212 sick: Multistate outbreak of cyclosporiasis linked to Del Monte Fresh produce vegetable tray

The U.S. Centers for Disease Control and Prevention (CDC) reports that Cyclospora cayetanensis is a single-celled parasite that causes an intestinal infection called cyclosporiasis.

As of July 5, 2018 (9am EDT), CDC has been notified of 212 laboratory-confirmed cases of cyclosporiasis in persons who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip. The reports have come from four states.

Seven (7) of these people have been hospitalized, and no deaths have been reported.

Epidemiologic evidence indicates that pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip are the likely source of these infections.

Most ill people reported eating pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip.

Most ill people reported buying pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip in the Midwest. Most people reported buying the trays at Kwik Trip convenience stores.

The investigation is ongoing. CDC will provide updates when more information is available.

General advice for consumers about prevention of cyclosporiasis can be found here.

On June 15, 2018, Del Monte Fresh Produce recalled 6 oz., 12 oz., and 28 oz. vegetable trays containing fresh broccoli, cauliflower, celery sticks, carrots, and dill dip. Recalled products were sold in clear, plastic clamshell containers.

Recalled products were distributed to the following stores: Kwik Trip, Kwik Star, Demond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket, and Peapod.

185 sick: Cyclosporiasis in Del Monte veggie trays

As of June 28, 2018 (11am EDT), the U.S Centers for Disease Control (CDC) has been notified of 185 laboratory-confirmed cases of cyclosporiasis in persons who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip. The reports have come from four states.

Seven (7) of these people have been hospitalized, and no deaths have been reported.

  • Epidemiologic evidenceindicates that pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip are the likely source of these infections.
    • Most ill people reported eating pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip.
    • Most ill people reported buying pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip in the Midwest. Most people reported buying the trays at Kwik Trip convenience stores.
    • The investigation is ongoing. CDC will provide updates when more information is available.

The median illness onset date among patients is May 31, 2018 (range: May 14 to June 9).  Ill people range in age from 13 to 79 years old, with a median age of 47. Fifty-seven percent (57%) are female and 7 people have been hospitalized. No deaths have been reported.

Illnesses that began after May 17, 2018 might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

They ain’t growing cantaloupes in Vancouver in Feb.

Freshpoint Vancouver, Ltd. is recalling Del Monte and Sysco Imperial Fresh brand cantaloupes from the marketplace due to possible Salmonella contamination. Consumers should not consume and retailers, hotels, restaurants and institutions should not sell, serve or use the recalled products described below.

cantaloupe.salmonellaConsumers who are unsure if they have the affected cantaloupes are advised to check with their retailer.

Recalled products

Brand Name Common Name Size Code(s) on Product UPC
Del Monte Cantaloupe 1 count Sold up to and including February 18, 2016 PLU 4050
Del Monte Cantaloupe (case) 12 count Lot 360012 None
Sysco Imperial Fresh Cantaloupe 3 count Lot 127 12 035 5 None

Check to see if you have recalled products in your home. Recalled products should be thrown out or returned to the store where they were purchased.

This recall was triggered by Canadian Food Inspection Agency (CFIA) test results. The CFIA is conducting a food safety investigation, which may lead to the recall of other products. If other high-risk products are recalled, the CFIA will notify the public through updated Food Recall Warnings.

The CFIA is verifying that industry is removing recalled product from the marketplace.

Illnesses

There have been no reported illnesses associated with the consumption of these products.

When to go public? First salmonella-in-Del-Monte cantaloupe illnesses IDed in Albany in Feb. public not told

Alex Paul of the Albany Democrat-Herald reports the first confirmed victims of a February outbreak of Salmonella Panama that eventually affected 20 people in 10 states and was traced to cantaloupe that came from a single farm in Guatemala, was in Albany, Oregon.

“We found one person confirmed and two others presumed with a pretty rare form of salmonella,” said Jane Fleischbein of the Linn County Public Health Department.

Fleischbein said the public wasn’t notified because Costco immediately pulled the product from its shelves.

“It all depends on timing,” Fleischbein said. “Sometimes it takes a while to track down and by the time the source has been identified, the product has already been consumed or taken off the shelves.”

Fleischbein said her office gets news of at least one recall per week.

“If local public health departments sent a notice about every recall, we would be awfully busy,” Fleischbein said. “There are many recalls that go under the radar.”

The three in Albany were among six people statewide who became sick. The investigation concluded they had eaten cantaloupe served at a church supper.

Salmonella in Del-Monte cantaloupes: epidemiology is faster, more powerful than laboratory confirmation

As part of continuing coverage of the yes-it-was-salmonella-in-Del-Monte-cantalopues-that-made-people-sick-no-it-wasn’t lawsuit, Kirk Smith, epidemiology supervisor for the Minnesota Department of Health, told the Washington Post it’s rare for scientists investigating foodborne illness outbreaks to test the exact food suspected of carrying pathogens. By the time symptoms occur and a foodborne illness is reported and confirmed, the product in question has likely been consumed or has exceeded its shelf-life and been thrown away.

Instead, scientists, like detectives, interview victims, collect data, analyze patterns and match food “fingerprints” to determine the likely source of an outbreak.

“The majority of outbreaks, we don’t have the food to test,” Smith said. “Laboratory confirmation of the food should never be a requisite to implicating a food item as the vehicle of an outbreak. Epidemiology is actually a much faster and more powerful tool than is laboratory confirmation.”

The Post also uncovered some e-mail exchanges between Oregon state epidemiologist William E. Keene and Del Monte execs.

Keene wrote in an e-mail to the company on March 19 that evidence the company’s cantaloupe was the source of contamination was “overwhelming. … I think we need to move ahead with the common understanding that your cantaloupes caused this outbreak.”

Keene included in the e-mail an epidemiological analysis of cantaloupe consumption in the United States and how it relates to the U.S. share of cantaloupe from a farm in Guatemala that supplies Del Monte Fresh Produce. He used this analysis to explain the high probability that the contaminated cantaloupe originated from the farm, located in AsuncionMita.

“In our world, these numbers are considered pretty good evidence, however circumstantial,” he wrote.

Thomas Young, Del Monte Fresh Produce’s vice president of research and agricultural services, wrote in one e-mail, “I cannot imagine how [salmonella] could be coming from our Mita operation, but I am available to assist you in your investigation.”

Young also argues that none of Del Monte Fresh Produce cantaloupes tested positive for Salmonella Panama. Keene responded that a positive test “is a pretty tough standard to meet,” given the fact that the implicated cantaloupe had already been consumed and whatever remained had likely been thrown away.

Our melons are salmonella-safe: Del Monte-FDA agreement expected before lawsuit reaches court?

Continuing with all things melon, did Del Monte cantaloupes, imported from a farm in Guatemala, sicken at least 20 people in 10 states with Salmonella Panama beginning in Feb. 2011?

Or was the link a result of zealous health types in Oregon and at the U.S. Food and Drug Administration?

William Neuman of the N.Y. Times writes a lawsuit filed by Del Monte Fresh Produce against FDA is being cheered by many in the produce industry, who often complain about what they call overreaching by regulators and welcome a company with resources pushing back.

Aside from suing the F.D.A., the company has threatened legal action against a leading state food-borne disease investigator in Oregon, where the Del Monte cantaloupes were identified as the cause of the salmonella outbreak. And it has challenged some of the basic techniques of food safety investigations, like relying on ill people’s memories of what they ate when microbiological testing does not find pathogens on food.

Dennis Christou, vice president of marketing for Del Monte Fresh Produce, which is based in Coral Gables, Fla., said, “It’s got to be a comprehensive and reliable investigation, and in our opinion this was neither. There’s absolutely no basis in the claim that this was done intentionally to intimidate or bully anyone.”

The company said Wednesday that it was in talks with the F.D.A. to resolve the dispute and expected an agreement soon.

When the outbreak was emerging, epidemiologists used data from Costco membership cards and found that the melons came from one farm in Guatemala, called Asunción Mita, owned by Del Monte Fresh Produce.

The investigators, working with the federal Centers for Disease Control and Prevention and the FDA asked Del Monte Fresh Produce for a recall, following the usual procedure. The company at first resisted but, according to its lawsuit, eventually agreed to a limited recall to prevent the FDA from issuing a broad warning about contaminated melons that could have affected the entire cantaloupe market. The recall was announced on March 22.

But in mid-July the FDA issued an import alert, saying that the conditions that caused the contamination might still exist on the Asunción Mita farm. The alert allowed inspectors to stop cantaloupes grown on the farm from entering this country.

Del Monte Fresh Produce fired back, filing its lawsuit and accusing federal and state inspectors of conducting a slipshod investigation. And it questioned the validity of the results because investigators had not found a cantaloupe contaminated with the bacteria that had made people sick.

The company’s filings include an audit report of the Guatemala farm, submitted to the FDA last month, which raises questions about the company’s practices.

The audit, done by a company hired by Del Monte Fresh Produce, found that a pipe containing raw sewage and wastewater emptied into an open ditch about 110 yards from the farm’s packing house. The ditch led into a lagoon containing additional sewage, more than 220 yards from the packing house. The audit recommended that the ditch be eliminated.

Mr. Christou said the ditch was protected by barbed wire to keep large animals from tracking the waste into fields. He said the lagoon contained chemicals to speed decomposition of the waste and was away from fields and wells. After the audit, he said, the company extended the pipe all the way to the lagoon and discontinued use of the open ditch.

Asked if having raw sewage in an open ditch near its packing house was consistent with high food safety standards, Mr. Christou said that tests on melons had found no pathogens.

Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said, “There’s no doubt the data are very tight. Del Monte caused that outbreak.”

And he said that many investigations involving sickness from produce did not find contaminated food because by the time officials became aware of the outbreak, the tainted produce had been eaten or discarded.

A table of cantaloupe- (or rock melon) related outbreaks is available at http://bites.ksu.edu/cantaloupe-related-outbreaks.

More food safety types voice concern about Del Monte’s ‘embarrassing and spurious’ lawsuit

“I would be the first one to defend any company if the data were incomplete or if the investigation didn’t show an association, but this one almost reminds me of the intimidation lawsuits the tobacco industry has used in the past.”

That’s what Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told Doug Ohlemeier of The Packer regarding Del Monte’s lawsuit targeting Oregon’s top food safety scientist, William Keene.

Michael Doyle, a former Food and Drug Administration advisor who heads the Center for Food Safety at the University of Georgia, said he fears such lawsuits could limit effectiveness of public health messages to consumers.

“One of the most difficult points that epidemiologists have to make is the call as to whether a specific food is a vehicle for an outbreak. If they do this later than sooner, more people could be exposed to the implicated food and made ill. There needs to be a balance because some epidemiologists may be overly aggressive with insufficient information or pulling the trigger too fast. This lawsuit could do more harm than good but it might make epidemiologists more cognizant of the fact that they’re responsible for not only public health, but economic consequences.”

Dennis Christou, Fresh Del Monte’s vice president of marketing, said the suit is necessary to ensure investigations are conducted properly.

“When a product recall is later determined baseless due to a failure to conduct a comprehensive and reliable investigation, the public health is not protected. The investigation must be comprehensive and reliable such that the public can be reasonable confident that the product recall effectively eliminates the threat to consumer safety.”

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

Will Del Monte’s lawsuit against Oregon health succeed in setting poisonous tone for outbreak investigations?

Del Monte Fresh Produce, a company that recalled its cantaloupes in March after health investigators in several states linked them to a Salmonella Panama outbreak, said yesterday that is plans to sue Oregon Health Authority and, Dr William Keene, one of the nation’s most well-known disease outbreak investigators (right, exactly as shown), claiming that the company’s products were wrongly singled out.

Lisa Schnirring of CIDRAP news at the University of Minnesota interviewed several public health types, who say the company’s suit is unprecedented, and some worry that it may inhibit future foodborne illness investigations.

Lon Kightlinger, MPH, PhD, state epidemiologist with the South Dakota Department of Health, said some of his department’s disease investigations have involved legal tug-of-wars. "Although we do have some worries of legal threats, that does not drive our investigation, but causes us to do a better job," he said.

In Iowa, laws require public health officials to treat the names of entities such as restaurants or companies the same as people, said Patricia Quinlisk, MD, MPH, medical director and state epidemiologist for the Iowa Department of Public Health.

She said that, before going public with names, health officials must discuss the issue with the state attorney general’s office to make sure the action complies with a "necessary for public health" clause. "Thus something like this might have more scrutiny here than other places," she said, adding that she’s never seen a legal threat like Del Monte’s.

Tim Jones, MD, MPH, state epidemiologist for the Tennessee Department of Health, said he’s been bullied and subjected to implied threats in the course of epidemiologic investigations. "I’ve never taken them seriously, and legally I’ve never been worried," he said.

Though Del Monte’s legal threat could create an inhibitory effect, epidemiologists take pride in being able to respond to outbreaks faster and freer than federal agencies, which are often bound by legal restrictions, Jones said.

"Our job is to protect people."

Some measure of immunity is needed for investigators, Jones said. "If anyone in public health is nervous about getting sued, it could be dangerously inhibitory."

13 sick from salmonella in cantaloupe; CDC update; salmonella in cantaloupe chart updated on bites

As of March 29, 2011, 13 persons infected with the outbreak strain of Salmonella Panama have been reported from Oregon (5 cases), Washington (4 cases), California (2 cases), Colorado (1 case) and Maryland (1 case). Reported dates of illness onset range from February 5, 2011 to March 4, 2011. Ill persons range in age from less than 1 year old to 68 years old, with a median age of 12 years old. Sixty-two percent are male. Among ill persons, three have been hospitalized and no deaths have been reported.

Collaborative investigative efforts of state, local, and federal public health and regulatory agencies have linked this outbreak to eating cantaloupe. On March 22, 2011, Del Monte Fresh Produce N.A., Inc. voluntarily recalled cantaloupes. Consumer should not eat recalled cantaloupes and restaurant and food service operators should not serve them. The cantaloupes, grown in and shipped from Del Monte Fresh’s farm Asuncion Mita in Guatemala, have a light brown color skin on the exterior with orange flesh. The recalled cartons of cantaloupes are dark brown cardboard with the “Del Monte” logo in red lettering and “cantaloupes” in yellow lettering on a green background. The cantaloupes have the lot codes: 02-15-24-10, 02-15-25-10, 02-15-26-10 and 02-15-28-10. No illness has been linked to cantaloupes from other sources.

An updated table of salmonella-in-cantaloupe outbreaks and recalls is available at:
http://bites.ksu.edu/cantaloupe-related-outbreaks.

12 sick with Salmonella; Del Monte cantaloupe grown in Guatemala recalled

At least 12 people have been sickened with Salmonella Panama in the U.S. and the Food and Drug Administration has identified an epidemiologic link with Del Monte cantaloupes grown in Guatemala.

So, Del Monte Fresh Produce N.A., Inc. of Coral Gables, Florida is voluntarily recalling 4,992 cartons of cantaloupes, each containing 4 plastic mesh sleeves with 3 cantaloupes per sleeve, because they have the potential to be contaminated with Salmonella Panama.

The cantaloupes were distributed through warehouse clubs in Alaska, California, Colorado, Idaho, Montana, Oregon, and Washington.

The recalled products consist of cartons of cantaloupes, each containing 4 plastic beige mesh sleeves each sealed with a plastic orange handle with the Del Monte logo and indication “3 count, Product of Guatemala” with 3 cantaloupes per sleeve and were available for sale between the 10th of March and the 21st of March, 2011.

The cantaloupes, grown in and shipped from Del Monte Freshs’ farm Asuncion Mita in Guatemala, have a light brown color skin on the exterior, with orange flesh. The recalled cartons of cantaloupes are dark brown cardboard with the “Del Monte” logo in red lettering and “cantaloupes” in yellow lettering on a green background. The cantaloupes have the lot codes: 02-15-24-10, 02-15-25-10, 02-15-26-10 and 02-15-28-10.

Consumers who believe that they are in possession of uneaten cantaloupe affected by this recall should return it to the place of purchase for a refund and for more information may contact 1-800-659-6500 (operational 24 hours a day, seven days a week) or email Del Monte Fresh at Contact-US-Executive-Office@freshdelmonte.com.