Two trichina outbreaks in Alaska; it was the walrus

There’s not a lot of trichina in the U.S. food supply anymore. It used to be a much more important pathogen. In the 1940s, when the US Public Health Service started tracking the illness, there was around 400 cases a year. Now there’s about 20.

A couple of the more notable incidents were reported in MMWR last week – two outbreaks in Alaska linked to raw walrus.

During July 2016–May 2017, the Alaska Division of Public Health (ADPH) investigated two outbreaks of trichinellosis in the Norton Sound region associated with consumption of raw or undercooked walrus (Odobenus rosmarus) meat; five cases were identified in each of the two outbreaks. These were the first multiple-case outbreaks of walrus-associated trichinellosis in Alaska since 1992.

The walrus consumed during the implicated meal in the second outbreak had been harvested and butchered by patients F and I during the previous 1–3 months, and the meat had been stored frozen in unlabeled bags in their respective household chest freezers. The meat was prepared by patient H, who reported that she boiled it for approximately 1 hour, after which the exterior was fully cooked, but the interior remained undercooked or raw, which was the desired result; interviewed persons reported that many community members prefer the taste and texture of undercooked or raw walrus meat to that of fully cooked meat.

These outbreaks also highlight the importance of culturally sensitive public health messaging. In areas where wild game species are harvested for subsistence, traditional methods of collecting, handling, preparing, storing, and consuming meat often have great cultural significance; however, some of these methods can be inconsistent with public health best practices. Rather than promoting or proscribing specific methods, public health messages that focus on communicating risks and explaining the manner and magnitude of risk reduction that can be achieved using different approaches (e.g., alternative methods of preparing meat for consumption) enable members of the target population to make informed decisions that integrate their traditional practices with their awareness and tolerance of risks.

The Walrus wasn’t Paul; and when will government set guidelines for going public about foodborne disease?

When John Lennon heard in 1967 that one of his former schools was making students deconstruct the lyrics to songs by the Beatles, he responded by writing the most nonsensical song he could come up with, combining the lyrics of 3 previously unfinished songs – two written on acid trips – and stated at the time about the result, I Am the Walrus, “Let the fu**ers work that one out.”

The Eggman in the song apparently referred to The Animals lead singer, Eric Burdon, who had a fondness for breaking eggs over the bodies of naked women.

This trivia is as useful as most of the information surrounding the salmonella-in-eggs outbreak that has sickened a thousand Americans.

There are hints of information but most public commenters are using the outbreak for political or legal opportunism.

Today’s USA Today reports that state and federal health agencies identified an Iowa egg company as a likely source of illness at least two weeks before the firm launched a massive egg recall Aug. 13 and the public got its first hint of a growing national salmonella outbreak.

In late July, the Centers for Disease Control and Prevention even considered reminding the public generally about the dangers of eating undercooked eggs, said Ian Williams, chief of the agency’s outbreak response branch. The CDC decided it would be more effective to wait until the Food and Drug Administration (FDA) completed its investigation of the firm, Wright County Egg in Galt, Iowa.

By late July, the California and Minnesota state health departments had identified several small restaurant outbreaks of salmonella with eggs as a likely culprit — and Wright County Egg as a common supplier, Williams said.

The FDA didn’t contact Wright County Egg until Aug. 10 and didn’t provide detailed information until Aug. 12, company spokeswoman Hinda Mitchell said. The recall decision was made after discussion with FDA officials the next morning, she said.

Jeff Farrar, FDA associate commissioner for food protection, said Wednesday that his agency was aware of the states’ findings in late July but needed to obtain detailed copies of invoices and other paperwork to further confirm that Wright County Egg was the supplier.

CNN also reports this morning the state of California believes it has identified its earliest cases related to the salmonella recall, and says its investigation helped tip off the rest of the country to the source of the problem.

On May 28 and 29, several people became sick after attending either a prom or a graduation party in Clara County, according to Joy Alexiou, a spokeswoman for the Santa Clara County Public Health Department. Tests on some of the victims, including a catering worker who nibbled on the food, determined that the culprit was salmonella, she said.

Three months later the state is bragging?

Sherri McGarry, a director at the F.D.A.’s Center for Food Safety and Applied Nutrition, told the N.Y. Times last week the Hillandale recall was prompted when Minnesota officials traced a cluster of illnesses in that state to the eggs from the company’s Iowa plants.

Doug Schultz, a spokesman for the Minnesota health department, said seven people had become ill with salmonella in mid-May after eating chile rellenos at a Mexican restaurant called Mi Rancho in Bemidji, Minn. He said that investigators established a connection to Hillandale eggs on May 24.

It was not clear why the F.D.A. did not act on the information sooner.

Why didn’t Minnesota go public if it had information that could limit future illnesses?

FDA and other federal agencies do themselves a tremendous disservice by failing to clearly articulate how and when the public (and industry) should be informed about potential health risks. No amount of federal legislation or lawsuits will fix this. Instead it requires a recommitment to having fewer people barf. And any company that wants to lead – especially with profits – will stop hiding behind the cloak of government inspection and will make test results public, market food safety at retail so consumers can choose, and if people get sick from your product, will be the first to tell the public.

You all sound like element’ry penguins.