Tag Archives: Sprouts

What we’ve got here is failure to communicate: sprouts and food safety

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Raw sprouts are the poster child for failures in what academics call, risk communication.

I’ve been thinking about this for a long time.

About 1999, graduate student Sylvanus Thompson started working with me on risk analysis associated with sprouts. He got his degree and went on to rock-star status in the food safety world with the implementation of the red-yellow-green restaurant inspection disclosure program with Toronto Public Health, but we never published anything.

I remember frantically flying to Kansas City to hang out with this girl in Manhattan (Kansas) I’d met a couple of weeks before, in the midst of the 2005 Ontario raw sprout outbreak that sickened over 700; Jen Tryon, now with Global News, interviewed me at the airport, with me wearing a K-State hockey shirt (that’s the joke; there is no hockey at K-State, and I was still employed by Guelph; and I was going to hang out with this girl).

After the German E. coli O104 outbreak that killed 53 people last year and sickened over 4,000, along with the ridiculous public statements and blatant disregard for public safety taken by sandwich artist Jimmy John’s in the U.S., I figured we really needed to publish something.

The basic conclusions:

• raw sprouts are a well-documented source of foodborne illness;

• risk communication about raw sprouts has been inconsistent; and,

• continued outbreaks question effectiveness of risk management strategies and producer compliance.

We document at least 55 sprout-associated outbreaks occurring worldwide affecting a total of 15,233 people since 1988. A comprehensive table of sprout-related outbreaks can be found at http://bites.ksu.edu/sprouts-associated-outbreaks.

Sprouts present a unique food safety challenge compared to other fresh produce, as the sprouting process provides optimal conditions for the growth and proliferation of pathogenic bacteria. The sprout industry, regulatory agencies, and the academic community have been collaborating to improve the microbiological safety of raw sprouts, including the implementation of Good Manufacturing Practices (GMP), establishing guidelines for safe sprout production, and chemical disinfection of seed prior to sprouting. However, guidelines and best practices are only as good as their implementation. The consumption of raw sprouts is considered high-risk, especially for young, elderly and immuno-compromised persons (FDA, 2009).

Sol Erdozain, now a graduate student in psychology at Kansas State University, took the lead on this one. Kevin Allen, now a prof-type and hockey goon at the University of British Columbia (that’s blue-eyes, right) who used to take great pleasure firing pucks off my head – even though he is also a goalie – weighed in with his microbiology expertise, Katija Morley (nee Blaine) made our arguments more coherent, and I pestered everyone. Because I should have published something like this 12 years ago.

Writing is hard.

From November 2010 into 2011, an outbreak linked to raw sprouts in the U.S. and involving sandwich franchise Jimmy John’s sickened 140 people. This was the third sprout related outbreak involving this franchise, yet the owner of the Montana Jimmy John’s outlet, Dan Stevens, expressed confidence in his sprouts claiming that because the sprouts were locally grown they would not be contaminated. By the end of December 2010 a sprout supplier, Tiny Greens Farm, was implicated in the outbreak. Jimmy John’s owner, John Liautaud, responded by stating the sandwich chain would replace alfalfa sprouts with clover sprouts since they were allegedly easier to clean. However, a week earlier a separate outbreak had been identified in Washington and Oregon in which eight people were infected with Salmonella after eating sandwiches containing clover sprouts from a Jimmy John’s restaurant. This retailer was apparently not aware of the risks associated with sprouts, or even outbreaks associated with his franchisees.

In late December 2011, less than one year after making the switch to clover sprouts, Jimmy John’s was linked to another sprout related outbreak, this time it was E.coli O26 in clover sprouts. In February 2012, sandwich franchise Jimmy John’s announced they were permanently removing raw clover sprouts from their menus. As of April 2012, the outbreak had affected 29 people across 11 states. Founder and chief executive, John Liautaud, attempted to appease upset customers through Facebook stating, “a lot of folks dig my sprouts, but I will only serve the best of the best. Sprouts were inconsistent and inconsistency does not equal the best.” He also informed them the franchise was testing snow pea shoots in a Campaign, Illinois store, although there is no mention regarding the “consistency” or safety of this choice.

Despite the frequent need for sprout-based risk communication, messaging with industry and public stakeholders has been limited in effectiveness. In spite of widespread media coverage of sprout-related outbreaks, improved production guidelines, and public health enforcement actions, awareness of risk remains low. Producers, food service and government agencies need to provide consistent, evidence-based messages and, more importantly, actions. Information regarding sprout-related risks and food safety concerns should be available and accurately presented to producers, retailers and consumers in a manner that relies on scientific data and clear communications.

Erdozain, M.S., Allen, K.J., Morley, K.A. and Powell, D.A. 2012. Failures in sprouts-related risk communication. Food Control. 10.1016/j.foodcont.2012.08.022

http://www.sciencedirect.com/science/article/pii/S0956713512004707?v=s5

Abstract

Nutritional and perceived health benefits have contributed to the increasing popularity of raw sprouted seed products. In the past two decades, sprouted seeds have been a recurring food safety concern, with at least 55 documented foodborne outbreaks affecting more than 15,000 people. A compilation of selected publications was used to yield an analysis of the evolving safety and risk communication related to raw sprouts, including microbiological safety, efforts to improve production practices, and effectiveness of communication prior to, during, and after sprout-related outbreaks. Scientific investigation and media coverage of sprout-related outbreaks has led to improved production guidelines and public health enforcement actions, yet continued outbreaks call into question the effectiveness of risk management strategies and producer compliance. Raw sprouts remain a high-risk product and avoidance or thorough cooking are the only ways that consumers can reduce risk; even thorough cooking messages fail to acknowledge the risk of cross-contamination. Risk communication messages have been inconsistent over time with Canadian and U.S. governments finally aligning their messages in the past five years, telling consumers to avoid sprouts. Yet consumer and industry awareness of risk remains low. To minimize health risks linked to the consumption of sprout products, local and national public health agencies, restaurants, retailers and producers need validated, consistent and repeated risk messaging through a variety of sources.

Maybe there’s an outbreak: Health Canada details risks of eating raw sprouts

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Health Canada has a habit of issuing food safety reminders about the same time an outbreak comes to public attention. The latest example was a completely useless reminder to wash produce after an E. coli O157:H7 outbreak in New Brunswick linked to Romaine lettuce from California, and just before another NB E. coli outbreak was announced.

Today, HC is “reminding Canadians that raw or undercooked sprouts should not be eaten by young children, older adults, pregnant women or those with weakened immune systems.”

Between 1995 and 2011, approximately 1,000 cases of sprout-borne illness were reported in eight outbreaks from five provinces across Canada. The largest outbreak in Canada was in 2005, when more than 648 cases of Salmonella were reported in Ontario.

Health Canada says children younger than five, older adults, pregnant women and those with weakened immune systems are particularly vulnerable and should not eat raw sprouts at all. They should also avoid eating cooked sprouts unless the sprouts have been cooked thoroughly.

This advice does not account for the risks of cross-contamination.

Bureaucracy in (non) action: lessons learned from the 2011 outbreak of E. coli O104:H4 in sprouted seeds

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Considering the outrageous scale of the E. coli O104 outbreak in sprouts, the lessons learned are incredibly banal.

The Commission of the European Communities writes in a new report that from May to July 2011, a major outbreak occurred in the European Union due to contamination of sprouted seeds by Shiga toxin-producing Escherichia coli (STEC) O104:H4 with clusters in the North of Germany and in the Bordeaux region in France.

Based on the date of onset, the outbreak started in Germany at the beginning of May and reached a peak on 22 May 2011. On 22 June 2012, an increase of hemolytic-uremic syndrome (HUS) and bloody diarrhea cases was also reported in the Bordeaux region of France. A few days later the strain was identified as the same as in German outbreak.

As soon as the outbreak was notified, the German and Länder health services were mobilized, launching of alert systems at all levels (local, national, EU and international) and all parties involved collaborated intensively. The German Robert Koch Instituted reported 855 cases of HUS and 2987 cases of bloody diarrhoea (without HUS), including 53 fatalities in Germany in its final presentation and evaluation on the outbreak. An additional 54 HUS (incl. 2 deaths) and 83 diarrhoea cases were reported through the European Centre for Disease Prevention and Control (ECDC) as linked to the German cluster in other countries of Europe, Canada and the United States. The Bordeaux cluster counted for 24 cases, including 7 HUS.

The losses for farmers in the fruit & vegetable sector were estimated at least 812 Million (Mio) € in the first 2 weeks. In addition a temporary export ban of vegetables to Russia occurred, constituting an annual value of 600 Mio €.

The objective of this document is to indicate possible actions from the EU to prevent similar outbreaks or to limit their scale and to be better prepared for food-borne outbreaks in general. Actions are also needed to strengthen coordination between the health and food safety authorities in line with the "One Health" principle.

And these are the big lessons learned:

• strengthen EU capacities to ensure protection of citizens against cross border health threats;
• awareness of the need for improvement of hygiene in food of non-animal origin including primary production and import by better enforcement of existing hygiene provisions;
• enhanced preparedness through regular practical exercises involving all key players in an outbreak;
• respect of responsibilities and involvement of all partners in outbreak management;
• better co-ordinated and clear communication;
• improve tools of market intervention and product promotion to reduce reaction time to crises outbreak and thereby limit the negative economic impact on the EU sector; and,
• strengthen public-private initiatives linking producers (incl. processing, retail and trade) and citizen/consumers to increase awareness and enhance communication and knowledge.

None of these would have presented the outbreak, although may limited things. And nowhere is the probable cause addressed: that sprout seeds themselves can become contaminated.

Sprouts in Europe: agencies try to make agencies look better

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The first rule of public health is, make public health look good.

That’s what I was told by a senior health type after the E. coli O157:H7 outbreak in Walkerton, Ontario in 2000 that killed seven and sickened 2,500 in a town of 5,000 (it’s in Canada).

This isn’t cynicism, it’s just something that has been repeated to me by front-line types for the past 20 years.

The European Food Safety Authority is doing some (belated) cleanup and after the E. coli O104 outbreak in sprouts last year that killed 53 and sickened 4,400.

In anything but a rapid response to a crisis, EFSA has written a report that has lots of notes about all the meetings they had, but has nothing about what they did for all those sick and dead people. Nor does it address widespread criticism at the time of the outbreak that health types were far too slow to pinpoint the source and respond.

To hammer home their role of inadequacy, EFSA published a companion piece, Risk communication: Making it clear, timely and relevant, with catchy soundbites like, “By communicating on risks in an open and transparent way based on the advice of its scientific expert panels, EFSA contributes to improving food safety in Europe and to building public confidence in the way risk is assessed. … To this end, in the last 10 years, EFSA has commissioned two Eurobarometer surveys on risk perception in the EU. The findings of the reports show that most Europeans view national and European food safety agencies as reliable sources of information on possible risks associated with food. The surveys have proved invaluable in guiding and informing EFSA’s communications.

Organizations can survey all they want to bolster their own self-opinions around the water cooler. Didn’t help contain a ridiculously large outbreak.

Reform falters in Europe after 53 deaths from E. coli O104 in sprouts

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In May, 2011, the delayed reporting of cases between agencies due to a decentralized government and its agencies was a contributing factor in the Germany-based E. coli O104 outbreak that led to 53 deaths and over 4,000 sick people. The E. coli strain responsible for the outbreak was unusually virulent, with high mortality and hemolytic uremic syndrome (HUS) rates observed in healthy adults.

A year later, Marian Turner writes in Nature that governments have made little progress towards improving the monitoring and reporting systems that allowed the crisis to drag on for weeks.

Although the panic has sparked some proposed policy changes, these have become mired in political debate at both German and European levels.

Under Germany’s current system, it can take up to 18 days for local and state health departments to relay case reports to the Berlin-based Robert Koch Institute (RKI), the German federal agency for disease surveillance. Legislators have proposed a law to bring the country’s disease-reporting schedule into line with the World Health Organization’s International Health Regulations. The law would require local health authorities to report cases of notifiable diseases to state authorities on the next working day; the states would then have another day to relay the information to the RKI. “We’ve been waiting almost a decade for this,” says Alexander Kekulé, a microbiologist at the Martin Luther University of Halle-Wittenberg in Halle, Germany.

The draft law has been passed by Germany’s federal parliament but is stuck in negotiations at the legislative council that represents Germany’s 16 states. For scientists, though, this change would still not be enough. “What really delayed the detection of this outbreak was the irregularity with which patients were referred for microbiological follow-up,” says Gérard Krause, an epidemiologist at the RKI. Like many European countries, Germany does not require that a patient with bloody diarrhoea or haemolytic uraemic syndrome (a life-threatening complication of some E. coli infections) be tested for the causative bacterial strain. The same is true of the United States.

After the outbreak, German diagnostic laboratories were provided with kits to test samples for genes belonging to certain pathogenic strains of bacteria, such as those expressing particular toxins, or proteins involved in adhesion or invasion.

But physicians are responsible for requesting the tests, and the cost is not covered by German health-insurance companies. “The problem is mostly getting the money to use these kits,” says Angelika Fruth, a microbiologist at the RKI, “and that situation is just the same as before the outbreak.”

In the wake of the outbreak, the European Food Safety Authority concluded that sprouted seeds pose a particular food-safety concern, and recommended that a standardized test for sprouts be developed and adopted across the European Union (EU). But EU member countries are still discussing the proposal, and scientists have yet to develop reliable methods to isolate pathogenic bacteria from seeds or sprouts.

Risk-reward for Jimmy John’s founder a case study in fluff

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Restaurants are about making money. So is everything involved with food. It’s nice if that food is healthy – however that is defined at the time – and abundant and whatever other marketing spins are out there, but follow the money.

That’s why business publications still exist, to provide puff pieces about titans of commerce who, especially in the U.S., reimagine their histories into storylines.

It’s about the money.

Jimmy-I-decided-to-pull-raw-sprouts-from-my-menus-after-5-outbreaks Liautaud said as part of a National Restaurant Association Show panel in Chicago last week that in 2003 he was unhappy with his potato chip supplier; they didn’t treat him very well, "So I figured out how to make potato chips myself. I designed the bag and everything. And my bags have 2½ times the chips that were in the other chip bags. What’s better is I’m making a lot more money with the Jimmy Chips than I did before."

Great. Maybe you can figure out what to do about sprouts rather than continue to sicken unsuspecting customers.

For the ambulance chasers, the story notes Jimmy John’s Gourmet Sandwiches is a 1,300-plus-unit chain that pulled in $895 million in 2011, according to Technomic.

Liautaud described his relationship with franchisees as one full of "tough love." A corporate team is in each restaurant every 30 days to make sure things are running smoothly.

"It works for us. I call it proactive discipline," he said. "Especially if you’re a new franchisor, it’s important to be in the store to make sure it’s successful."

Success in the world of Jimmy John’s apparently does not include serving safe food.

Certain Mumm’s Sprouting Seeds – Sunflower may contain Salmonella

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At least the seeds were recalled before someone got sick – unless there are sick people and regulators aren’t saying. They also aren’t saying if the testing was done by government or the company or who knows else. Or saying where the seed originated.

The Canadian Food Inspection Agency (CFIA) and Mumm’s Sprouting Seeds Ltd. are warning the public not to consume the Mumm’s brand Sprouting Seeds described below because the product may be contaminated withSalmonella.

The affected product, Mumm’s brand Sprouting Seeds – Sunflower, are sold in 75g packages bearing UPC 7 73295 07582 3 and lot # SF2020.

This product is known to have been distributed in British Columbia, Alberta, Saskatchewan and Ontario and may have been distributed nationally.

There have been no reported illnesses associated with the consumption of this product.

The importer, Mumm’s Sprouting Seeds Ltd., Parkside, SK, is voluntarily recalling the affected product from the marketplace. The CFIA is monitoring the effectiveness of the recall.

Raw sprouts still sicken, but not in The Atlantic

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The Atlantic was once a semi-respected magazine worth perusing, but has lately been diving to the food-news gutter faster than Dr. Oz.

After too many stories on the electronic version with snappy headlines but little content, The Atlantic fully jumped the shark with its piece on the virtues of sprouts.

Besides the usual gush about how sprouting awakens a life force within the seeds – and yes, there are chemical changes that happen during sprouting that may provide nutritional benefit – one holistic expert said raw sprouts were great for at-home cleansing.

The brief does note that seed source is a key component for safe sprouts, but fails to mention any potential risks.

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

German science type: E. coli O104 in sprouts exaggerated by media interviewing ‘third-grade’ local scientists

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Blame the media is a routine strategy for politicians and scientists (no difference when speaking on the public stage) but one that is rarely valid.

Except most media these days opts for puppy-eyed compliance rather than critical questions.

Dr. Rainer Wessel, director of the CI3 excellence cluster of the German Rhein-Mainz region, managed to keep a straight face as he told an audience in Berlin last week that the death toll in the E. coli O104 outbreak in sprouts last year that killed 53 was “minimal” and paled in comparison to the daily death toll of car accidents.

Risk comparisons are risky.

Because only 53 people died, Wessel viewed the reaction of the public health surveillance system as a success, adding, “Biological threats are complicated. The machine was working pretty well, even if some reactions were slow.” But this can be improved, it depends how much society wants to invest in it.

Maybe something was lost in translation.

According to the Future Challenges website, Wessel argued the media played a big role in frightening the population and creating a unnecessary outburst in society.

“The media are also enterprises, they have to sell too.”

Wessel didn’t mention that during two weeks the public received contradictory information, which wasn’t invented by journalists, but given by government officials.

On the 22th of May 2011, German health authorities said: “Clearly, we are faced with an unusual situation“ and didn’t deliver further information on the origin of the outbreak.

On the 25th, the Health Minister of Hamburg Cornelia Storck declared that the disease was carried by Spanish cucumbers. The German federal government withdrew them from the market causing €51 million in losses to Spanish agriculture, according to the Spanish environment minister. After some tests, the cucumbers were invalidated as the source of the epidemic.

On the 4th of June, German officials alleged that a restaurant in Lübeck, North Germany, was the starting point of the outbreak.

On the 5th, officials pointed to a farm in Lower Saxony being the source of the epidemic, an information that was invalidated and then finally confirmed again on the 10th of the same month.

Wessel maintains that the press should be better informed, which is always good. In case of risk, the Robert-Koch-Institut, the German official health surveillance agency, should receive funding for a small press room in order to give correct information and respond to the questions of journalists, “to avoid that a second or third grade scientist gets interviewed on a local level.”

25 now sick up from 14; Jimmy John’s keeps winning with E. coli O26 in sprouts

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A total of 25 persons infected with the outbreak strain of Shiga toxin producing E. coli (STEC) O26 have been reported from 8 states.

The U.S. Centers for Disease Control says results of the epidemiologic and traceback investigations indicate eating raw clover sprouts at Jimmy John’s restaurants is the likely cause of this outbreak.
March 8, 2012

The 11 new ill persons have been reported from Alabama, Michigan, and Ohio. Of the 24 ill persons with available information, 21 (87%) reported consuming sprouts at Jimmy John’s restaurants in the 7 days preceding illness.