Raw is risky: Oysters suspected as jury awards couple $6.7 million in Tampa food poisoning

Jonathan Capriel of Tampa Bay reports a jury awarded a couple $6.7 million after they got sick from eating seafood at a Tampa restaurant. The verdict came in May, years after the husband’s illness led to a rare disorder that causes paralysis and nerve damage.

Angel Martinez and his wife Maria Elena Martinez had eaten 10 times earlier at Lobster Haven, 12807 W Hillsborough Ave., when they sat down Dec. 21, 2013, for their usual — two three-pound lobsters and a dozen Bluepoint oysters, according to court records.

The couple declined to comment for this story, as did Lobster Haven owner Daniel Hall.

Attorneys for the couple said the illness was likely caused by the oysters.

“You take a risk when eating raw oysters,” said Brandon Cathey, who represented the Martinezes. “It might get you sick, but you don’t expect it to cause lifelong nerve damage.”

A few hours after the meal, the couple experienced vomiting and diarrhea, according to court records.

Maria Elena Martinez recovered in a few days, but three weeks later, her husband had to be taken by ambulance to Pasco Regional Medical Center after he collapsed on the floor at his home, according to court records.

Doctors transferred him to Tampa General Hospital, where he spent seven days in the intensive care unit, according to court records. He was paralyzed from the waist down for several months and had to learn how to walk again, according to court records.

Martinez’s foodborne illness developed into Guillain-Barre Syndrome, a rare disorder that causes the immune system to attack one’s own body.

He has recovered from the most severe symptoms of the illness but will likely feel long term effects, said his attorney Brent Steinberg.

Lobster Haven admitted it served the couple seafood that poisoned them but denied that it caused Guillain-Barre Syndrome, blaming instead a lamb that Mr. Martinez slaughtered and ate days later.

Lobster Haven’s insurance company offered to settle the case for $20,000 in 2016, Cathey said, but by then Martinez’s medical bills had reached more than $325,000, according to court records.

The restaurant had liability insurance up to $1 million and the Martinez’ likely would have settled for that amount, Cathey said.

“Now this restaurant may go out of business,” he said, “because of the way his insurance company handled this.”

Raw is risky: Squid sperm buries into woman’s tongue

A 63-year-old woman got a nasty shock when tucking into a seafood dinner.

According to Sophie Roberts of the Daily Star, the South Korean patient sought medical attention after she consumed raw squid.

Doctors discovered that her mouth had been inseminated by the creature’s sperm, which had lodged into her tongue and gums.

A Journal of Parasitology report noted that the woman immediately knew something was wrong with the dish.

Even though she spat out the mouthful, she was still affected by the uncooked seafood.

It explained: “As soon as she put a piece into her mouth, she felt like many ‘bugs’ were biting her oral mucosa.

“She experienced severe sharp pain and spat out the entire portion without swallowing.

“Despite that, she could feel many small squirming white bug-like organisms penetrating her.”

The squid sperm acted as it would during reproduction, leading to it implanting itself into the patient’s mouth.

After seeking medical attention, the woman was believed to make a full recovery.

While this case may seem very out of the ordinary, it isn’t the first time it has happened.

In 2011, a 21-year-old woman fell victim to a similar problem after consuming the sexual organs of a raw squid.

Pathology International reported that she also suffered issues with her gums and tongue.

The study warned: “Consumption of a squid with sperm bags and an active ejaculatory apparatus can lead to unintended ejection of the sperm bag and injury to the oral mucosa.”

This whole process is actually autonomous, meaning that the squid’s sex organ is prone to firing off without any conscious decision by the squid, according to a study in the journal Zoomorphology.

Why quarterbacks should stick to football: New Oregon QB commit Cale Millen celebrates by chugging raw eggs with head coach Mario Cristobal

There’s nothing worse than athletes trying to speak.

Bull Durham captured it (below).

This ain’t Rocky, this is Salmonella.

Apparently, it was representative of Cale Millen’s dedication to the University of Oregon. The newest Ducks commit, a Mount Si (Wash.) three-star junior, announced his college decision on Sunday and celebrated by chugging a glass of three raw eggs with his future head coach, Mario Cristobal, as captured by The Oregonian Oregon beat writer Andrew Nemec.

If that sounds unhealthy, well, it is. Sure, raw eggs pack plenty of protein, but they also pack a risk of salmonella. Not a huge risk of salmonella, mind you (there’s actually a greater risk of salmonella on contaminated egg shells than eggs), but the risk is there.

Raw is risky: Salmonella growth on sprouts and microgreens

Microgreens, like sprouts, are relatively fast-growing products and are generally consumed raw. Moreover, as observed for sprouts, microbial contamination from preharvest sources may also be present in the production of microgreens.

In this study, two Salmonella enterica serovars (Hartford and Cubana), applied at multiple inoculation levels, were evaluated for survival and growth on alfalfa sprouts and Swiss chard microgreens by using the most-probable-number (MPN) method. Various abiotic factors were also examined for their effects on Salmonella survival and growth on sprouts and microgreens. Community-level physiological profiles (CLPPs) of sprout/microgreen rhizospheres with different levels of S. enterica inoculation at different growth stages were characterized by use of Biolog EcoPlates. In the seed contamination group, the ability of S. enterica to grow on sprouting alfalfa seeds was affected by both seed storage time and inoculation level but not by serovar. However, the growth of S. enterica on Swiss chard microgreens was affected by serovar and inoculation level. Seed storage time had little effect on the average level of Salmonella populations in microgreens. In the irrigation water contamination group, the growth of Salmonella on both alfalfa sprouts and microgreens was largely affected by inoculation level. Surprisingly, the growth medium was found to play an important role in Salmonella survival and growth on microgreens. CLPP analysis showed significant changes in the microbial community metabolic diversity during sprouting for alfalfa sprouts, but few temporal changes were seen with microgreens. The data suggest that the change in rhizosphere bacterial functional diversity was dependent on the host but independent of Salmonella contamination.

Sprouts and microgreens are considered “functional foods,” i.e., foods containing health-promoting or disease-preventing properties in addition to normal nutritional values. However, the microbial risk associated with microgreens has not been well studied. This study evaluated Salmonella survival and growth on microgreens compared to those on sprouts, as well as other abiotic factors that could affect Salmonella survival and growth on microgreens. This work provides baseline data for risk assessment of microbial contamination of sprouts and microgreens. Understanding the risks of Salmonella contamination and its effects on rhizosphere microbial communities enables a better understanding of host-pathogen dynamics in sprouts and microgreens. The data also contribute to innovative preventive control strategies for Salmonella contamination of sprouts and microgreens.

Plant-microbe and abiotic factors influencing salmonella survival and growth on alfalfa sprouts and Swiss chard microgreens

16 February 2018

Applied and Environmental Microbiology, vol 84 no 9

Elizabeth ReedaChristina M. Ferreiraa, Rebecca BellaEric W. Browna and Jie Zhenga

doi:10.1128/AEM.02814-17

http://aem.asm.org/content/84/9/e02814-17.abstract?etoc

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.

Raw is risky: Norovirus outbreak linked to raw oysters rises to 126 in BC

In a follow-up on the norovirus outbreak linked to the consumption of British Columbia raw oysters, The Public Health Agency of Canada has reported that a total of 126 cases of gastrointestinal illness linked to oyster consumption have been reported in three provinces: British Columbia (92), Alberta (9), and Ontario (25). No deaths have been reported.

Ensure oysters are fully cooked before consuming them. Lightly cooking oysters does not kill norovirus. Oysters need to be cooked to an internal temperature of 90° Celsius (194° Fahrenheit) for a minimum of 90 seconds in order to kill norovirus.

Oysters contaminated with viral norovirus RNA in France

Following calls from RASFF and the Ministry of Health, the Dicastery once again issued a warning to recall the concealed oysters (Crassostrea gigas) bred in France contaminated by the Norovirus Genogroup GI marketed under the GISA brand SRL. The warning came from France, the country of origin of the molluscs, and came to Italy via the Rasff system, which sees the risk as serious.

 The new reference concerns many oysters, GTO 4024, packed by GISA SRL in the Anzio (RM) plant via Colle Cocchino 1 3 / A, in 3 kg boxes. The most aggressive virus under attack is Norovirus. Pathogen for which there is currently no vaccine.

35 in 11 states sick with E. coli from Romaine lettuce grown in Arizona

It’s time to end the leafy greens cone of silence.

Top view of romaine lettuce that has been sliced on a wood cutting board.

This time it has made people unnecessarily sick.

I wouldn’t touch their product.

But how would I know?

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. The FDA learned from the Centers for Disease Control and Wisconsin health officials that the outbreak may have been linked to the consumption of produce and identified bagged fresh spinach as a possible cause.

Eventually, four would die and at least 200 sickened.

One of the responses was to form the Leafy Greens Marketing Agreement (LGMA) which apparently overseas most of the leafy greens production in the U.S.

They are known primarily for self-aggrandizing press releases.

And lots of rumors about how they inhibit epidemiological investigations into outbreaks of foodborne illness linked to their products (search ‘cone of silence’ on barfblog.com for plenty of examples)

According to the U.S. Centers for Disease Control, since the last update on April 10, 2018, 18 more people from 9 states were added to this outbreak.

How many of those could have been prevented if CDC or State health types fingered chopped Romaine lettuce when rumors started circulating? Is the goal of LGMA really to forego epi and demand absolute proof before going public?

As of April 12, 2018, 35 people infected with the outbreak strain of E. coli O157:H7 have been reported from 11 states. 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 29. Sixty-nine percent of ill people are female. Twenty-two ill people have been hospitalized, including three people who developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

Illnesses that occurred after March 27, 2018, might not yet be reported due to the time it takes between when a person becomes ill with E. coli and when the illness is reported. This takes an average of two to three weeks.

Epidemiologic evidence collected to date indicates that chopped romaine lettuce is the likely source of this outbreak. Twenty-six (93%) of 28 people interviewed reported consuming romaine lettuce in the week before their illness started. This percentage is significantly higher than results from a survey[787 KB] of healthy people in which 46% reported eating romaine lettuce in the week before they were interviewed. Most people reported eating a salad at a restaurant, and romaine lettuce was the only common ingredient identified among the salads eaten. The restaurants reported using bagged, chopped romaine lettuce to make salads. At this time, ill people are not reporting whole heads or hearts of romaine.

Traceback investigations are ongoing to determine the source of chopped romaine lettuce supplied to restaurant locations where ill people ate. At this time, no common grower, supplier, distributor, or brand has been identified. However, preliminary information indicates that the chopped romaine lettuce was from the Yuma, Arizona growing region.

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.

Advice to Restaurants and Retailers:

  • Restaurants and retailers should not serve or sell any chopped romaine lettuce, including salads and salad mixes containing chopped romaine lettuce, from the Yuma, Arizona growing region.
  • Restaurants and retailers should ask their suppliers about the source of their chopped romaine lettuce.

That’s right, consumers, it’s up to you.

It should be up to the restaurant or retailer, who markets food safety at point-of-purchase.

And LGMA, which covers Yuma growing, should be forthcoming about risks, rather than blowing themselves in nonsensical tweets.

Raw is risky: At least 40 sick linked to 2 Canadian oyster farms

Two B.C. Vancouver Island oyster farms have been closed following an outbreak of norovirus associated with eating the raw shellfish.

The B.C. Centre for Disease Control says about 40 cases of acute gastrointestinal illness have been connected to the consumption of raw oysters since March. Testing has confirmed some of the cases were norovirus.

Federal officials with Fisheries and Oceans Canada (DFO) confirmed the affected farms are located on the east coast of Vancouver Island at Deep Bay and Denman Island.

While the two farms are no longer harvesting oysters for consumption, no recall of oysters has been issued by the Canadian Food Inspection Agency.

While the precise sources of contamination have not been identified, human sewage in the marine environment is currently believed to be the most plausible cause of shellfish contamination, according to BCCDC epidemiologist Marsha Taylor.

In late 2016 and early 2017, more than 400 norovirus cases associated with raw or undercooked B.C. oysters led to the closure of 13 farms.

The outbreak was declared over in April 2017. Human sewage was also suspected as the cause.

In order to kill norovirus and other pathogens, the BCCDC recommends consumers cook oysters thoroughly, to an internal temperature of 90 C for 90 seconds. Consumption of raw oysters is not encouraged.

Use a tip sensitive thermometer and stick it in.

And stop eating raw: It’s just a put on.

(The video is from The Who’s farewell concert in Toronto in 1982, which I watched in my girlfriend’s residence in 1982 at uni, but they’re still around to make a buck, just like food hacks. At least Towsend had tales to tell)

Raw meat does not confer ‘strength’ 12 sick with trichinellosis from wild boar, 2017

The U.S. Centers for Disease Control reports on January 15, 2017, a hospital physician notified the Alameda County Public Health Department (ACPHD) in California of a patient with a suspected diagnosis of trichinellosis, a roundworm disease transmitted by the consumption of raw or undercooked meat containing Trichinella spp. larvae (1).

A family member of the initial patient reported that at least three other friends and family members had been evaluated at area hospitals for fever, myalgia, abdominal pain, diarrhea, and vomiting. The patients had attended a celebration on December 28, 2016, at which several pork dishes were served, including larb, a traditional Laotian raw pork dish, leading the hospital physician to suspect a diagnosis of trichinellosis. Although the event hosts did not know the exact number of attendees, ACPHD identified 29 persons who attended the event and seven persons who did not attend the event, but consumed pork taken home from the event by attendees. The event hosts reported that the meat had come from a domesticated wild boar raised and slaughtered on their private family farm in northern California. ACPHD conducted a case investigation that included identification of additional cases, testing of leftover raw meat, and a retrospective cohort study to identify risk factors for infection.

Investigation and Findings

Contact information for additional attendees and exposed persons was obtained during interviews with confirmed attendees. Reports of suspected diagnoses of trichinellosis among event attendees were requested from hospital infection prevention specialists, outpatient clinic providers, and local health jurisdictions where event attendees lived.

Exposure to Trichinella was defined as consumption of pork in which Trichinella spiralis larvae were identified. Thirty-six potentially exposed persons were identified, including 29 who attended the event and seven who consumed food taken home from the event by attendees. Among the potentially exposed persons, 20 (56%) were interviewed, 16 for whom professional language interpreters were used. Fourteen potentially exposed persons were not interviewed because contact information was unavailable, and two persons could not be reached. Clinical and exposure information from all 20 persons who were interviewed was collected using a structured questionnaire administered by telephone 28–92 days after the December 28 event. Medical records for patients with a suspected diagnosis of trichinellosis were requested from hospitals and outpatient providers and abstracted. In consultation with the California Department of Public Health and CDC, ACPHD recommended serologic testing for Trichinella for all persons with a suspected diagnosis of trichinellosis using a commercial laboratory’s enzyme-linked immunosorbent assay* to detect immunoglobulin G (IgG) directed against a Trichinella excretory-secretory antigen.

An illness that was clinically compatible with trichinellosis was defined as the occurrence of 1) myalgia and fever; or 2) periorbital edema; or 3) eosinophilia (≥6% eosinophils), with or without gastrointestinal symptoms (e.g., diarrhea, vomiting, or abdominal pain) in an attendee or someone who had consumed food brought home by an attendee. A probable case was defined as clinically compatible illness in a patient with exposure to Trichinella. Confirmed cases were defined as laboratory-confirmed Trichinella infection (i.e., a positive serologic test for Trichinella IgG antibodies) in a patient with history of exposure and clinically compatible illness.

Ten confirmed and two probable cases of trichinellosis were identified; 11 occurred in men. Eleven patients self-identified as Asian, and one identified as Asian and white. The median age was 58 years (range = 39–71 years). Onset dates ranged from December 28, 2016, to January 23, 2017. Nine patients were hospitalized, two of whom were admitted to the intensive care unit; nine had sepsis, seven had acute kidney injury, and two had gastrointestinal bleeding, one case of which was attributed to nonsteroidal antiinflammatory drug use. Eight patients had elevated peak creatine phosphokinase levels indicating skeletal muscle damage (median = 2,821 μg/L; range = 566–25,467 [normal <200 μg/L]), and seven had elevated peak lactic acid levels, which is an indicator of sepsis (median = 3.1 mmol/L; range = 2.3–5.3 [normal = 0.5–2.2 mmol/L]). Six had elevated peak troponin levels indicating damage to the myocardium (median = 0.76 μg/L; range = 0.23–2.02 [normal <0.10 μg/L]). Ten cases were confirmed by a positive Trichinella serological test; two patients were not tested (Table).

Several event attendees had also assisted with food preparation. The three pork-containing dishes reported to have been served at the event included pork stew, grilled pork, and raw larb. Attendees were interviewed about preparation and consumption of the three pork dishes served at or taken home from the event, as well as consumption of any other pork-containing dishes served at the event and other sources of wild boar or bear meat. Attack rates and relative risks were calculated. Leftover raw pork from the implicated meal was obtained from the event hosts.

Larvae in an unstained touch preparation from the raw pork were verified as Trichinella spp. from a photomicroscopic image (Figure); samples were sent to CDC’s Division of Parasitic Diseases and Malaria diagnostic laboratory and identified as Trichinella spiralis through sequencing of the polymerase chain reaction–amplified ITS1-ITS2 region. Consumption of larb was significantly associated with trichinellosis, with an attack rate of 100% and a relative risk of 3.33 (95% confidence interval = 1.29–8.59). No other meat dishes were associated with an increased relative risk.

Public Health Response

The caretaker of the source farm could not be reached, but the event host who owns the farm reported that the caretaker purchased the pig from a private farm at age 5 weeks, raised it in an outdoor, fenced pen, and slaughtered it with the farm owner at age 2.5 years. The farm owner stated there are several pigs being raised on the farm, and the swine are only given commercial feed and never cooked or uncooked meat, offal, or garbage. The farm owner denied any rodent infestation issues on the farm but did state that small animals such as chicks had occasionally gotten into the fenced pen and been eaten by the pigs, indicating that small mammals infected with Trichinella could have entered the pen and been consumed by the swine. The event host has slaughtered pigs and served the fresh raw pork dish at previous celebrations; no illnesses had been reported before this event. Health education regarding safe food handling practices and avoiding consumption of raw meat was provided during interviews with potentially exposed persons and patients. The host was educated about reducing the risk for trichinellosis when consuming pigs from his farm by freezing raw meat for 30 days and cooking meat to a minimum internal temperature of 160°F (71.1°C) to kill Trichinella larvae (2). Although the host did not indicate that he would employ these risk reduction techniques, he did state that he would not serve raw pork from pigs from his farm in the future. Some patients said they would no longer eat raw meat; one patient reported he would continue to eat raw meat from animals that he hunts, believing that raw meat confers strength.

Discussion

Historically, most cases of trichinellosis were associated with the consumption of raw or undercooked Trichinella-infected pork (median = 360 cases reported to CDC per year during 1947–1956); however, largely owing to improvements in agricultural and food processing standards (3), many fewer cases are currently reported (median = 14.5 cases reported per year during 2006–2015) (4). Whereas trichinellosis is rare in the United States, it remains a public health threat, especially among populations that consume raw or undercooked wild game meat or pork from noncommercial sources (5). Recent outbreaks of trichinellosis have been associated with wild boar, bear, walrus, and unspecified pork (4,6). The outbreak described in this report was linked to consumption of a privately raised boar, yet surveillance data during 2008–2012 identified just one case of trichinellosis linked to the consumption of home-raised swine (4), suggesting that this might be an underrecognized risk factor for trichinellosis. Home-raised and home-slaughtered swine produced for personal consumption typically are not subject to the same safety and inspection standards as are commercially produced swine and might be outside the purview of inspections by the state agriculture department or animal health board. Home-raised swine with access to the outdoors are also at risk for acquiring other zoonotic parasites, including toxoplasmosis and Ascaris suum (large roundworm of pigs). Educating persons who raise swine for personal consumption about these safety concerns by public health or agriculture authorities might mitigate the risks.

Clinical disease associated with trichinellosis can be severe and might include sepsis, which has rarely been reported in the English-language scientific literature. This outbreak investigation indicates that high-risk meat preparation and consumption practices might be part of valued cultural traditions. Public health, agriculture, and wildlife authorities should strengthen efforts to provide culturally competent education about trichinellosis prevention to private farmers, hunters, and communities whose cultural practices include raw meat consumption.

Acknowledgments

Marcos de Almeida, Henry Bishop, Kathleen Breen, Jeffrey Jones, Division of Parasitic Diseases and Malaria, CDC; Edward Powers, Infectious Diseases Branch, California Department of Public Health; Barbara Gregory, City of Berkeley Public Health Department, California; Susan Farley, Ileen Quimora, Contra Costa Public Health, Martinez, California.

Conflict of Interest

No conflicts of interest were reported.

Trichinellosis Outbreak Linked to Consumption of Privately Raised Raw Boar Meat — California, 2017

Morbidity and Mortality Weekly Report; March 2, 2018; 67(8);247–249

Dustin Heaton, MSN; Sandra Huang, MD; Rita Shiau, MPH; Shannon Casillas, MPH; Anne Straily, DVM; Li Kuo Kong, MD; Valerie Ng, MD, PhD; Viviana Petru, MD

https://www.cdc.gov/mmwr/volumes/67/wr/mm6708a3.htm?s_cid=mm6708a3_e