Multistate outbreak of Vibrio parahaemolyticus infections linked to fresh crab meat imported from Venezuela

The U.S. Centers for Disease Control (CDC), is getting in on the vibrio outbreak linked to crab meat imported from Venezuela – often posing as Maryland crab – along with state and local health officials, and the U.S. Food and Drug Administration.

CDC recommends that consumers not eat, restaurants not serve, and retailers not sell fresh crab meat imported from Venezuela at this time.

How would consumers know? Ask questions?

Consumers are not the critical control point of this food safety system.

Yet my 9-year-old knew enough to ask if the aioli that was served with her chips at a hockey tournament in Newcastle, Australia, this was weekend, contained raw egg.

I wasn’t around, but a shiver of pride went through my body.

This type of product may be labeled as fresh or precooked. It’s commonly found in plastic containers.

Food contaminated with Vibrio parahaemolyticus usually looks, smells, and tastes normal.

Steamed crab meat from blue crab (close up)

If you buy crab meat and do not know whether it is from Venezuela, do not eat, serve, or sell it. Throw it away.

CDC, state and local health officials, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Vibrio parahaemolyticus infections linked to eating fresh crab meat imported from Venezuela.

Epidemiologic evidence indicates that precooked fresh crab meat imported from Venezuela is the likely source of this outbreak.

Twelve people infected with Vibrio parahaemolyticus who ate fresh crab meat have been reported from Maryland, Louisiana, Pennsylvania, and the District of Columbia.

Four people (33%) have been hospitalized. No deaths have been reported.

Illnesses started on dates ranging from April 1, 2018 to July 3, 2018.

100 sick from Salmonella in 33 states: Kellogg’s Honey Smacks Cereal still suck and still being sold

The U.S. Food and Drug Administration (FDA) has become aware that recalled Kellogg’s Honey Smacks cereal are still being offered for sale. All Honey Smacks cereal was recalled in June 2018.

Retailers cannot legally offer the cereal for sale and consumers should not purchase Kellogg’s Honey Smacks cereal.

The FDA has learned that some retailers are still selling this product. The FDA will continue to monitor this situation closely and follow up with retailers as we become aware of recalled products being offered for sale. Additionally, the public is urged to report any product being offered for sale to the FDA Consumer Complaint Coordinator in their region. More information about the recall can be found at FDA.gov.

The FDA, CDC, along with state and local officials are investigating a multi-state outbreak of Salmonella Mbandaka infections linked to Kellogg’s Honey Smacks sweetened puffed wheat cereal.

The CDC reports that 100 people in 33 states have become ill. There have been 30 hospitalizations and no deaths.

Following discussion with FDA, CDC, and state partners, the Kellogg Company voluntarily recalled Kellogg’s Honey Smacks cereal. The recalled products were distributed across the United States including Guam and Saipan and internationally. Consumers should not eat any Honey Smacks cereal.

As this is an ongoing investigation, the FDA will update this page as more information becomes available, such as product information, epidemiological results, and recalls.

The FDA provided a more detailed a list of foreign countries to which the Kellogg’s Honey Smacks cereal was distributed.. Here is the list of the foreign countries: Aruba/Curaçao/Saint Maarten (Netherlands Antilles), the Bahamas, Barbados, Tortola (British Virgin Islands), Costa Rica, Guatemala, Haiti, Mexico, Panama, and Tahiti (French Polynesia).

The FDA is advising consumers to not eat and to discard any Kellogg’s Honey Smacks cereal. This is regardless of size or “best if used by” dates. The recall notice accounts for all of the product that is on the market within the cereal’s estimated one year shelf-life. However, Honey Smacks products with earlier dates could also potentially be contaminated.  

The FDA quickly initiated an inspection at the contract facility where Kellogg’s Honey Smacks is manufactured. As part of the inspection, investigators collected environmental and product samples. Analysis of the environmental samples is now complete, and they were found to be a match to the outbreak strain. In addition, product samples collected and analyzed by state partners were positive for the outbreak strain of Salmonella Mbandaka. As of June 12, 2018, the manufacturing facility is no longer producing product. The FDA continues to work with the firm to address corrective actions.

When the Miami Herald filed a Freedom of Information Act request for the inspection of the facility, the FDA denied the request. The agency claimed two exemptions: “disclosure could reasonably be expected to interfere with enforcement proceedings” and possible disclosure of “trade secret and confidential commercial information.”

61 sick in 7 states from Cyclospora in new outbreak linked to McDonald’s; 3000 locations removing salads

At least 61 people in seven Midwestern States have been sickened with Cyclospora possibly linked to salads served at McDonald’s restaurants.

The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention (CDC) report that two people have been hospitalized and to date, no deaths have been reported.

Ashley Nickle of The Packer reports that health authorities in Illinois and Iowa have reported 105 recent cases of cyclosporiasis and have linked some of them to McDonald’s salads.

“Out of an abundance of caution, we decided to voluntarily stop selling salads at impacted restaurants until we can switch to another lettuce blend supplier,” McDonald’s said in a statement. “We are in the process of removing existing salad blends from identified restaurants and distribution centers, which includes approximately 3,000 of our U.S. restaurants, primarily located in the Midwest.”

McDonald’s spokeswoman Terri Hickey said, “McDonald’s is committed to the highest standards of food safety and quality control. We are closely monitoring this situation and cooperating with state and federal public health authorities as they further investigate”

In June, federal agencies investigated cyclosporiasis cases that were linked to Del Monte vegetable trays. More than 225 illnesses have been reported in that outbreak. At this time, no link has been made by health authorities between the outbreak linked to McDonald’s salads and the outbreak linked to Del Monte vegetable trays, which included broccoli, cauliflower, carrots and dip.

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.

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.

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.

Will it mean fewer sick people? Trump’s plan to consolidate federal food safety efforts won’t work

Timothy D. Lytton, Associate Dean for Research & Faculty Development and Distinguished University Professor & Professor of Law at Georgia State University College of Law writes in this contributed op-ed that:

The Trump administration on June 21 unveiled an ambitious plan to consolidate federal food safety efforts within the U.S. Department of Agriculture.

Currently, 15 agencies throughout the federal government administer 35 different laws related to food safety under the oversight of nine congressional committees.

The administration calls this system “illogical” and “fragmented.”

“While [the USDA’s Food Safety Inspection Service] has regulatory responsibility for the safety of liquid eggs, [the Food and Drug Administration in the Department of Health and Human Services] has regulatory responsibility for the safety of eggs while they are inside of their shells,” the document explains. “FDA regulates cheese pizza, but if there is pepperoni on top, it falls under the jurisdiction of FSIS; FDA regulates closed-faced meat sandwiches, while FSIS regulates open-faced meat sandwiches.”

Concern about this state of affairs has been fueling similar consolidation proposals for decades.

But my research for a forthcoming book on the U.S. food safety system suggests that the Trump administration plan faces a number of challenges that make a major reorganization of federal food safety regulation both impractical and undesirable.

The curious division of labor between the U.S. Department of Agriculture and the Food and Drug Administration dates back to the passage of two laws enacted in 1906.

The Meat Inspection Act mandated inspection of all beef carcasses. The Pure Food and Drug Act prohibited the sale of adulterated food in interstate commerce.

Initially, both laws were implemented by officials at the USDA. Its Bureau of Animal Industry placed inspectors trained in veterinary science at every meat plant. Meanwhile, its Bureau of Chemistry employed laboratory scientists to test foods for adulteration.

In 1940, Franklin Roosevelt moved the Bureau of Chemistry, by then renamed the Food and Drug Administration, out of the USDA and into the Federal Security Agency, which later became the Department of Health and Human Services. Today, the FDA is responsible for overseeing the production of most foods other than meat and poultry.

Separately, the Bureau of Animal Industry was renamed the Food Safety Inspection Service, which is still responsible for all meat and poultry inspections.

Concerns about regulatory fragmentation grew as Congress assigned new tasks related to food safety to a variety of other agencies.

For example, Congress instructed the Federal Trade Commission to regulate food advertising, the Environmental Protection Agency to set pesticide tolerances and the National Marine Fisheries Service to inspect seafood.

Proponents of putting food safety under the roof of a single agency have argued that the current system causes confusion because different agencies produce inconsistent standards.

They further allege that overlapping jurisdictions create inefficiencies and that inadequate coordination leaves gaps in coverage. They also worry that the involvement of so many different actors diffuses political accountability.

The first high-profile proposal to consolidate federal food safety regulation was made in 1949, during the Truman administration, when a presidential commission recommended transferring food safety oversight to the USDA, just as the Trump administration has.

In 1972, consumer activist Ralph Nader advocated creating a new consumer safety agency to oversee food safety. And a few years later, a Senate committee recommended moving the USDA’s food safety responsibilities to the FDA.

Those are just three examples of more than 20 such proposals from both sides of the political aisle, including one by President Barack Obama in 2015.

None of these consolidation efforts succeeded for the same reasons the current one is unlikely to work now.

First of all, the many congressional committees that currently oversee agencies that regulate food safety are unlikely to support any reorganization that would reduce their power. Congressional oversight affords lawmakers who serve on committees opportunities to help interest groups and constituents in exchange for political support.

Similarly, industry associations are unlikely to support a reorganization that would disrupt their relationships with existing agencies. Consolidation threatens to reduce their access and influence over agency decisions.

In addition to the political obstacles to consolidation, there are practical problems. Merely merging the 5,000 food safety officials in the FDA and the 9,200 officials in the FSIS under the oversight of a single administrator would not eliminate the differences in jurisdiction, powers and expertise responsible for the current bureaucratic fragmentation. Meaningful consolidation would require a complete overhaul of federal food safety laws and regulations, a task of extraordinary legal and political complexity.

Moreover, consolidating food safety efforts in a single agency might create new forms of fragmentation. For example, transferring the FDA Center for Veterinary Medicine’s program for regulating drug residues in beef and poultry to the USDA would separate it from the FDA’s veterinary drug approval program.

And finally, reorganization is costly and would take years for the different agency teams newly working together to develop bonds of trust and cooperation. And these costs would have to be paid upfront, without a clear idea of whether the expected gains will ever pay off.

Consolidation need not be all or nothing.

For example, some have proposed more modest consolidation of inspection services, policy planning and communications that would be less costly and not so difficult.

Nonetheless, Congress has shown little interest in considering any bureaucratic reorganization of federal food safety regulation, even a partial consolidation.

In other words, the Trump administration may have to settle for the less ambitious goal of better interagency coordination, which offers an alternative way to address concerns about duplication and coverage gaps. This more modest approach would not, however, address the persistent problem of fragmentation.

In food safety, as in other regulatory reform arenas, it may turn out that half a loaf is better than none.

On Salmonella, go with science or rapper who craves Honey Smacks?

Joshua Espinoza of Complex writes that Boosie Badazz is in disbelief over the 2018 Honey Smacks recall.

Just days after it was announced that the beloved cereal was linked to 73 salmonella outbreaks in 31 states, the Baton Rouge rapper went to social media demanding further proof of the reported contamination.

“I just got home and my kids told me some shit about Honey Smacks are no longer available. I don’t if this true, but I’m pissed. I need proof,” he said in an Instagram video. “I think somebody might be tryin’ to fuck with me […] They say it’s full of salmonella, they were sayin’ something—well I’m full of salmonella!”

Boosie’s love for Honey Smacks has been well documented over the years. There are a number of videos of the rapper doing nothing more than grubbing on the puffed wheat breakfast cereal.

“I need proof, man. Fuck that. They just can’t take them off the market,” he goes on in the video. “I need proof. Somebody DM proof. The scientists, somebody, DM me some proof.”

How badazz is it to eat a kid’s cereal?

5 dead, 197 sick from E. coli O157 linked to romaine lettuce

The U.S. Centers for Disease Control reports there are now five people dead and 197 sick from E. coli O157:H7 linked to romaine lettuce.

  • 197 people infected with the outbreak strain of E. coli O157:H7 have been reported from 35 states.
  • 89 people (48%) have been hospitalized, including 26 people who have developed hemolytic uremic syndrome.
  • 5 deaths have been reported from Arkansas (1), California (1), Minnesota (2), and New York (1).
  • Illnesses started on dates ranging from March 13, 2018 to May 12, 2018.
  • Ill people range in age from 1 to 88 years, with a median age of 29.
  • Sixty-eight percent of ill people are female.

The Public Health Agency of Canada has identified people in several Canadian provinces infected with the same DNA fingerprint of E. coli O157:H7.

It takes two to three weeks between when a person becomes ill with E. coli and when the illness is reported to CDC. Most of the people who recently became ill ate romaine lettuce when lettuce from the Yuma, Arizona, growing region was likely still available in stores, restaurants, or in peoples’ homes. Some people who became sick did not report eating romaine lettuce, but had close contact with someone else who got sick from eating romaine lettuce.

According to the U.S. Food and Drug Administration, the last shipments of romaine lettuce from the Yuma growing region were harvested on April 16, 2018, and the harvest season is over. It is unlikely that any romaine lettuce from the Yuma growing region is still available in people’s homes, stores, or restaurants due to its 21-day shelf life.

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 has identified Harrison Farms of Yuma, Arizona, as the grower and sole source of the whole-head romaine lettuce that sickened several people in an Alaskan correctional facility, but has not determined where in the supply chain the contamination occurred.

On May 31, 2018 the FDA released a blog with updated information on the traceback investigation (for additional information, visit FDA Update on Traceback Related to the E. coli O157:H7 Outbreak Linked to Romaine Lettuce).

A listing of 78 outbreaks linked to leafy greens since 1995 is posted here.

This is a thing: FDA issues warning about snorting chocolate

For a while last year, snorting chocolate was a thing. It was peddled to folks in the club scene as an alternative to doing illegal drugs. Now, federal regulators have issued a warning to a company that distributes chocolate to be used for snorting (right, someone who looks creepily like Chapman, who would know as much about snorting anything as Woody Allen did in Annie Hall).

Known as Coco Loko, this is a powder mixed with other ingredients usually found in energy drinks. While not referring specifically to Coco Loko, the U.S. Food and Drug Administration has warned that inhaling chocolate powder can cause vocal cord spasms that make it hard to speak or breathe and may induce or aggravate asthma. It can also cause tightening of the muscles that line the airways in the lungs. Two of the ingredients — taurine and guanine — have not been evaluated for use through inhalation.

The powdered chocolate, sold by Orlando-based Legal Lean, debuted in mid-2017. The company’s website promises that Coco Loko will provide a blast of the feel-good chemical serotonin — similar to the euphoria produced by the club drug ecstasy. The company’s website cautions users to consume it responsibly, and that is isn’t intended for children or pregnant women.