How the hell would I know? 395 sickened by Cyclospora linked to McDonalds salads

There was this one time, in 2010, I got a phone call at 6 a.m. from the esteemed Michael Osterholm of the Minnesota food safety system.

My wife does a better Minnosotan accent, spending her yute in Albert Lea, eh?

He didn’t like the photo, right, made by the creative couple of Heather and Christian, who used to work in my lab, and opened the conversation with, “How could you print that?”

I said it was an accurate description of what had been publically known about the leafy greens folks since the E. coli O157 spinach outbreak of 2006 (I’m old, waiting for news on the birth of my third grandson).

He then told me he was a consultant for Fresh Express and that they had an excellent food safety system.

I said great, make it public, so people can judge on their own.

Fresh Express has now been linked to 395 cases of Cyclospora through their lettuce served at McDonalds.

U.S. Rep. Rosa DeLauro, D-Conn., is pressing Food and Drug Administration Commissioner Scott Gottlieb for specifics about the investigation of the cyclosporaoutbreak linked to product sold by Fresh Express.

In an Aug. 3 letter her office released to the media, DeLauro said she wrote the letter “out of concern about the current outbreak of cyclosporiasis as well as the transparency and timeliness of your agency’s ongoing investigation.”

“Although once rare in the United States, parasitic outbreaks caused by cyclospora have become more common over the last several decades,” she said in the letter. “Many of these outbreaks have continually been found to be associated with imported fruits and vegetables.”

The recent outbreak is currently responsible for 395 infections — including 16 hospitalizations — across 15 states.

The parasite was first found when the FDA conducted testing on an unused package of Fresh Express salad mix, distributed to a McDonald’s restaurant, containing romaine lettuce and carrots.

The FDA states as of July 13, McDonald’s decided to stop selling the salads at restaurants impacted in Illinois, Iowa, Indiana, Wisconsin, Michigan. Ohio, Minnesota, Nebraska, South Dakota. Montana, North Dakota, Kentucky, West Virginia and Missouri.

In a July 20, statement, McDonald’s said the health and safety of their customers is their top priority.

“The health and safety of our customers and the people who work in McDonald’s restaurants is always our top priority. The additional states identified by the FDA and CDC are among the same states where a week ago we proactively decided to remove our lettuce blend in impacted restaurants and replace it through a different supplier. McDonald’s is committed to the highest standards of food safety and quality and we continue to cooperate and support regulatory and public health officials in their investigations. For those seeking additional information about Cyclospora, we encourage them to visit the CDC and FDA websites.”

Uh-huh.

Cyclospora sucks. My aunt, my mom’s sister, got it in Florida from basil, about a decade ago.

(Doesn’t she look amazing at 80, left.)

Cyclospora isn’t one of those things doctors routinely check for. Then you’re sick for about six weeks until some bright doc figures it out.

The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued an alert to the public on “beef, pork and poultry salad and wrap products potentially contaminated with Cyclospora that were distributed by Caito Foods LLC, of Indianapolis,” Indiana.

USDA also released a public health alert after Indianapolis-based food distributor Caito Foods “received notification from their lettuce supplier, Fresh Express, that the chopped romaine that is used to manufacture some of their salads and wraps was being recalled.”

“Fresh Express follows rigid food safety requirements and preventive controls throughout our supply chain that are carefully designed to mitigate against potential health risks. Working together with public health officials, we are hopeful a definitive source of the outbreak clusters will be identified soon.”

Uh-huh.

Still here, Mike. You can call me in Australia through Google voice 785-532-1925 and tell me what Fresh Express is doing, and why they are importing lettuce in the middle of North American summer.

Norovirus inside leafy greens

Lettuce has been implicated in human norovirus (HuNoV) outbreaks. The virus is stable on the leaf surface for at least 2 weeks; however, the dynamics of virus internalization have not been fully investigated. The purpose of this study was to assess the internalization and distribution of HuNoV and two surrogate viruses, porcine sapovirus (SaV) and Tulane virus (TV), in lettuce and spinach.

Viral inoculations through the roots of seedlings and the petiole of leaves from mature plants were performed, and the viruses were tracked on days 1 and 6 post-root inoculation and at 16 h and 72 h post-petiole inoculation. Confocal microscopy was used to visualize root-internalized HuNoV.

In both lettuce and spinach, (i) HuNoV was internalized into the roots and leaves at similar RNA titers, whereas surrogate viruses were more restricted to the roots, (ii) all three viruses were stable inside the roots and leaves for at least 6 days, and (iii) HuNoV disseminated similarly inside the central veins and leaf lamina, whereas surrogate viruses were more restricted to the central veins. Infectious TV, but not SaV, was detectable in all tissues, suggesting that TV has greater stability than SaV. HuNoV was visualized inside the roots’ vascular bundle and the leaf mesophyll of both plants.

In conclusion, using surrogate viruses may underestimate the level of HuNoV internalization into edible leaves. The internalization of HuNoV through roots and cut leaves and the dissemination into various spinach and lettuce tissues raise concerns of internal contamination through irrigation and/or wash water.

IMPORTANCE Human noroviruses are the leading cause of foodborne outbreaks, with lettuce being implicated in the majority of outbreaks. The virus causes acute gastroenteritis in all age groups, with more severe symptoms in children, the elderly, and immunocompromised patients, contributing to over 200,000 deaths worldwide annually. The majority of deaths due to HuNoV occur in the developing world, where limited sanitation exists along with poor wastewater treatment facilities, resulting in the contamination of water resources that are often used for irrigation.

Our study confirms the ability of lettuce and spinach to internalize HuNoV from contaminated water through the roots into the edible leaves. Since these leafy greens are consumed with minimal processing that targets only surface pathogens, the internalized HuNoV presents an added risk to consumers. Thus, preventive measures should be in place to limit the contamination of irrigation water. In addition, better processing technologies are needed to inactivate internalized viral pathogens.

Tissue distribution and visualization of internalized norovirus in leafy greens

April 2018

Applied Environmental Microbiology, vol.84 no.12

Malak A. EsseiliaTea MeuliabLinda J. Saifa and Qiuhong Wanga

 doi:10.1128/AEM.00292-18

http://aem.asm.org/content/84/12/e00292-18.abstract?etoc

All the news just repeats itself: Leafy greens in public

In October, 1996, a 16-month-old Denver girl drank Smoothie juice manufactured by Odwalla Inc. of Half Moon Bay, California. She died several weeks later; 64 others became ill in several western U.S. states and British Columbia after drinking the same juices, which contained unpasteurized apple cider — and E. coli O157:H7. Investigators believed that some of the apples used to make the cider might have been insufficiently washed after falling to the ground and coming into contact with deer feces (Powell and Leiss, 1997) not that washing would do much.

Almost 10 years later, on Sept. 14, 2006, the U.S. Food and Drug Administration announced that an outbreak of E. coli O157: H7 had killed a 77-year-old woman and sickened 49 others (United States Food and Drug Administration, 2006). The outbreak ultimately killed four and sickened at least 200 across the U.S. This was documented-outbreak 29 linked to leafy greens, but also apparently the tipping point for growers to finally get religion about commodity-wide food safety, following the way of their farmer friends in California, 10 years later.

In the decade between these two watershed outbreaks, almost 500 outbreaks of foodborne illness involving fresh produce were documented, publicized and led to some changes within the industry, yet what author Malcolm Gladwell would call a tipping point — “a point at which a slow gradual change becomes irreversible and then proceeds with gathering pace” — in public awareness about produce-associated risks) did not happen until the spinach E. coli O157:H7 outbreak in the fall of 2006. At what point did sufficient evidence exist to compel the fresh produce industry to embrace the kind of change the sector has heralded since 2007? And at what point will future evidence be deemed sufficient to initiate change within an industry?

The 1993 outbreak of E. coli O157:H7 associated with undercooked hamburgers at the Jack-in-the-Box fast food chain propelled microbial food safety to the forefront of public awareness, at least in the U.S. (Powell and Leiss, 1997). In 1996, following extensive public and political discussions about microbial food safety in meat, the focus shifted to fresh fruits and vegetables, following an outbreak of Cyclospora cayetanesis ultimately linked to Guatemalan raspberries that sickened 1,465 in 21 U.S. states and two Canadian provinces (U.S. Centers for Disease Control and Prevention, 1997). That same year, Beuchat (1996) published a review on pathogenic microorganisms in fresh fruits and vegetables and identified numerous pathways of contamination.

By 1997, researchers at CDC were stating that pathogens could contaminate at any point along the fresh produce food chain — at the farm, processing plant, transportation vehicle, retail store or foodservice operation and the home — and that by understanding where potential problems existed, it was possible to develop strategies to reduce risks of contamination (Tauxe et al., 1997). Researchers also reported that the use of pathogen-free water for washing would minimize risk of contamination (Suslow, 1997; Beuchat, 1998).

Beuchat and Ryu (1997) reported in a review that sources of pathogenic microorganisms for produce included:

Preharvest

  • Feces
  • Soil
  • Irrigation water
  • Water used to apply fungicides, insecticides
  • Green or inadequately composted manure
  • Air (dust)
  • Wild and domestic animals (including fowl and reptiles)
  • Insects
  • Human handling

Postharvest

  • Feces
  • Human handling (workers, consumers)
  • Harvesting equipment
  • Transport containers (field to packing shed)
  • Wild and domestic animals (including fowl and reptiles)
  • Insects
  • Air (dust)
  • Wash and rinse water
  • Sorting, packing, cutting, and further processing equipment
  • Ice
  • Transport vehicles
  • Improper storage (temperature, physical environment)
  • Improper packaging (including new packaging technologies)
  • Cross-contamination (other foods in storage, preparation, and display areas)
  • Improper display temperature.

kFresh fruits and vegetables were identified as the source of several outbreaks of foodborne illness in the early 1990s, especially leafy greens (Table 1).

Date Product Pathogen Cases Setting/dish State
Apr-92 Lettuce S. enteriditis 12 Salad VT
Jan-93 Lettuce S. Heidelberg 18 Restaurant MN
Jul-93 Lettuce Norovirus 285 Restaurant IL
Aug-93 Salad E. coli O157:H7 53 Salad Bar WA
Jul-93 Salad E. coli O157:H7 10 Unknown WA
Sep-94 Salad E. coli O157:H7 26 School TX
Jul-95 Lettuce E. coli O153:H48 74 Lettuce MT
Sep-95 Lettuce E. coli O153:H47 30 Scout Camp ME
Sep-95 Salad E. coli O157:H7 20 Ceasar Salad ID
Oct-95 Lettuce E. coli O153:H46 11 Salad OH
May-96 Lettuce E. coli O157:H10 61 Mesclun Mix ML
Jun-96 Lettuce E. coli O153:H49 7 Mesclun Mix NY

Outbreaks of foodborne illness related to leafy greens, 1992-1996.

Dave Gombas told an International Association for Food Protection symposium on leafy green safety on Oct. 6, 2006 in Washington, D.C. that if growers did everything they were supposed to do — in the form of good agricultural practices — and it was verified, there may be fewer outbreaks. He then said government needs to spend a lot more on research.

Wow. The same person who has vacillated between the Produce Marketing Association and the U.S. Food and Drug Administration for the past couple of decades (all you critics who complain about folks jumping back-and-forth-and-back as part of a genetically-engineered conspiracy may want to look at the all-natural, all-good-for-ya produce sector) pronounced on grower verification in which nothing has been done.

Since we were on the same panel in Washington, in 2006, I asked Gombas, why is the industry calling for more investment in research about the alleged unknowns of microbial contamination of produce when the real issue seems to be on-farm delivery and verification? Hiding behind the unknown is easy, working on verifying what is being done is much harder.

More calls for research.

Nothing on human behavior in a fresh produce environment.

It’s just another case of saying the right things in public, but failing to acknowledge what happens on individual farms. Verification is tough. Auditing may not work, because many of these outbreaks happened on third -party audited operations. Putting growers in a classroom doesn’t work, and there’s no evidence that begging for government oversight yields a product that results in fewer sick people.

In 1999, several more outbreaks of Shiga-toxin producing E. coli (STEC) were linked to leafy greens (Table 2), and the U.S. group, the United Fresh Fruit and Vegetable Association, developed and published HACCP-based food safety guidelines for industry (United Fresh Fruit and Vegetable Association, 1999).

Date Product Pathogen Cases Setting/dish State
Feb-99 Lettuce E. coli O157:H9 65 Restaurant NE
Jun-99 Salad E. coli O111:H8 58 Texas Camp TX
Sep-99 Lettuce E. coli O157:H11 6 Iceberg WA
Oct-99 Lettuce E. coli O157:H7 40 Nursing Home PA
Oct-99 Lettuce E. coli O157:H7 47 Restaurant OH
Oct-99 Salad E. coli O157:H7 5 Restaurant OR

Table 2. 1999 U.S. outbreaks of STEC linked to leafy greens

By 2000, Rafferty and colleagues demonstrated that E. coli could spread on-farm in plant production cuttings from one contaminated source, magnifying an outbreak to a whole farm (Rafferty et al., 2000). A 2001 outbreak of Shigella flexneri (886 ill) in tomatoes further focused public and scientific attention onto fresh produce.

Solomon and colleagues (2002a) discovered that the transmission of E. coli O157:H7 to lettuce was possible through both spray and drip irrigation. They also found that the pathogen persisted on the plants for 20 days following application and submerging the lettuce in a solution of 200ppm chlorine did not eliminate all viable E.coli O157:H7 cells, suggesting that irrigation water of unknown microbial quality should be avoided in lettuce production (Solomon et al., 2002a). In a follow-up experiment, Solomon and colleagues (2002b) explored the transmission of E. coli O157:H7 from manure-contaminated soil and irrigation water to lettuce plants. The researchers recovered viable cells from the inner tissues of the lettuce plants and found that the cells migrated to internal locations in plant tissue and were thus protected from the action of sanitizing agents. These experiments demonstrated that E. coli O157:H7 could enter the lettuce plant through the root system and migrate throughout the edible portion of the plant (Solomon et al., 2002b). Such results were widely reported in general media.

During this time, several outbreaks of E. coli were again linked to lettuce and salad (Table 3).

Date Product Pathogen Cases Setting/dish State
Oct-00 Salad E. coli O157:H7 6 Deli IN
Nov-01 Lettuce E. coli O157:H7 20 Restaurant TX
Jul-02 Lettuce E. coli O157:H8 55 Bagged, Tossed WA
Nov-02 Lettuce E. coli O157:H7 13 Restaurant IL
Dec-02 Lettuce E. coli O157:H7 3 Restaurant MN

Table 3: Leafy green outbreaks of STEC, 2000 — 2002.

 In 2003, according to Mexican growers, the market impact of an outbreak of hepatitis A traced to exported green onions lasted up to 4 months while prices fell 72 per cent (Calvin et al., 2004). Roma tomatoes were identified as the source of a salmonellosis outbreak that resulted in over 560 cases in both Canada and the US (CDC 2005).

During 2003-2005, several additional outbreaks of E. coli O157:H7 were linked to fresh leafy greens, including one multi-state outbreak involving Dole bagged lettuce (Table 4). 

Date Product Pathogen Cases Setting/dish State
Sep-03 Lettuce E. coli O157:H7 51 Restaurant CA
Nov-03 Spinach E. coli O157:H7 16 Nursing Home CA
Nov-04 Lettuce E. coli O157:H7 6 Restaurant NJ
Sep-05 Lettuce E. coli O157:H7 11 Dole, bagged Multiple

Table 4: Leafy green STEC outbreaks, 2003 — 2005.

During 2005–2006, four large multistate outbreaks of Salmonella infections associated with eating raw tomatoes at restaurants occurred in the U.S., resulting in 459 culture-confirmed cases of salmonellosis in 21 states. Investigations determined that the tomatoes had been supplied to restaurants either whole or precut from tomato fields in Florida, Ohio, and Virginia (CDC, 2006).

Allwood and colleagues (2004) examined 40 items of fresh produce taken from a retail setting in the U.S. that had been preprocessed (including cut, shredded, chopped or peeled) at or before the point of purchase. They found fecal contamination indicators (E. coli, F-specific coliphages, and noroviruses) were present in 48 per cent of samples.

 Researchers in Minnesota conducted a small-scale comparative study of organic versus conventionally grown produce. They found that while all samples were virtually free of pathogens, E. coli was 19 times more prevalent on produce acquired from the organic farms (Mukherjee et al., 2004). They estimated that this was due to the common use of manure aged for less than a year. Use of cattle manure was found to be of higher risk as E. coli was found 2.4 times more often on farms using it than other animal manures (Mukherjee et al., 2004).

On Sept. 14, 2006, the U.S. Food and Drug Administration (2006) issued a public statement warning against the consumption of bagged fresh spinach.

“Given the severity of this illness and the seriousness of the outbreak,” stated Dr. Robert Brackett, Director of FDA’s Center for Food Safety and Applied Nutrition (CFSAN), “FDA believes that a warning to consumers is needed (United States Food and Drug Administration, 2006).”

That is no different from the sometimes conflicting messages coming from FDA today about the E. coli O157:H7 outbreak on lettuce that originated in Yuma, Arizona: these public health folks are figuring it out on the go.

Sean Rossman of USA Today reports today that in the current E. coli O157:H7 outbreak linked to Yuma lettuce, 70% of those who’ve gotten sick are female.

Similarly, when leafy greens were the culprit of an E. coli outbreak last year, 67% of those infected were women or girls. In 2016, females were 73% of those ill from an outbreak in alfalfa sprouts, notes the U.S. Centers for Disease Control and Prevention.

Here are some suggestions:

  • The first line of defense is the farm, not the consumer.
  • All ruminants — cows, sheep, goats, deer — can carry dangerous E. coli like the O157:H7 strain that sickened people in the spinach outbreak, as well as the Taco Bell and Taco Johns outbreaks ultimately traced to lettuce.
  • Any commodity is only as good as its worst grower.

We’ve had a few peer-reviewed thoughts on these topics:

Powell, D.A. and Chapman, B. 2007. Fresh threat: what’s lurking in your salad bowl?. Journal of the Science of Food and Agriculture. 87: 1799-1801.

Implementing On-Farm Food Safety Programs in Fruit and Vegetable Cultivation, Improving the Safety of Fresh Fruit and Vegetables

Luedtke, A., Chapman, B. and Powell, D.A. 2003. Implementation and analysis of an on-farm food safety program for the production of greenhouse vegetables. Journal of Food Protection. 66:485-489.

Powell, D.A., Bobadilla-Ruiz, M., Whitfield, A. Griffiths, M.G.. and Luedtke, A. 2002. Development, implementation and analysis of an on-farm food safety program for the production of greenhouse vegetables in Ontario, Canada. Journal of Food Protection. 65: 918- 923.

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

Lettuce grazers rejoice: Consumer Reports says it’s ok to eat romaine lettuce again

Actually, it was the U.S.  Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) who jointly declared an end to the E coli O157 outbreak after nearly two months of investigation. At least 66 people across the U.S and Canada became ill, 22 were hospitalized, and 2 died during November and December, all linked to consumption of romaine lettuce.

Consumer Reports went along for the ride.

What’s been missing is any response from the leafy greens marketing agency types.

Silence – the LGMA cone of silence — is golden, I guess.

CDC announced on January 25, 2018, that this outbreak appears to be over, because the last case became ill on December 12, 2017. This indicates that the food causing illness is no longer available in the marketplace or consumers’ homes.

Although this outbreak appears to be over, the FDA’s outbreak investigation team is continuing to work with federal, state and local partners to determine what leafy greens made people ill, what people ate, where they bought it, and identify the distribution chain — all with the goal of identifying any common food or points where the food might have become contaminated. To date, no common link has been identified.

Because whole genome sequencing showed that the E. coli O157:H7 strain that resulted in the U.S. illnesses was closely related genetically to the strain that caused illnesses in Canada, the FDA and CDC have been in contact with Canadian food safety authorities throughout this outbreak.

 

Two outbreaks? One outbreak? Two different products? Same product? Romaine?

I dunno.

I’m having trouble agreeing with the avoid-romaine-in-the-US statement from Consumer Reports. Maybe it’s the same outbreak; maybe it’s not (and CDC didn’t say a lot about whether Canadian and US cases even have the same pfge match). Could be same pathogen on different product.

Just not sure yet. And public health folks share more about uncertainty; PHAC, share any info you have on distribution of the romaine you think it is.

Go public. Share data with the people.

Washing is futile: Leafy green cone of silence

Lettuce is overrated.

lettuce-skullThat’s my response to people who ask about the proportionally high rates of foodborne illness in lettuce and other leafy greens eaten raw.

I like spinach – in a lasagna or stir-fry – but not raw.

Raw is risky.

There’s a bunch of new findings on foodborne pathogens and leafy greens which are summarized below.

In the sphere of public conversation, it is notable the Leafy Greens Marketing Agreement, the group formed after the 2006 E. coli-in-spinach outbreak that killed four and sickened at least 200 in the U.S. – has been once again silent on any research or outbreaks that associate risk with greens.

The leafy green cone of silence.

Investigations by University of Leicester microbiologists have revealed that just a small amount of damage to salad leaves can massively stimulate the presence of the food Salmonella in ready-prepared salad leaves.  

The scientists have discovered that juices released from damaged leaves also had the effect of enhancing the virulence of the pathogen, potentially increasing its ability to cause infection in the consumer.  

The research is led by Dr Primrose Freestone of the University’s Department of Infection, Immunity and Inflammation and PhD student Giannis Koukkidis, who has been funded by a Biotechnology and Biological Sciences Research Council (BBSRC) i-case Studentship.  

Their research investigates novel methods of preventing food poisoning pathogens from attaching to the surface of salad leaves to help producers improve food safety for consumers.

This latest study, published in Applied and Environmental Microbiology, found that juices from damaged leaves in bagged spinach and mixed salad increased Salmonella pathogen growth 2400-fold over a control group and also enhanced their adherence to surfaces and overall virulence, or capacity to cause disease.  

Dr Freestone said: “Salad leaves are cut during harvesting and we found that even microliters of the juices (less than 1/200th of a teaspoon) which leach from the cut-ends of the leaves enabled Salmonella to grow in water, even when it was refrigerated. These juices also helped the Salmonella to attach itself to the salad leaves so strongly that vigorous washing could not remove the bacteria, and even enabled the pathogen to attach to the salad bag container.  

“This strongly emphasizes the need for salad leaf growers to maintain high food safety standards as even a few Salmonella cells in a salad bag at the time of purchase could become many thousands by the time a bag of salad leaves reaches its use by date, even if kept refrigerated. Even small traces of juices released from damaged leaves can make the pathogen grow better and become more able to cause disease.  

 “It also serves as a reminder to consume a bagged salad as soon as possible after it is opened. We found that once opened, the bacteria naturally present on the leaves also grew much faster even when kept cold in the fridge.  

“This research did not look for evidence of Salmonella in bagged salads. Instead, it examined how Salmonella grows on salad leaves when they are damaged.”  

Leafy green and other salad vegetables are an important part of a healthy diet, providing vitamins, minerals, and dietary fiber. Ready to eat prepared salads are particularly popular, are widely consumed and so of significant economic importance. Over recent years there has however been a number of outbreaks associated with fresh salad produce contaminated with Salmonella and E. coli both in the USA and Europe. 

lettuce-harvestThis has triggered considerable interest in effective strategies for controls and interventions measures both in UK industry, the EU and key research funding bodies. 

Despite a number of published reports on improving the microbiological safety of salad leaf production, very few studies have investigated the behavior of Salmonella once the leaves have been bagged.  

Giannis said: “Anything which enhances adherence of foodborne pathogens to leaf surfaces also increases their persistence and ability to resist removal, such as during salad washing procedures.  Even more worrying for those who might eat a Salmonella contaminated salad was the finding that proteins required for the virulence (capacity to cause infection) of the bacteria were increased when the Salmonella came into contact with the salad leaf juices. “Preventing enteric pathogen contamination of fresh salad produce would not only reassure consumers but will also benefit the economy due to fewer days lost through food poisoning. We are now working hard to find ways of preventing salad-based infections.”  

No comment from the LGMA.

While this research may make it seem like pre-packaged salads pose a scary risk, the researchers themselves were quick to say they still eat bagged salads. But they make sure to look for packages that have appropriate use-by dates and crisp-looking leaves. They stay away from salads that have mushy, slimy-looking greens, or bags with accumulated salad juice at the bottom. And they make sure to eat the greens within one day of purchase.

“Our project does not indicate any increased risk to eating leafy salads, but it does provide a better understanding of the factors contributing to food poisoning risks,” said Freestone. 

If you feel like it, you can wash greens that have already been pre-washed by manufacturers just before eating, but Freestone says this doesn’t have much of an effect on the salmonella bacteria that may already be attached or internalized by the leaves. 

Her study was published in the journal Applied and Environmental Microbiology.

No comment from LGMA.

Assessment of irrigation water quality and microbiological safety of leafy greens in different production systems

Journal of Food Safety, 2 November 2016, DOI: 10.1111/jfs.12324

http://onlinelibrary.wiley.com/doi/10.1111/jfs.12324/abstract;jsessionid=883317B2001984CC39815B1792B68759.f04t01

Foodborne disease outbreaks associated with fresh produce irrigated with contaminated water are a constant threat to consumer health. In this study, the impact of irrigation water on product safety from different food production systems (commercial to small-scale faming and homestead gardens) was assessed.

spongebob-oil-colbert-may3-10Hygiene indicators (total coliforms, Escherichia coli), and selected foodborne pathogens (Salmonella spp., Listeria monocytogenes, and Escherichia coli O157:H7) of water and leafy green vegetables were analyzed. Microbiological parameters of all irrigation water (except borehole) exceeded maximum limits set by the Department of Water Affairs for safe irrigation water. Microbial parameters for leafy greens ranged from 2.94 to 4.31 log CFU/g (aerobic plate counts) and 1 to 5.27 log MPN/100g (total coliforms and E. coli). Salmonella and E. coli O157:H7 were not detected in all samples tested but L. monocytogenes was present in irrigation water (commercial and small-scale farm, and homestead gardens).

This study highlights the potential riskiness of using polluted water for crop production in different agricultural settings.

No comment from LGMA.

Adaptive response of Listeria monocytogenes to heat, salinity and low pH, after habituation on cherry tomatoes and lettuce leaves

PLOS

Sofia V. Poimenidou, Danai-Natalia Chatzithoma, George-John Nychas, Panagiotis N. Skandamis

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0165746

Pathogens found on fresh produce may encounter low temperatures, high acidity and limited nutrient availability. The aim of this study was to evaluate the effect of habituation of Listeria monocytogenes on cherry tomatoes or lettuce leaves on its subsequent response to inhibitory levels of acid, osmotic and heat stress.

Habituation was performed by inoculating lettuce coupons, whole cherry tomatoes or tryptic soy broth (TSB) with a three-strains composite of L. monocytogenes, which were further incubated at 5°C for 24 hours or 5 days. Additionally, cells grown overnight in TSB supplemented with 0.6% yeast extract (TSBYE) at 30°C were used as control cells. Following habituation, L. monocytogenes cells were harvested and exposed to: (i) pH 3.5 adjusted with lactic acid, acetic acid or hydrochloric acid (HCl), and pH 1.5 (HCl) for 6 h; (ii) 20% NaCl and (iii) 60°C for 150 s.

Results showed that tomato-habituated L. monocytogenes cells were more tolerant (P < 0.05) to acid or osmotic stress than those habituated on lettuce, and habituation on both foods resulted in more stress resistant cells than prior growth in TSB. On the contrary, the highest resistance to heat stress (P < 0.05) was exhibited by the lettuce-habituated L. monocytogenes cells followed by TSB-grown cells at 5°C for 24 h, whereas tomato-habituated cells were highly sensitized. Prolonged starvation on fresh produce (5 days vs. 24 h) increased resistance to osmotic and acid stress, but reduced thermotolerance, regardless of the pre-exposure environment (i.e., tomatoes, lettuce or TSB).

lettuce-woolies-sep_-12-300x225These results indicate that L. monocytogenes cells habituated on fresh produce at low temperatures might acquire resistance to subsequent antimicrobial treatments raising important food safety implications.

No comment from LGMA.

Efficacy of post-harvest rinsing and bleach disinfection of E. coli O157:H7 on spinach leaf surfaces

Food Microbiology, April 2017, vol 62, pg 212-220, http://dx.doi.org/10.1016/j.fm.2016.10.019

Attachment and detachment kinetics of Escherichia coli O157:H7 from baby spinach leaf epicuticle layers were investigated using a parallel plate flow chamber. Mass transfer rate coefficients were used to determine the impact of water chemistry and common bleach disinfection rinses on the removal and inactivation of the pathogen. Attachment mass transfer rate coefficients generally increased with ionic strength. Detachment mass transfer rate coefficients were nearly the same in KCl and AGW rinses; however, the detachment phase lasted longer in KCl than AGW (18 ± 4 min and 4 ± 2 min, respectively), indicating that the ions present during attachment play a significant role in the cells’ ability to remain attached. Specifically, increasing bleach rinse concentration by two orders of magnitude was found to increase the detachment mass transfer rate coefficient by 20 times (from 5.7 ± 0.7 × 10−11 m/s to 112.1 ± 26.8 × 10−11 m/s for 10 ppb and 1000 ppb, respectively), and up to 88 ± 4% of attached cells remained alive.

lettuceThe spinach leaf texture was incorporated within a COMSOL model of disinfectant concentration gradients, which revealed nearly 15% of the leaf surface is exposed to almost 1000 times lower concentration than the bulk rinse solution.

No comment from LGMA.

Development of growth and survival models for Salmonella and Listeria monocytogenes during non-isothermal time-temperature profiles in leafy greens

Food Control, Vol 71, Part A, Jan 2017, Pg 32-41

http://dx.doi.org/10.1016/j.foodcont.2016.06.009

http://www.sciencedirect.com/science/article/pii/S0956713516303164

Leafy greens contaminated with Salmonella enterica have been linked to large number of illnesses in many countries in recent years. Listeria monocytogenes is also a pathogen of concern for leafy greens because of its prevalence in the growing and processing environment and its ability to grow at refrigeration temperatures. Experimental data for the growth and survival of S. enterica and L. monocytogenes under different conditions and storage temperatures were retrieved from published studies. Predictive models were developed using the three-phase linear model as a primary growth model and square-root model to calculate specific growth rate (ln CFU g−1 h−1) at different temperatures (°C). The square-root model for S. enterica was calculated as μ = (0.020(Temperature+0.57))2. The square-root model for L. monocytogenes was fitted as μ = (0.023(Temperature-0.60))2. The growth-survival model for S. enterica and growth model for L. monocytogenes were validated using several dynamic time-temperature profiles during the production and supply chain of leafy greens. The models from this study will be useful for future microbial risk assessments and predictions of behavior of S. enterica and L. monocytogenes in the leafy greens production and supply chain.

No comment from LGMA.

 

Is there a relation between the microscopic leaf morphology and the association of Salmonella and Escherichia coli O157:H7 with iceberg lettuce leaves?

Journal of Food Protection, Number 10, October 2016, pp. 1656-1662, pp. 1784-1788(5)

I Van der Linden, M  Eriksson, M Uyttendaele, F Devlieghere

http://www.ingentaconnect.com/content/iafp/jfp/2016/00000079/00000010/art00017

To prevent contamination of fresh produce with enteric pathogens, more insight into mechanisms that may influence the association of these pathogens with fresh produce is needed.

lettuce-washIn this study, Escherichia coli O157:H7 and Salmonella were chosen as model pathogens, and fresh cut iceberg lettuce was chosen as a model fresh produce type. The morphological structure of iceberg lettuce leaves (stomatal density and length of cell margins per leaf area) was quantified by means of leaf peels and light microscopy of leaves at different stages of development (outer, middle, and inner leaves of the crop) on both leaf sides (abaxial and adxial) and in three leaf regions (top, center, and bottom). The morphology of the top region of the leaves was distinctly different from that of the center and base, with a significantly higher stomatal density (up to five times more stomata), different cell shape, and longer cell margins (two to three times longer). Morphological differences between the same regions of the leaves at different stages of development were smaller or nonsignificant. An attachment assay with two attenuated E. coli O157:H7 strains (84-24h11-GFP and BRMSID 188 GFP) and two Salmonella strains (serovars Thompson and Typhimurium) was performed on different regions of the middle leaves. Our results confirmed earlier reports that these pathogens have a higher affinity for the base of the lettuce leaf than the top. Differences of up to 2.12 log CFU/g were seen (E. coli O157:H7 86-24h11GFP). Intermediate attachment occurred in the central region.

The higher incidence of preferential bacterial attachment sites such as stomata and cell margins or grooves could not explain the differences observed in the association of the tested pathogens with different regions of iceberg lettuce leaves.

No comment from LGMA.

The N.Y Times reports the one place the one place the Salinas Valley’s bounty of antioxidants does not often appear is on the tables of the migrant workers who harvest it.

sponge-bob-handwashingMore than a third of the children in the Salinas City Elementary School District are homeless; overall diabetes rates are rising and projected to soar; and 85 percent of farmworkers in the valley are overweight or obese, partly because unhealthy food is less costly, said Marc B. Schenker, a professor at the University of California, Davis, who studies the health of farmworkers.

No comment from LGMA.

Sponge Bob wants answers.

133 sickened in Norway: ‘Improvements required in production processing of fresh salad products’

In May 2014, a cluster of Yersinia enterocolitica (YE) O9 infections was reported from a military base in northern Norway. Concurrently, an increase in YE infections in civilians was observed in the Norwegian Surveillance System for Communicable Diseases. We investigated to ascertain the extent of the outbreak and identify the source in order to implement control measures.

radicchioA case was defined as a person with laboratory-confirmed YE O9 infection with the outbreak multilocus variable-number tandem repeat analysis (MLVA)-profile (5-6-9-8-9-9). We conducted a case–control study in the military setting and calculated odds ratios (OR) using logistic regression. Traceback investigations were conducted to identify common suppliers and products in commercial kitchens frequented by cases. By 28 May, we identified 133 cases, of which 117 were linked to four military bases and 16 were civilians from geographically dispersed counties. Among foods consumed by cases, multivariable analysis pointed to mixed salad as a potential source of illness (OR 10.26; 95% confidence interval (CI): 0.85–123.57). The four military bases and cafeterias visited by 14/16 civilian cases received iceberg lettuce or radicchio rosso from the same supplier. Secondary transmission cannot be eliminated as a source of infection in the military camps.

The most likely source of the outbreak was salad mix containing imported radicchio rosso, due to its long shelf life. This outbreak is a reminder that fresh produce should not be discounted as a vehicle in prolonged outbreaks and that improvements are still required in the production and processing of fresh salad products.

National outbreak of Yersinia enterocolitica infections in military and civilian populations associated with consumption of mixed salad, Norway, 2014

Eurosurveillance, Volume 21, Issue 34, 25 August 2016, DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.34.30321

E MacDonald, M Einöder-Moreno, K Borgen, L Thorstensen Brandal, L Diab, Ø Fossli, B Guzman Herrador, AA Hassan, GS Johannessen, EJ Johansen, R Jørgensen Kimo, T Lier, BL Paulsen, R Popescu, C Tokle Schytte, K Sæbø Pattersen, L Vold, Ø Ørmen, AL Wester, M Wiklund, K Nygård

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=22561

157 sickened from Enteroinvasive Escherichia coli in lettuce, 2014, UK

Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party.

lettuce.skull.e.coli.O145We conducted 2 analytical studies: a case–control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19–positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed.

These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe.

Two linked enteroinvasive Escherichia coli outbreaks, Nottingham, UK, June 2014

Emerging Infectious Diseases, Volume 22, Number 7, July 2016, DOI: 10.3201/eid2207.152080

Newitt, V. MacGregor, V. Robbins, L. Bayliss, M.A. Chattaway, T. Dallman, D. Ready, H. Aird, R. Puleston, J. Hawker

http://wwwnc.cdc.gov/eid/article/22/7/15-2080_article

Going public (not): Leafy green cone of silence on Cyclospora in Romaine lettuce, 2013

Read this Packer story from 2013 for the convoluted hoops public health types are faced with while investigating foodborne illness outbreaks. And now the scientific report: same hoops, same dance, same unsatisfactory outcome for consumers who want to know what’s safe.

cone.of.silence.get.smartA regional, multistate investigation into a June–August 2013 cyclosporiasis outbreak was conducted in Nebraska, Iowa, and neighbouring states. Cases were confirmed on the basis of laboratory and clinical findings.

Of 227 cases in Iowa (n = 140) and Nebraska (n = 87) residents, 162 (71%) reported dining at chain A/B restaurants – 96% reported house salad consumption. A case-control study identified chain A/B house salad as the most likely vehicle. Traceback was conducted to ascertain production lot codes of bagged salad mix (iceberg and romaine lettuce, red cabbage, and carrots) served as house salad in implicated restaurants. A single production lot code of salad mix supplied by both a common producer and distributor was linked to the majority of confirmed cases in persons reporting regional chain A/B exposure.

The salad mix linked to illnesses contained imported romaine lettuce from two separate single-grower fields-of-origin and ≥1 additional field from another grower.

Regional investigation of a cyclosporiasis outbreak linked to imported romaine lettuce – Nebraska and Iowa, June–August 2013

Epidemiology and Infection / Volume 144 / Issue 09 / July 2016, pp 1807-1817Copyright © Cambridge University Press 2015  DOI: http://dx.doi.org/10.1017/S0950268815002484 (About DOI), Published online: 22 October 2015

F. Buss, M. V. Joshi, A. L. O’keefe, C. D. Allensworth, A. Garvey, K. Obbink, S. Mandernach And T. J. Safranek

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10346466&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG

are.you.mental