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.

What will I do with those tossed salads and scrambled eggs? Ditch them

Amy and I agree on this: If we need to fall asleep, put on an episode of Frasier.

Five minutes later we’re in la-la land.

Inspectors with the U.S. Food and Drug Administration say they found dozens of rodents and poor worker hygiene at a North Carolina chicken farm operated by an Indiana egg producer that last week recalled more than 200 million eggs.

Vic Ryckaert and Holly Hays of the Indy Star report that according to a FDA report, inspectors spent March 26 to April 11 at the Rose Acre Farms egg operation in Pantego, North Carolina, and found “unacceptable rodent activity” and dirty equipment. They also noted employees touching dirty floors, equipment and their bodies without washing their hands.

The unsafe conditions allow “for the harborage, proliferation and spread of filth and pathogens,” inspectors said.

In an emailed statement, Seymour-based Rose Acre Farms said the inspection report “is based on raw observations and in some cases lack proper context.”

“It’s unfair to be judged on the farm’s operation without proper perspective or a chance to formally respond to an incomplete representation of a massive facility that houses more than three million hens,” the company said. 

Context this.

The company said it will make public its response to the inspection, which is due on April 26.

“Until then, we would urge everyone to wait until all the facts are presented before rushing to judgment,” the company said.

The FDA said at least 23 illnesses have been reported. The eggs were distributed to consumers in Colorado, Florida, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia and West Virginia.

FDA spokesman Peter Cassell declined to comment specifically about the Rose Acre Farms inspections but said the facility must correct the issues before the next inspection or face repercussions. Consequences could include product seizures or, in a more serious step, shutting down the facility. 

Cassell encouraged shoppers not to assume that they are not exposed to the recall because they are not geographically near the states where cases have been reported.

“Consumers should look for the brands and the lot numbers we provided,” he said. “We want to make sure that people are getting the right information.”

The recall involved eggs sold under the brand names Country Daybreak, Crystal Farms, Coburn Farms, Sunshine Farms, Glenview and Great Value. Also included were eggs sold at Walmart and Food Lion stores.

The cartons were stamped with plant number P-1065 and the Julian date range of 011 through 102.

The company’s Hyde County Egg facility in North Carolina produces 2.3 million eggs a day.

Inspectors found “insanitary conditions and poor employee practices” throughout the farm, according to the FDA report.

The inspectors’ observations in the report included:

Dozens of live and dead rodents, including baby mice, in chicken houses and manure pits.

Employees skipping steps in the cleaning process by wiping off detergent before allowing it to soak in the eggs.

Condensation dripping onto crack detectors, egg graders and other production equipment.

Water pooling on floors and forklift pathways.

Grimy, dirty floors, pallets and equipment. 

Farm workers touching dirty equipment and trash cans as well as their face, hair and “intergluteal cleft” before touching eggs or handling equipment that touches eggs without washing hands or changing gloves.

The deli is not safer: Slicer cleaning and Listeria

The Centers for Disease Control and Prevention (CDC) estimates that 3,000 people die in the United States each year from foodborne illness, and Listeria monocytogenes causes the third highest number of deaths. Risk assessment data indicate that L. monocytogenes contamination of particularly delicatessen meats sliced at retail is a significant contributor to human listeriosis. Mechanical deli slicers are a major source of L. monocytogenes cross-contamination and growth.

In an attempt to prevent pathogen cross-contamination and growth, the U.S. Food and Drug Administration (FDA) created guidance to promote good slicer cleaning and inspection practices. The CDC’s Environmental Health Specialists Network conducted a study to learn more about retail deli practices concerning these prevention strategies. The present article includes data from this study on the frequency with which retail delis met the FDA recommendation that slicers should be inspected each time they are properly cleaned (defined as disassembling, cleaning, and sanitizing the slicer every 4 h).

Data from food worker interviews in 197 randomly selected delis indicate that only 26.9% of workers (n = 53) cleaned and inspected their slicers at this frequency. Chain delis and delis that serve more than 300 customers on their busiest day were more likely to have properly cleaned and inspected slicers. Data also were collected on the frequency with which delis met the FDA Food Code provision that slicers should be undamaged. Data from observations of 685 slicers in 298 delis indicate that only 37.9% of delis (n = 113) had slicers that were undamaged. Chain delis and delis that provide worker training were more likely to have slicers with no damage.

To improve slicer practices, food safety programs and the retail food industry may wish to focus on worker training and to focus interventions on independent and smaller delis, given that these delis were less likely to properly inspect their slicers and to have undamaged slicers.

Retail deli slicer inspection practices: An EHS-Net study, May 2018

LAUREN E. LIPCSEI,1* LAURA G. BROWN,1 E. RICKAMER HOOVER,1 BRENDA V. FAW,2 NICOLE HEDEEN,3 BAILEY MATIS,4DAVID NICHOLAS,5 and DANNY RIPLEY6

Journal of Food Protection, vol. 81 no. 5

https://doi.org/10.4315/0362-028X.JFP-17-407

http://jfoodprotection.org/doi/abs/10.4315/0362-028X.JFP-17-407?code=fopr-site

Flour power: Raw is risky

When I was a kid, I had this multi-colored swim towel that stated Flower Power (right, not exactly as shown).

I should have known that if a 1960s slogan had been co-opted by towel manufacturers in the early 1970s, it was a sign of corporate greed rather than earth-tone sentiment.

For the past decade, raw flour has increasingly come under the food safety microscope.

Flour was suspect in a 2008 outbreak of Salmonella in New Zealand. In June, 2009, an outbreak of shiga-toxin producing E. coli (primarily O157:H7) in Nestle Toll House cookie dough sickened at least 77 people in 30 American states. Thirty-five people were hospitalized – from flour in the cookie dough.

Hemp seed flour sickened 15 Germans in 2010.

There was the U.S. General Mills outbreak of 2016 which sickened at least 56 people with the outbreak strain of E. coli O121 and O26, followed by a separate outbreak of E. coli O121 in Robin Hood flour in Canada in late 2016 going into 2017, that sickened at least 29.

It’s this latter outbreak that has journalist Jim Romahn’s attention.

Romahn writes the release of 759 pages of mostly e-mails indicates there was a massive effort involved in a recall of flour milled in Saskatoon that was contaminated with E. coli O121.

Twenty-two Canadians were identified as sickened by the flour, including one key case where the person consumed raw dough.

With hindsight, health officials were able to determine the first person sickened was Nov. 13, 2016. The others sickened and linked to the flour were between then and Feb. 26, 2017.

Robin Hood flour was identified as the source in March and on March 26 the Canadian Food Inspection Agency began a recall that eventually grew to scores of brand-name products across Canada and even an export shipment to Guyana.

The recall involved a number of major companies, such as Smucker Foods of Toronto and the Sobeys supermarket chain.

There were some unusual difficulties, including the challenge of contacting Mennonites who have no telephones.

The investigation and lab results eventually traced the source to flour milled at Ardent’s Saskatoon plant on Oct. 15, 16 and 17.

A high percentage of packages of flour milled on those dates turned up with E. coli O121.

But even then it’s not clear where the wheat originated.

Ardent Mills said it was probably spring wheat, but it could have also contained soft wheat, and that it probably was from the 2016 harvest, but might have had some wheat from the 2015 harvest.

That’s reflective of the amount of blending that happens both with the wheat used in milling and the flours that are blended into products for sale.

The documents were released under Access to Information at the request of a woman who spent time in a hospital in Medicine Hat, Alta.

 An Outbreak of Shiga Toxin–Producing Escherichia coli O121 Infections Associated with Flour – Canada, 2016–2017

MMWR Morb Mortal Wkly Rep 2017; 66: 705–706

Morton V, Cheng JM, Sharma D, Kearney A.

Waiter, is that romaine from Yuma? At least 53 sick across 16 US states with outbreak strain of E. coli O157:H7 linked to lettuce

David Meyer of Fortune magazine reports the U.S.’s mysterious E. coli outbreak now has a likely culprit: romaine lettuce grown around Yuma, Arizona. And consumers are being given conflicting advice on what to do to protect themselves.

The Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) said Wednesday that any consumers in the U.S. who have store-bought chopped romaine lettuce should throw it away. If they want to buy romaine lettuce from now on, they should first check with the store or restaurant that it wasn’t grown in the Yuma region, the agencies said.

However, Consumer Reports has gone a step further, advising people to avoid all romaine lettuce for the time being. Why? Because people may find it difficult to establish for sure that their lettuce does not come from the growing region that’s suspected to be the source.

Niraj Chokshi of the New York Times reported that CDC said in a statement, “If you do not know if the lettuce is romaine, do not eat it and throw it away,” the C.D.C..

The agency was first alerted to the outbreak by health officials in New Jersey, who had noticed an increase in E. coli cases in the state, said Dr. Laura Gieraltowski, an epidemiologist at the C.D.C. After some discussion, it became clear that many of those infected had eaten chopped romaine lettuce at restaurants before getting sick.

Concerned, the agency looked for related cases by checking PulseNet, a national network of laboratories that catalog samples of harmful bacteria from infected patients.

“When we looked back into our PulseNet system we saw that there were other cases in other states with the same DNA fingerprint,” Dr. Gieraltowski said.

The C.D.C. learned that the others infected by that particular strain, E. coli O157:H7, had also eaten chopped romaine lettuce at restaurants before getting sick, she said. It turned over the information to the Food and Drug Administration, which helped trace the outbreak to Yuma, Ariz.

To pinpoint the exact source, though, investigators would need samples of the tainted lettuce. But because of the short shelf life of lettuce and the time it takes for an outbreak to be identified, obtaining such a sample may prove difficult.

However, a cluster of eight illnesses in an Alaska prison may help pinpoint the source.

Dr. Joe McLaughlin, with the Epidemiology Section at the state Department of Health and Social Services, said health officials had responded last week to an outbreak of E. coli O157:H7 bacteria at the Anvil Mountain Correctional Center in Nome, Alaska.

None of the eight patients have died or been hospitalized, in cases which were noticed between April 5 and April 15. All ate “significantly higher” numbers of salads than other people at Anvil Mountain, however, and have shown the same symptoms.

“Our outbreak is the first one I know of that’s been associated nationally with the consumption of whole heads of lettuce rather than chopped lettuce,” McLaughlin said. “What this outbreak suggests is that the source of contamination may actually be at the farm rather than the actual processing of the lettuce.”

Duh.

CDC reports in its latest outbreak update  that information collected to date indicates that chopped romaine lettuce from the Yuma, Arizona growing region could be contaminated with E. coli O157:H7 and could make people sick.

At this time, no common grower, supplier, distributor, or brand has been identified.

Consumers anywhere in the United States who have store-bought chopped romaine lettuce at home, including salads and salad mixes containing chopped romaine lettuce, should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick. If you do not know if the lettuce is romaine, do not eat it and throw it away.

Before purchasing romaine lettuce at a grocery store or eating it at a restaurant, confirm with the store or restaurant that it is not chopped romaine lettuce from the Yuma, Arizona growing region. If you cannot confirm the source of the romaine lettuce, do not buy it or eat it.

Restaurants and retailers should ask their suppliers about the source of their chopped romaine lettuce.

22 sick: Over 200M eggs recalled by Rose Acre Farms

Rose Acre Farms of Seymour, Indiana, the second largest egg producer in the United States, is voluntarily recalling 206,749,248 eggs because they have the potential to be contaminated with Salmonella Braenderup.

The eggs were distributed from the farm in Hyde County, North Carolina and reached consumers in: Colorado, Florida, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia, and West Virginia through retail stores and restaurants via direct delivery.

22 illnesses have been reported to date. 

The affected eggs, from plant number P-1065 with the Julian date range of 011 through date of 102 printed on either the side portion or the principal side of the carton or package.

The voluntary recall was a result of some illnesses reported on the U.S. East Coast, which led to extensive interviews and eventually a thorough FDA inspection of the Hyde County farm, which produces 2.3 million eggs a day. The facility includes 3 million laying hens with a USDA inspector on-site daily. 

Their own PR says 22 sick people, and then, “some illnesses.” Outpouring of corporate empathy there. And the USDA inspector on site means …?

17 sick in 7 states with E. coli O157:H7: Source not yet identified

CDC, several states, the U.S. Food and Drug Administration, and the U.S. Department of Agriculture’s Food Safety and Inspection Service are investigating a multistate outbreak of Shiga toxin-producing E. coli O157:H7 infections. The investigation is still ongoing and a specific food item, grocery store, or restaurant chain has not been identified as the source of infections. CDC is not recommending that consumers avoid any particular food at this time. Restaurants and retailers are not advised to avoid serving or selling any particular food. CDC will provide more information as it becomes available.

As of April 9, 2018, 17 people infected with the outbreak strain of E. coli O157:H7 have been reported from 7 states. A list of the states and the number of cases in each can be found on the Case Count Map page. Illnesses started on dates ranging from March 22, 2018 to March 31, 2018. Ill people range in age from 12 to 84 years, with a median age of 41. Among ill people, 65% are female. Six ill people have been hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Raw is risky: Fresh herbs can be contaminated

I’m not a fan of the guac, ever since a hungover former partner spewed vile smelling green stuff at the side of the road decades ago.

And I’m wary of fresh herbs, based on previous outbreaks.

So is the U.S. Food and Drug Administration which on Feb. 23, 2018, revealed details on just how many bacteria are hiding in fresh, store-bought herbsThe agency plans to continue testing herbs through 2019 to thoroughly assess their “rates of bacterial contamination.”

The plan is to test 1,600 samples of items “typically eaten without having undergone a ‘kill step,’ such as cooking, to reduce or eliminate bacteria.” These items include fresh cilantro, parsley, and basil.

This first round of results revealed that of the 139 fresh herb samples tested, four tested positive for salmonella and three contained E. coli bacteria.

The Packer noted the testing found  no pathogens in the U.S. herbs versus imported herbs.

In the same period, the FDA found that three of the 58 U.S.-processed avocado products that were tested had listeria, and one of the 49 imported samples had listeria.

From 1996 to 2015, the FDA linked 2,699 illnesses and 84 hospitalizations to fresh herbs.

The FDA also plans to sample processed avocado for similar reasons – from 2005 to 2015, 525 illnesses were linked to avocados in 12 separate outbreaks. Of 107 avocado and guacamole samples in the initial results, four contained listeria. Avocados, the FDA notes, “have a high moisture content and a non-acidic pH level, conditions that can support the growth of harmful bacteria.”

Raw is risky, for pets and humans

I have never fed any of my dogs or cats raw pet food.

They may eat each other’s poop, but I control what I can control.

The U.S. Food and Drug Administration is alerting pet owners to a history of four recalls of and multiple complaints associated with Darwin’s Natural and ZooLogics pet foods, manufactured by Arrow Reliance Inc., dba Darwin’s Natural Pet Products, over the period from October 17, 2016 to February 10, 2018. In each instance, the company recalled these products after being alerted to positive findings of Salmonella and/or Listeria monocytogenes in samples of their raw pet food products.

In its most recent recall, on February 10, 2018, Arrow Reliance/Darwin’s Natural recalled ZooLogics Duck with Vegetable Meals for Dogs (Lot #41957) and ZooLogics Chicken with Vegetable Meals for Dogs (Lot #41567) because the products may be contaminated with Salmonella and therefore have the potential to cause salmonellosis in humans and animals. The company states that it only sells its products online through direct-to-consumer sales.

The FDA has investigated six complaints of illness and death in animals that have eaten the recalled products.

Arrow Reliance/Darwin’s Natural has notified its customers directly of the recalls, but has so far not issued any public notification announcing this or any of the previous recalls.

This issue is of particular public health importance because Salmonella can make both people and animals sick.

As part of an ongoing investigation into complaints associated with products manufactured by Arrow Reliance/Darwin’s Natural of Tukwila, WA, the FDA has confirmed that new samples of Darwin’s Natural Pet Products raw pet foods have tested positive for Salmonella. These raw pet foods include ZooLogics Duck with Vegetable Meals for Dogs Lot #41957 and ZooLogics Chicken with Vegetable Meals for Dogs Lot #41567.

The latest recall was triggered by a complaint of an adult dog that had recurring diarrhea over a nine-month period. The dog tested positive for Salmonella from initial testing by the veterinarian and by follow-up testing by the FDA’s Veterinary Laboratory Investigation and Response Network (Vet-LIRN). The Darwin’s Natural raw pet food that the dog had been fed was also positive for Salmonella.

Arrow Reliance/Darwin’s Natural is aware of the dog’s illness and the positive results and initiated a recall on February 10, 2018 by directly notifying its customers via email. The firm has not issued a public recall notice.

Since October 2016, Arrow Reliance/Darwin’s Natural has initiated four recalls and had six reported complaints (some referring to more than one animal) associated with their raw pet food products, including the death of one kitten from a severe systemic Salmonella infection. The Salmonella isolated from the kitten was analyzed using whole genome sequencing and found to be indistinguishable from the Salmonella isolated from a closed package from the same lot of Darwin’s Natural cat food that the kitten ate.

In addition to reports of illnesses associated with Salmonella contamination in the products, the FDA is aware of complaints of at least three animals who were reportedly injured by bone shards in the Darwin’s Natural raw pet food products.