh. …

This is a serious outbreak; there is going to be more dead and sick people, and it’s sorta gross that all the social actors quoted by the media seem to care about is advancing their political agendas. And kissing industry ass and providing pregnant Canadian women with lousy advice about listeria.

Most compassionate award of the day goes to Quiznos spokesman Kyle Holmes in Toronto who said,

"At the end of the day, it (this recall) could happen to anybody and fortunately, it didn’t happen to us. Recently, we had a tomato recall and our tomatoes were not affected at all but it was still bad publicity. People are hypochondriacs.”
 

1 dead, dozens sickened in Canadian listeria outbreak: some questions

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Amy is 6 months pregnant: An outbreak of listeria in Canada which has killed one and sickened dozens, is exactly why she hasn’t eaten any cold cuts or smoked salmon for the past six months.

It has been thoroughly documented that many pregnant women are not aware of the risks associated with consuming refrigerated, ready-to-eat foods like cold cuts. Nor does the literary dancing from various Canadian spokesthingies inspire confidence.

About 3 a.m. Sunday, Aug. 17/08, the Canadian Food Inspection Agency (CFIA) and Maple Leaf Consumer Foods issued an advisory warning the public not to serve or consume Sure Slice brand Roast Beef and Corned Beef because these products may be contaminated with Listeria monocytogenes.

The press statement said,

“There have been no confirmed illnesses associated with the consumption of these products.”

Usually, CFIA press releases say there have been no illnesses associated with the product in question, if that is indeed the case. The “confirmed illness” was a wiggle phrase that Canadian media dutifully reported and then went back to sleep.

Then, about 4 a.m. Wednesday Aug. 20/08, another press release arrived from CFIA, this time announcing that Maple Leaf was voluntarily recalling everything from the suspect Toronto plant and that,

“… a number of the affected products … are part of a listeriosis outbreak investigation.”

About the same time, Maple Leaf Foods put out a press release stating,

“A small number of Sure Slice packaged meat products produced at the Company’s Bartor Road, Toronto facility, predominantly for foodservice customers, have tested positive to contain low levels of listeria monocytogenes.”

Always good to get someone else to read stuff to catch grammatical errors, but there may not always be time.

And maybe it wasn’t that small of a contamination, because Wednesday afternoon, Ontario’s Chief Medical Officer of Health advised the public that there is an outbreak of Listeriosis in the province.

“In July 2008, routine surveillance conducted by the Ministry detected a marked increase in cases of Listeriosis being reported by Ontario health units.

“As of yesterday, there have been 29 cases associated with the outbreak across 17 health units. Of these, 13 are confirmed cases, and the rest are probable and suspect cases which are under investigation by the local health units. Outbreak associated cases of Listeriosis have also been reported in British Columbia, Saskatchewan and Quebec. Ontario is working with the Public Health Agency of Canada and the other provinces in the investigation.”

Yet, as reported by Canwest News Service, health officials in Ontario would not confirm a link between the cases and the recall. Dr. Eleni Galanis with the B.C. Centre For Disease Control said officials in that province had interviewed the two confirmed cases and were satisfied there was sufficient evidence to show a link.

"First, they have the same strain as the outbreak strain that has been identified in Ontario and second they have been exposed to the foods that are under recall. It does seem that they are linked."

Galanis, who said B.C. is also reviewing three more suspected cases, said she was particularly concerned for people with compromised immune systems and pregnant women.

"In pregnant women it could result in still birth," she said.

Despite the words of Dr. Galanis, the story has spun into political nonsense, with the two major political parties throwing barbs at each other, and one University of Guelph type defending small agriculture by saying,

“That’s not to say that a small butcher can’t make mistakes, but at best, he’s going to kill off a few of his neighbours. When you take that same mistake and you put it into a plant that serves millions, the risk is vastly expanded.”

Wow. There’s a whole bunch of sick people out there. That’s where the focus should be. And then, journos should ask, at what point did health authorities make an epidemiological link to Maple Leaf cold cuts? Would some illnesses have been prevented if the warning Sunday morning had been expanded? What is the process used to decide when to issue public warnings? How much evidence is enough?

Oh, and the CFIA advice if you are pregnant or have a weakened immune system?

“Although the risk of listeriosis associated with foods from deli counters, such as sliced packaged meat and poultry products, is relatively low, pregnant women and immunosuppressed persons may choose to avoid these foods.”

Here’s the advice from the U.S. Centers for Disease Control for persons at high risk, such as pregnant women and persons with weakened immune systems:

• Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot.???-Avoid getting fluid from hot dog packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats.???

• Do not eat soft cheeses such as feta, Brie, and Camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela, unless they have labels that clearly state they are made from pastuerized milk.???

• Do not eat refrigerated pâtés or meat spreads. Canned or shelf-stable pâtés and meat spreads may be eaten.???-Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.

The USDA risk assessment for listeria is ready-to-eat foods is available here

http://www.fsis.usda.gov/OPPDE/rdad/FRPubs/97-013F/ListeriaReport.pdf

and one from the World Health Organization is here

http://www.who.int/foodsafety/publications/micro/mra_listeria/en/index.html
 

Culture, camp, pregnancy and … synchronized diving?

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Why is synchronized diving an Olympic sport?

I don’t know either, but it caught the attention of my dining companions, each with their own food safety story to share.

Philippa Ross-James, Program Manager Communications, with the New Zealand Food Safety Authority, gave a great talk Monday morning at Kansas State University, sharing the agency’s experience promoting food safety practices in culturally acceptable ways with New Zealand’s indigenous people — Maori, and New Zealand’s Pacific peoples.

The take home messages: build trust, get out of the office, and be in it for the long term. That’s Philippa (right), with Curtis Kastner, director of Kansas State’s Food Science Institute, me, Philippa, and Lisa Freeman, associate dean for research at K-State’s vet college, and a v.p. at K-State’s new Olathe innovation campus.

My youngest daughter, Courtlynn, is back from camp and spending some time in Manhattan (Kansas). She told me on the last day of camp, the chicken that was served was still cold in the middle. A camp counselor came around and told the kids, don’t eat the chicken, it’s not cooked.

If you’re making food for 300 or so kids, have some standard operating procedures, and use a damn thermomter.

Finally, during the synchro swimming display last night, pregnant Amy inquired about the bruschetta with goat cheese. It was a soft cheese and there is a risk of post-processing contamination – the soft cheese can support listeria growth if contaminated with a knife or someone’s dirty hand – so she didn’t order it, but I had to ask, “Is the goat cheese made from raw or pasteurized milk.”

The waiter didn’t have a clue, but did offer to ask, returned from the kitchen, and said it was made from pasteurized milk, and someone had asked the chef the same question last week.

Consumers can ask questions.

Philippa left for the 30-something hour trek back to Wellington this morning.

Courtlynn, Amy and I are heading to Florida for some much needed beach time.