Father of Tennessee E. coli victim ‘Nutritionist recommended raw milk’

James Zenker never imagined his young son would battle for his life at just two-years-old.

“It’s affected his kidneys; they shut down,” Zenker said. “It affected his intestines; he couldn’t digest any of his food and its affected his brain — he has a substantial brain injury.”

His son William got E. coli after drinking raw milk linked to French Broad Farm. Zenker said a nutritionist recommended the raw milk to help William fight allergies.

“He’s not able to speak and not able to do the same activities as before he was ill,” Zenker said.

The vast majority of nutritionists, dieticians and physicians I encounter – and it’s frequent with my brain status and trips to emergency – know shit about microbial food safety.

The odd ones do, and they are food safety heros.

But when hospitals continue to serve raw sprouts to immunocompromised people, when they won’t be sold at WalMart in the U.S., I gotta question their food safety credibility.

To reiterate, I stared the Food Safety Network (the original FSN) over 25 years ago as an incoming graduate student in 1993 in the wake of the Jack-in-the-Box outbreak, combining my science and journalism learnings, and because a constant refrain I observed was, I never knew foodborne illness could be so serious.

That’s why I continue to do it as a form of community service (I haven’t been paid since 2016).

Of the 15 children sick with E. coli in Tennessee that has now been linked to consumption of raw milk and contact with ruminants from French Broad Farm, William is the last one left in the hospital. His father said East Tennessee Children’s Hospital saved his son’s life.

The Knox County Health Department said an investigation concluded that the outbreak was caused by two separate sources, the exposure to farm animals and exposure to raw milk.

“While it is rare, it appears we had two sets of children sickened by two different strains of E. coli O157 at the same time. The epidemiological evidence overwhelmingly supported the two-source theory: consumption of raw milk and some type of contact, most likely indirect, with ruminant animals,” said KCHD Director Dr. Martha Buchanan.

William has had several blood transfusions during his recovery and still needs more. His home church Temple Baptist in Powell (no relation – dp) hosted a replacement drive Tuesday for William and the community.

“It’s so encouraging to see people take time out of their busy day and donate from their own life to help Will and others affected by E. coli,” Zenker said.

If you would like more information about future blood drives click here: 
Blood drives scheduled to help children infected with E. coli.

4 confirmed sick with Shiga-toxin E. coli associated with I Love Sushi and Sodexo’s Café Mario in Washington state

Seattle’s King County public health is investigating an outbreak of Shiga toxin-producing E. coli (STEC) associated with I Love Sushi and Sodexo’s Café Mario at Nintendo of America campus in Redmond. Café Mario is operated by Sodexo and is not open to the public. At this time, the source of the illnesses has not been identified.

Since July 2, 2018, we have learned that four people (two King and two Snohomish County residents) have tested positive for STEC. All four consumed food from Café Mario in King County and work at the Nintendo of America campus in Redmond. Symptoms included abdominal cramps and bloody diarrhea. Illness onsets occurred during June 25–28, 2018. The four ill people consumed food from Café Mario on multiple days during June 18–22, 2018; one ill person also ate at I Love Sushi on June 19 and June 26, 2018, which is a food establishment that operates out of Café Mario once a week.\

On July 3, 2018, Public Health – Seattle & King County Environmental Health investigators visited Café Mario. Inspections were completed for both Café Mario and I Love Sushi.

At Café Mario, potential risk factors were identified and corrective actions discussed with Café Mario’s management, including inadequate hand washing practices and improper cold holding temperatures of food. At I Love Sushi, potential risk factors were also identified and discussed, including improper temperature storage of foods. Both restaurants were not open on July 4 due to it being a holiday.

On July 5, 2018, investigators closed Café Mario and the onsite I Love Sushi food services. Both restaurants will remain closed until approved to reopen by Public Health. Both food establishments will be required to complete a thorough cleaning and disinfection before reopening. Remaining food products are being held and environmental swabs were collected for laboratory testing. We are currently investigating whether any employees of these restaurants had a recent diarrheal illness. Investigators also reviewed with Café Mario’s management the Washington State Retail Food Code requirement that staff are not allowed to work while having vomiting or diarrhea.

Raw isn’t rad, it’s risky: Radagast Pet Food, Inc. voluntarily recalls three lots of rad cat raw diet free-range chicken recipe and one lot of pasture-raised venison recipe because of possible health risk

Radagast Pet Food, Inc. of Portland, OR is recalling three lots of Rad Cat Raw Diet Free-Range Chicken Recipe because testing results indicate they have the potential to be contaminated with Listeria monocytogenes.

The Company is also recalling one lot of Rad Cat Raw Diet Pasture-Raised Venison Recipe because testing results indicate it has the potential to be contaminated with Shiga Toxin producing E. coli O121.  This recall is being conducted out of an abundance of caution.  Due to Radagast Pet Food’s commitment to food safety and quality, The Company is conducting this voluntary recall.

Uh-huh.

Victims blame FDA for food-recall failures

I don’t blame any regulatory type for going early or going late in a foodborne disease outbreak.

There’s lots of armchair quarterbacks out there, and we’ve tried to present the various viewpoints on many an outbreak.

There’s also a lot people out there with nothing but a personal agenda, based on profit rather than peer review.

Christine Haughney of Politico reports that people had been getting sick from eating I.M. Healthy Original Creamy SoyNut Butter for more than two months when Peter Ebb, a 59-year-old Boston lawyer and health enthusiast, went for a run and then ate his usual gluten-free English muffin smeared with soy nut butter.

Later that morning — March 6, 2017 — Ebb saw a message from Amazon, which had sold him the nut butter, that the manufacturer had recalled it for contamination by E. coli bacteria. Ebb threw away a protein drink he had made with the soy nut butter, but didn’t worry too much. The Food and Drug Administration warning that was linked to the email was worded very cautiously: Though serious illnesses might result, even potentially leading to death, “most healthy adults can recover completely within a week.”

Six days later, Ebb was hospitalized and developed a deadly type of kidney failure. Within days, doctors told his wife to send for their children in case they needed to bid him a last goodbye. He survived, but remains unable to work full time and has trouble climbing the stairs. Now, he’s joining with 18 other victims to file claims against the companies responsible and call attention to the inadequacy of the nation’s recall system.

“If I had heard about the problem even one week earlier and stopped then, I might have been able to avoid the disease completely, and life today would be very different,” Ebb said.

A POLITICO investigation found that the I.M. Healthy SoyNut Butter case — which officials at the FDA and the Centers for Disease Control and Prevention have hailed as an improvement over past failures — was nonetheless emblematic of persistent weaknesses in the nation’s food-safety system, some of which haven’t been corrected for two years after being flagged by the agency’s inspector general.

Two months elapsed between the first person sickened by eating I.M. Healthy SoyNut Butter on Jan. 4 and the recall orders that began on March 3 and expanded three more times until March 10. The FDA, working through a national network of labs that identifies outbreaks, pinpointed the contamination on Feb. 22. The nine-day lag time in persuading the manufacturer to begin recalling the tainted products was a significant improvement over previous lag times — which were as high as 165 days in one infamous case, according to the inspector general. But victims maintain that the FDA should have ordered a recall on its own authority, given that a few days or even hours can make a difference in a deadly outbreak.

Going public: Early disclosure of food risks for the benefit of public health

Mar.17

NEHA, Volume 79.7, Pages 8-14

Benjamin Chapman, Maria Sol Erdozaim, Douglas Powell

http://www.neha.org/node/58904

Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public. Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions. Information provision on its own is not enough. Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions. There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.

The power of lemons


Every morning I am awaken to the sound of my preprogrammed espresso machine grinding beans. With young kids at home and my slowly aging body, this is a necessity. Anyone with kids can certainly relate. However, before departing for work, my wife and I have a shot of lemon juice for a number of health reasons. Last week I visited the dentist and apparently the acidity from the lemons was slowly corroding my teeth. I neglected to mention that we also add a splash of vinegar to the juice for added benefit. First time I ever heard my dentist laugh and swear. I guess I need something alkaline to balance all of the acidity.

Maggie Angst of the Insider  reports:

Adding a lemon wedge to your water can help shake up the dull beverage and help you reach your recommended 10 to 15 cups of water a day.
Lemon water is touted by experts and celebrities for its long list of benefits including preventing dehydration, assisting with digestion, and supporting weight loss.
But, like most things in life, you can have too much of a good thing.
Here are six dangerous things that can occur when you drink too much lemon water. Keep in mind most of these would take quite a bit of lemon juice before becoming a problem.
It can damage your teeth.
Although a squeeze of lemon in your water every day may seem harmless, it can wreak some major havoc on your pearly whites.
Since lemons are highly acidic, frequent exposure can erode your tooth enamel, the American Dental Association warns. If you’re not sure what eroded enamel would look like, imagine your teeth with a yellow tint and a coarse feeling when you touch them to the tongue.
If that doesn’t convince you to skip the lemon wedge, at least try to drink it out of a straw to cut down on the acid exposure on your teeth.
It can upset your stomach.
Too much of anything is a bad thing, even when it comes to lemon water.
While lemon juice contains a wide range of health benefits, squeezing too much in your water can cause dangerous side effects to your health including worsening ulcers and developing GERD, Livestrong reports.
GERD, also known as gastroesophageal reflux disorder, is triggered by acidic foods like lemon juice and can cause heartburn, nausea, and vomiting.
Lemon skins serve as a host for unpleasant organisms.
If you’re a germaphobe, you may want to steer clear of putting lemon wedges in your water — at least in a restaurant.
In a 2007 study in the Journal of Environmental Health, researchers tested the rinds and flesh of lemons from more than 21 restaurants. In conclusion, they found that nearly 70% of the lemons contained organisms such as E. Coli, which can cause vomiting and diarrhea.
To avoid the germs, squeeze the lemon instead your drink instead of dropping the whole wedge inside your glass.
Using concentrated lemon juice can cause cavities.
Growing up, you were probably instructed not to eat too much candy or you would get cavities. Well, it turns out candy isn’t the only culprit of tooth decay.
According to Healthline, cavities are a result of damaging bacteriathat digest the sugar in foods and produce acids. Although lemon water on its own may not lead to the development of cavities, if you typically sweeten it with sugar or use concentrated lemon juices instead of a freshly squeezed lemon, then you could have a problem on your hands… and teeth.
You may worsen canker sores.
Nothing is worse than waking up to the painful irritation of a newly formed canker sore in your mouth.
While most canker sores will clear up on their own within a week or two, coping with the uncomfortable annoyance for even that long can feel like forever.
If you drink lemon water while dealing with a mouth sore, you’re probably making it worse without realizing it. Lemon water can do more damage to your mouth than just decay your tooth enamel, it also has the potential to exacerbate canker sores and irritate mouth sores, according to the American Dental Association.
Citrus fruits may trigger migraines.
If you deal with headaches or migraines of any nature, it’s safe to say you don’t want to take any chances by eating or drinking something that could trigger them. And citrus fruits, including lemons, are among that category.
Some studies over the years have discovered a connection between migraines and citrus fruits, while a handful of others have not proven a link. Still, citrus fruits like lemons are on doctors’ radars as a possible trigger for migraines, Rebecca Traub, a neurologist with ColumbiaDoctors, told Health.

Petting zoos as a source of shiga-toxin producing E. coli in Austria

Hey Gonzo, they cited us.

Too bad your soccer teams suck, and I don’t care.

But I do care when others cite the gumshoe work we put into our research activities.

And I especially care when every year, I tell our public school or the local shopping mall that petting farms around kids can lead to heartache.

They call me crazy, just like they continue to top salads with raw alfalfa sprouts at Brisbane Private Hospital, despite my protestations.

I do what I can.

These others are microbiological idiots.

There, I’m done.

Despite their general low incidence, Shiga toxin-producing Escherichia (E.) coli (STEC) infections are considered an important public health issue due to the severity of illness that can develop, particularly in young children.

 We report on two Austrian petting zoos, one in Tyrol (2015) and one in Vorarlberg (2016), which were identified as highly likely infection sources of STEC infections. The petting zoo related cases involved a case of hemolytic uremic syndrome (HUS) due to STEC O157:HNM in 2015 and an outbreak of STEC O157:H7 infections affecting five young children and two adults in 2016. The HUS case accounted for 2.8% of the 36 STEC O157:HNM/H7 infections notified in Austria in 2015 (5,9% of 17 HUS cases). The seven cases described for 2016 accounted for 4.0% of the 177 human STEC infections documented for Austria in 2016, and for 19% of the 36 STEC O157:HNM/H7 infections notified that year.

The evaluation of the STEC infections described here clearly underlines the potential of sequence-based typing methods to offer suitable resolutions for public health applications. Furthermore, we give a state-of-the-art mini-review on the risks of petting zoos concerning exposure to the zoonotic hazard STEC and on proper measures of risk-prevention.

A table of petting zoo outbreaks is available at http://www.barfblog.com/wp-content/uploads/2017/08/Petting-Zoo-Outbreaks-Table-7-26-17.xlsx

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos.

Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact.

Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

Petting zoos as sources of shiga toxin-producing Escherichia coli (STEC) infections

27.june.18

International Journal of Medical Microbiology, DOI: 10.1016/j.ijmm.2018.06.008 

Sabine Schlager, Sarah Lepuschitz, Werner Ruppitsch, Oksana Ableitner, Ariane Pietzka, Sabine Neubauer, Anna Stöger, Heimo Lassnig, Claudia Mikula, Burkhard Springer, Franz Allerberger
http://www.x-mol.com/paper/721663

Canada Day and Fourth of July food safety fun

Today is my ninth Canada Day in Raleigh.

In previous years we’ve sought out Canadian beers; found the best poutine in town; skated with the Canadian club of the triangle; and curled.

This year is a bit lower-key: I’m hanging out in the backyard, watching Don Cherry talk about the opening day of free agent signings in the NHL (right, exactly as shown).

As I get a bit older I think more about what I miss about Canada, what I don’t, what it means to me to be Canadian and why I choose to live in the U.S.. There are lots of similarities and differences between the two countries.

Some stuff is easy to explain, others, like an emotional connection to The Tragically Hip and Jr. hockey, is a bit tougher.

The combination of Canada Day and July 4th (just a couple of days apart) is one of my favorite times of year. The traditional signal of summer vacation season in both countries and – and a bunch of cookouts, grillouts, bbqs, or whatever you want to call it.

The seasonal lede is also often used for talking food safety.

Cooking a bunch of hot dogs and hamburgers, folks coming to a backyard party or hanging out around the pool is something that many can identify, north and south of the 49th parallel.

The preliminary results of some work that I was part of is making the rounds this weekend with the grilling hook, which is kinda cool. Over the past 18 months a team of us planned and carried out a series of observations in kitchen settings asking regular people to come in, cook a couple of turkey burgers, prepare a salad and some salad dressing in front of a series of cameras while students and staff coded what took place – stuff handwashing, thermometer use, cross-contamination.

The project was built on concepts that were developed more than a decade ago when I visited the a creative food safety group in Cardiff, Wales (then UWIC, now Cardiff Met) who were all about observations. Following that trip, Sarah DeDonder, Brae Surgeoner, Randy Phebus, Doug and I adapted the approach to look at handling of frozen chicken entrées.

I’ll wait for a couple of weeks until some of this work is presented at the 2018 International Association for Food Protection annual meeting to share more results- and publication for all the fun details, but here’s some good highlights from USDA.

“As a mother of three young children, I am very familiar with the mad dash families go through to put dinner on the table,” said Carmen Rottenberg, Acting Deputy Under Secretary for Food Safety at USDA. “You can’t see, smell or feel bacteria. By simply washing your hands properly, you can protect your family and prevent that bacteria from contaminating your food and key areas in your kitchen.”
The preliminary results of the observational study, conducted by USDA in collaboration with RTI International and North Carolina State University, showed some concerning results.
* Handwashing: the study revealed that consumers are not washing their hands correctly 97 percent of the time.
* Most consumers failed to wash their hands for the necessary 20 seconds, and
* Numerous participants did not dry their hands with a clean towel.

* Thermometer use: results reveal that only 34 percent of participants used a food thermometer to check that their burgers were cooked properly.
* Of those who did use the food thermometer, nearly half still did not cook the burgers to the safe minimum internal temperature.

* Cross contamination: the study showed participants spreading bacteria from raw poultry onto other surfaces and food items in the test kitchen.
* 48 percent of the time are contaminating spice containers used while preparing burgers,
* 11 percent of the time are spreading bacteria to refrigerator handles, and
* 5 percent of the time are tainting salads due to cross-contamination.

One positive for E. coli, 30 others ill after eating at North Carolina restaurant

Health officials say dozens of people became very ill after eating at a restaurant in Taylorsville in Alexander County.

Health officials said one person tested positive for E. coli, and more than 30 others are also sick after eating chicken at the restaurant.

The bacterial infection causes severe stomach cramps, diarrhea, vomiting and sometimes a low-grade fever.

Officials say the restaurant has been cooperating and will remain open after all the infected products have been removed.

Doesn’t matter if your kid has E. coli, US privileged want playground taken down

Tim Sanders claims his family’s neighborhood association wants him to take down the playground he installed for his daughter, who is fighting kidney failure.

“It’s important to have this playground when my daughter gets home from the hospital, because it’s hope,” Sanders said. E. coli led to kidney failure for 6-year-old Ashlin three years ago.

The Sanders family moved to Oconomowoc to be closer to family and Ashlin’s doctors in Madison.

She had a kidney transplant on Father’s Day and is expected to return home soon.

“Today they pulled out a pic-line in her chest where they administer fluids and things of that nature,” Sanders said.

Sanders says the former neighborhood president approved the playground and trees. An email says “permission was granted for the rainbow playground set.” It goes on to say trees were also allowed.

“We are not breaking codes. Everything was permitted,” Sanders said.

Sanders said the new HOA board wants him to take everything down “in order to obtain and maintain harmony in appearance,” according to a letter.

Suburbia, I smile and wave.

Beware the canal waters (I’m looking at you Holland Marsh, Ontario, that’s in Canada): Canal irrigation water likely source of E. coli O157 outbreak linked to romaine lettuce 5 dead, 218 sick

The U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC) and state and local partners, are investigating a multistate outbreak of E. coli O157:H7 illnesses linked to romaine lettuce from the Yuma, Arizona, growing region.

The FDA, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak.

Samples have been collected from environmental sources in the region, including water, soil, and cow manure. Evaluation of these samples is ongoing.

To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli O157:H7 with the same genetic finger print as the outbreak strain. We have identified additional strains of Shiga-toxin producing E. coli in water and soil samples, but at this time, the samples from the canal water are the only matches to the outbreak strain.

Analysis of additional samples is still ongoing, and any new matches to the outbreak strain will be communicated publicly and with industry in the region.

Identification of the outbreak strain in the environment should prove valuable in our analysis of potential routes of contamination, and we are continuing our investigation in an effort to learn more about how the outbreak strain could have entered the water and ways that this water could have come into contact with and contaminated romaine lettuce in the region.

As of June 27, the CDC reports that 218 people in 36 states and Canada have become ill. These people reported becoming ill in the time period of March 13, 2018 to June 6, 2018. There have been 96 hospitalizations and five deaths.

The traceback investigation indicates that the illnesses associated with this outbreak cannot be explained by a single grower, harvester, processor, or distributor. While traceback continues, the FDA will focus on trying to identify factors that contributed to contamination of romaine across multiple supply chains.  The agency is examining all possibilities, including that contamination may have occurred at any point along the growing, harvesting, packaging, and distribution chain before reaching consumers. 

The FDA, along with CDC and state partners, initiated an environmental assessment in the Yuma growing region to further investigate potential sources of contamination linked to this outbreak. To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli O157:H7 with the same genetic finger print as the outbreak strain. We have identified additional strains of E. coli in water and soil samples, but at this time, the samples from the canal water are the only matches to the outbreak strain.

The FDA is continuing to investigate this outbreak and will share more information as it becomes available.

“More work needs to be done to determine just how and why this strain of E. coli O157:H7 could have gotten into this body of water and how that led to contamination of romaine lettuce from multiple farms,” said Dr. Scott Gottlieb, commissioner of the U.S. Food and Drug Administration, in a statement.