Monthly Archives: September 2008

More listeria revelations: CFIA waited (at least) 5 days to issue advisory, policy on going public seems to suck

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Toronto’s Globe and Mail newspaper reported Saturday that health officials in Ontario ordered hospitals and nursing homes to stop serving Maple Leaf meats five days before the public was told about a deadly source of food poisoning that has so far claimed 19 lives and left another 60 people seriously ill across Canada.

The CFIA launched its investigation on Aug. 6, after officials at the Ontario Ministry of Health informed it that there was an outbreak of listeriosis in the province. Many local health officials were already grappling with a spike in listeriosis cases, but they did not become aware that the outbreak spanned several provinces until July 30, when they received a directive from the ministry, telling them to urgently report any new cases.

On Aug. 14, health officials in Ontario learned during a telephone conference call with the CFIA that the agency had some test results revealing that Maple Leaf deli meats contained the foodborne bacteria known as Listeria monocytogenes.

The CFIA waited until it had the DNA fingerprint evidence establishing a definitive link before it went public – on Aug. 19, 2008.

CFIA spokesman Garfield Balsom said,

“We had lab results indicating that there was positive listeria in a product and we would issue our normal recall based on that.”

So epidemiology doesn’t count? If CFIA really does not issue public advisories unless it has a positive result, that would explain the low number outbreaks linked to fresh fruits in vegetables in Canada. Who knows how many sick people there are, and how many illnesses and deaths could have been prevented in the current listeriosis outbreak.

A positive listeria sample would have triggered an immediate recall in the U.S. So what is the CFIA policy on going public – on issuing advisories that specific foods may pose an imminent danger to the health of Canadians. CFIA won’t say what their policy is, at least not publicly, but a policy that maligns epidemiology and relies excessively on positive test results – especially when those samples appear to be delivered by stagecoach – is restrictive and reckless.

As past of that accountability, I told the Toronto Star on Thursday that Canada does not need an inquiry and does not need more inspectors, rather,

"People need to do their jobs. The CFIA is accountable to Parliament through the minister of agriculture, so either the minister, or the Prime Minister’s Office, should call the head of CFIA on the carpet and say, `You’ve had this internal report since 2005. Issue some clear guidelines on how to communicate during an outbreak of food-borne illness. Give clear instructions to inspectors and the industry on what is expected to ensure a safe food supply … If you can’t do that, I will find someone else who can – and not some political appointment, someone with a food safety background who will do what is necessary to protect the safety of the Canadian food supply and bolster the Canadian brand in international circles.’"

Such straight talk, especially when it comes to informing the public about health risks, is largely missing in Canada, experts agree.

So while the politicians and unionists pontificate, a columnist at the University of Calgary student paper got the most rightest:

"Canadians have entrusted one single agency, the CFIA, to protect the entire Canadian food supply– we have placed all food security in one basket.

"If the CFIA did not exist, perhaps Canadians would be better off. … The current food inspection system has failed Canadians. Maybe it is time for a change."

As an aside, a columnist with the Ottawa Citizen who fancies himself as some sort of risk guru wrote Saturday that,

“Another clue lies in the number of listeriosis deaths in past years. According to Statistics Canada, there were five in 2000. In 2001, four. In 2002, seven. In 2003, three. In 2004, one. (Data for subsequent years were unavailable.) …

“The Globe also noted the Canadian regulatory standard is weaker than that of the United States, which allows no listeria content at all in ready-to-eat foods. But the Globe did not report that, according to the Centers for Disease Control, roughly 2,500 Americans become seriously ill with listeriosis each year and 500 die.

“Thus the listeriosis fatality rate is far smaller in Canada than the U.S. That, too, does not suggest a crisis.”

The columnist is comparing actual listeria cases in Canada with estimated cases in the U.S. And why no alarm that the most recent numbers in Canada are from 2004?

 

Lettuce linked to Michigan E. coli O157:H7 outbreak; MSU needs to check its food safety facts

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On the same day that congressional investigators cited shoddy oversight of produce processing operations, wholesale, bagged iceberg lettuce appears to be the culprit in the Michigan E. coli O157:H7 outbreak that has sickened at least 26 people.

“Some of the 26 Michigan cases consumed shredded or chopped iceberg lettuce in restaurants or institutions purchased from Aunt Mid’s Produce Company, a Detroit-based wholesale distributor; and other distributing outlets could be identified. Product trace back and additional tests results are still in progress.

“Our top priority at the Michigan Department of Community Health is to protect the public,” said Dr. Gregory Holzman, chief medical executive for MDCH. “We appreciate all of the assistance from Aunt Mid’s. They have been very helpful in this investigation. We want to ensure that the public’s health and well-being is protected. Even though the investigation is ongoing, available evidence is strongly pointing to iceberg lettuce.”

Wouldn’t it be nice if just one public health official in Canada had a similar statement – our top priority is to protect public health – during the listeria outbreak that has killed at least 18?

Although I do have some concerns about statements from Michigan State University physician Beth Alexander, who tonight said,

“We will continue to be as cautious as possible, until this issue is completely resolved.”

This is the same MSU physician Beth Alexander who said on Sept 16, 2008,

“Generally, the infection isn’t serious. It’s usually caused by food or water that has been contaminated with that bacteria.”

The eight MSU students who were hospitalized probably thought it was serious.

Further, a press release from MSU tonight said,

“The one food item typically associated with E. coli outbreaks is undercooked hamburger. Health officials advise all chefs to cook their hamburgers until the juice runs clear.”

I’m not sure what that has to do with lettuce. And color is a lousy indicator for judging whether meat is done or not – a digital, tip-sensitive thermometer is a must. Cooking until the juices run clear seems reckless rather than cautious.

Alexander also stressed that thorough hand washing remains the most effective way of fighting communicable diseases, and,
 
“Always wash your hands before preparing any foods. Make sure your countertops are clean and don’t do any food preparation if you are sick.”

Again, I’m not sure what this has to do with lettuce. Doesn’t instill a lot of confidence in the ability of MSU food service to provide safe food – no matter how much Spartan spirit they have. Maybe MSU should be examining their food procurement policies. If this is what a top-10 land grant university produces, maybe those rankings don’t mean too much.

A table of at least 28 previous North American outbreaks of shiga-toxin producing E. coli, like O157:H7, is available at:
 
http://foodsafety.ksu.edu/en/article-details.php?a=3&c=32&sc=419&id=903
 

FDA lax in produce oversight

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The U.S. Government Accountability Office reported today that the Food and Drug Administration’s efforts to combat foodborne illness are hampered by infrequent inspections, not enough staff and the failure to implement a program devoted to the safety of fresh produce.

The report said that inspections at produce-processing facilities are rare and that when problems are discovered, the FDA relies on the industry to correct them without oversight or follow-up. …

The report also cited previously unpublished FDA data showing that 14 people died and 10,253 were sickened in 96 outbreaks associated with fresh produce from 1996 through 2006. This summer, salmonella sickened at least 1,440 people in 43 states and Washington, D.C.

But the report found that only 3% of the FDA’s food safety budget goes toward efforts to protect fresh produce.


 

Casey Jacob, guest barfblogger: Swiss restaurant barred from serving human breast milk

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The Swiss restaurant hailed as the inspiration for PETA’s plea to Ben and Jerry’s to replace the cow’s milk in their ice cream with human breast milk is facing legal action if it continues with its plan to use breast milk purchased from new mothers in its soups and sauces.

The public was startled by Hans Loucher’s newspaper advertisements to new mothers to purchase their excess breast milk for $14.50/liter (or about $3.50 per 8oz. baby bottle) for use in his restaurant, the Storchen, whose name ironically refers to a stork in English.

“The mother’s milk is the most natural thing in the world – how can anyone be against it?” Mr. Loucher asked the Times Online. “I served the meals to my friends without telling them about the new ingredient and the feedback was excellent.”

Of course, being a “natural” food does not make it free of disease-causing microorganisms. It would be very difficult to regulate how the milk was handled before purchase by the restaurateur, and it is not likely he possesses the equipment necessary to pasteurize it before use.

Last week, as reported by the Times Online, the canton’s food regulatory body ruled that Mr. Locher would not be able to store the human milk properly nor guarantee that it was fresh and safe for consumption, since the product was not a registered or regulated food. Along with the Association of Swiss Milk Producers, Zurich’s food regulator has threatened lawsuits against Mr. Locher and anyone who provides human milk for his cause.


 

E. coli continues to kill and maim

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There’s a lot of E. coli, the kind that sickens and kills, circulating around the U.S. In addition to the Locust Grove, OK, outbreak of E. coli O111 which has killed one and sickened 314, E. coli O157:H7 continues its rampage.

A three-year-old in Colorado died last Friday; another child who attended the same day-care has also tested positive but is expected to recover. The daycare is closed.

In Ohio, a three-year-old girl died Sept. 13 of kidney failure at Akron Children’s Hospital after suffering from diarrhea, blood in her stool and vomiting, the hallmarks of shiga-toxin E. coli infection.

A Redmond family is praying for their 19-month-old son’s recovery after he was diagnosed with E. coli and flown to a children’s hospital in Portland.

A benefit was held for a three-year-old and his family after he spent a month in a Minneapolis Children’s Hospital, again with E. coli.

A fundraising BBQ for the Forest Ranch, California, volunteer firefighters has sickened at least 24, with two remaining in hospital, including a 6-year-old girl.

In Michigan, health officials have confirmed 24 cases of E. coli O157:H7 throughout the state, broadening their investigation from an initial cluster at Michigan State University.

The child pictured is five-year-old Mason Jones who died after eating a school lunch in Wales in Oct. 2005. These are the faces and stories of foodborne illness. And that’s just one week in the U.S.

Trendspotting: Shopping cart sanitation

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Some of you may remember the 2004 International Association for Food Protection meting in Phoenix. At a local supermarket I found this sanitizing system for shopping carts displayed prominently. That’s when I started to think, maybe food safety can be marketed.

A few months later and I was in the Gold Coast, Australia, for a food safety meeting. I told one journalist about this new trend I’d observed –always gotta be trendspotting – of more prominent use of sanitizers in grocery stores.

That turned into,

“Doug Powell, a food safety expert from Canada, says a decision to put hand wipes in supermarkets and provide sanitising towels for shopping trollies has been successful in reducing the number of food poisoning cases in the US and Canada.”

And it ran all over Australia.

So I wrote a letter which was published in the Sydney Morning Herald and read in part,

“The use of hand wipes in supermarkets and sanitizing towels for shopping carts has been experimental at best in the U.S., and has not and cannot be correlated with any reduction in foodborne illness (Shoppers urged to clean hands to wipe out food-borne diseases, October 11/04, Sydney Morning Herald).

“However, as the Food Safety Information Council correctly noted, and as I stressed during the interview, any measure — whether on the farm, in processing, at food service, in the home, and yes, at retail — that can enhance food safety awareness should be explored and encouraged.”

Now it appears some such work has been done.

USA Today reports today that supermarkets and other retailers that provide shopping carts are increasingly looking to limit germ exposure for customers and their families.

“A ShopRite supermarket in Passaic, N.J., installed a push-through cleaning machine on Tuesday that sprays each shopping cart between uses with a misty peroxide solution to kill bacteria, according to Jim Kratowicz, president of PureCart Systems, the manufacturer of the machine. …

“Studies conducted in 2006 and 2007 by FoodNet found riding in a shopping cart beside meat and poultry is risky for infants under six months.

“Doing so triples the chance they may contract salmonella and quadruples it for campylobacter, a diarrhea illness, according to Olga Henao, an epidemiologist for the CDC.

“Infants can become ill when they transfer bacteria from the packaging into their mouths, Henao said. Also, if raw juices leak out onto the cart, it can create a bacteria risk for the next infant in the cart, she said.”

Trendspotting is just so hip. Here’s Demetri Martin with his own trendspotting.
 

Barfblog: fart and vomit edition

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A West Virginia man who police said passed gas and fanned it toward a patrolman has been charged with battery on a police officer.

Jose A. Cruz, 34, of Clarksburg, was pulled over early Tuesday for driving without headlights, police said. According to the criminal complaint, Cruz smelled of alcohol, had slurred speech and failed three field sobriety tests before he was handcuffed and taken to a police station for a breathalyzer test.

As Patrolman T.E. Parsons prepared the machine, Cruz scooted his chair toward Parsons, lifted his leg and "passed gas loudly," the complaint said.

"The gas was very odorous and created contact of an insulting or provoking nature with Patrolman Parsons," the complaint alleged.

Meanwhile in Tempe, eight to 10 members of an Arizona State University fraternity are believed to have caused a car accident by vomiting milk onto traffic below an ASU footbridge on University Drive Tuesday night.

The prank caused a woman to rear-end another vehicle at about 6 p.m. after that vehicle stopped to avoid the vomit.

It is unknown why the men were drinking and vomiting the milk.
 

Listeria has been my worst nightmare for the past 9 months

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I’m a self-described food safety nerd. I don’t hide from this obsession, I embrace it.  But my fixation on everything food safety has led to much stress lately — for the past 9 months my food safety spidey-sense has been heightened more than normal as Dani and I have been expecting a baby.

And he finally arrived last week.

Our little dude, Jack Neil Chapman, showed up Friday morning at 4:11am (Yes, the Neil part is named after the greatest Canadian singer/songwriter, Neil Young — I’ll fight anyone who disagrees, Ari Gold style, http://www.youtube.com/watch?v=QGVoLsDS3t8&e)

Throughout Dani’s pregnancy I became the food police in our house — no soft cheeses or cold deli meats made it to Dani’s plate, most didn’t even make it in the house. Everything (and I mean everything) has been temped during cooking. I read pretty well every paper I could on listeria, and Doug and I discussed the merits of broad food surveys and listeria growth in blue-veined cheese. It was a bit ridiculous, but I hear that first time parents sometimes can be obsessive.

During the recent Canadian listeria outbreaks I selfishly felt vindicated for keeping the products out of our house — our view was that no matter what type of food safety system food processors had, we weren’t taking the risk. Maple Leaf is a huge company that can afford lots of food safety controls, spoke about their commitment to food safety, and even used the food safety culture term Doug and I are so fond of. But 18 people have so far died from listeria in their products.

When I held Jack for the first time, about 30 seconds after he was born, I first thought "Wow, you’re tiny and light, and you don’t smell as manky as I had thought you would" and soon after I thought about the parents, people just like us, who have been recently affected by listeria.  The victims include at least one miscarriage and  six babies born prematurely in Quebec resulting from the consumption of soft cheeses. A 6-week old Manitoba infant born with a listeria, not linked to either Maple Leaf or Quebec soft cheeses outbreak, also died last week. Those are the ones we know about.

And then I realized that, although I thought I did a great job managing risks in our house, I and the rest of the food safety world have probably failed many out there who haven’t reduced risks.  Not the individuals who made the choice to eat risky foods, but the parents who have never heard about listeria, the ones who ate risky foods without knowing that listeria is 20 times more likely to infect pregnant women or that listeria infections during preganancy are likely to cause miscarriages or stillbirth.   Who knows what effect our risk-reduction practices had on Dani’s pregnancy. Maybe things would have been fine without being so strict, but we weren’t interested in taking the chance.

I’m all about informed decisions around risk. I even think there is a place for raw milk consumption for adults.  But we had the info to make the decisions.  Info that came from a variety of places (for us it was primary resources, outbreak reports and review papers). Other parents rely on food safety professionals, like the health authorities, for info.

Last weekend was all about Jack, and I didn’t get back into reading FSNet until yesterday morning (I’m getting quite good at holding him and reading emails at the same time) and I came across Canada’s Chief Public Health Officer, Dr. David Butler-Jones’ advice concerning listeria, including the below:
*Wash your hands. This will help avoid many kinds of infections. Wash your hands in warm soapy water before preparing food, afterwards, and again before eating.
*Read labels and follow cooking and storage instructions for all foods. Make sure to check the “best before” date.
*Freeze or consume leftovers within four days of cooking. Always reheat leftovers until steaming hot before eating.
*Keep refrigerators clean and at a temperature below 4 C, or 40 F. Listeria can grow in the fridge, but the colder it is, the slower it grows. Install a thermometer in your fridge to be sure.
Those tips apply to all of us, all the time, and not just during an outbreak.

There are so many holes in his list of advice, many have nothing to do with listeria, and I don’t think there is evidence that supports many of his statements. Following the list of consumer blames, Butler-Jones did get into listeria with feel-good language: "For seniors, pregnant women, and those with weakened immune systems, or for those serving or caring for anyone in these groups, some extra precautions are very important as [various] foods pose some risk."  He ended his advice with "these steps form a simple approach to food safety."

The most important message missing from his list was: Don’t eat this stuff unless you are cool with the risks.

I sent an email to Doug (the subject line was "what a f*ing joke"), saying where was Dr. Butler-Jones when the outbreak was announced a month ago.  Did it really take a month for his staff to wake up and get some info out there?  A question echoed in the upcoming Canadian Medical Association Journal which says that the Public Health Agency of Canada should be the primary source of information for the public during a crisis and that Canada’s chief public health officer has not been the lead voice to inform the public.

So I guess my preachy message is along the lines of don’t eat poop (especially baby poop, though Jack’s hasn’t started to smell yet).We need to do a better job of creating a dialogue around food safety risks with specific target audiences — especially those at higher risk for foodborne illnesses.  And though the bureaucrats talk a lot, they need to be the real leaders in information — and forget about the fuzzy language that will make the minister happy.  Tell people to stay away from the risky stuff.
 

Casey Jacob, guest barfblogger: PETA wants human breast milk in Ben & Jerry’s ice cream

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People for the Ethical Treatment of Animals sent a letter to Ben Cohen and Jerry Greenfield, cofounders of Ben & Jerry’s Homemade Inc., urging them to replace cow’s milk used in their ice cream products with human breast milk.

"The fact that human adults consume huge quantities of dairy products made from milk that was meant for a baby cow just doesn’t make sense," said PETA Executive Vice President Tracy Reiman in a press release. "Everyone knows that ‘the breast is best,’ so Ben & Jerry’s could do consumers and cows a big favor by making the switch to breast milk."

Whatever floats your boat, I guess… as long as it’s pasteurized for the kiddos. And, yes, evidence suggests that Ben and Jerry are fans of pasteurization.

A blog post in The PETA Files explains the inspiration behind their request. “Storchen, a (very innovative) restaurant in Switzerland, has just announced that they will be unveiling a new menu that includes soups, stews, and sauces made with at least 75 percent human breast milk,” blogged Carrie Ann Harris. “Some folks might think that drinking human breast milk is strange … but really, what’s even stranger is that humans are the only species on the planet that drinks the milk of another species.”

Ben and Jerry’s responded by saying, “We applaud PETA’s novel approach to bringing attention to an issue, but we believe a mother’s milk is best used for her child.”
 

Canadian food safety bureaucrats still aren’t that into you

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If Canadian cattle or chickens get sick, the public is told all about it.

If Canadian people get sick, not so much.

That’s what I wrote in Dec. 2006 in a piece called, Sorry, bureaucrats just aren’t that into you.

I’ve said the same thing for the past month as the listeria in Canadian cold-cuts outbreak became public. The latest figures show at least 18 dead and 60 confirmed or suspected ill.

The several-week delay in telling Canadians about listeria in Maple Leaf cold-cuts, coupled with the self-congratulatory and exceedingly false statements about the superiority of Canadian disease surveillance is just another episode in the arrogant and dysfunctional father-knows-best approach to providing health advice practiced by various Canadian authorities.

Dr. Phil would say the relationship between officials at the Canadian Food Inspection Agency (CFIA) and the Canadian public is like a couple headed for divorce: they don’t speak unless forced to, and when asked, it’s denial, deceit and deception.

Rob Cribb of the Toronto Star reports today that a major review of Canada’s food recall system three years ago identified serious problems that experts say continue to threaten public safety.

“Spotty inspections across the country, delays in warning the public about tainted food and a lack of follow-up to prevent repeat outbreaks are documented in the government report, obtained through access to information legislation.

The 2005 Canadian Food Inspection Agency (CFIA) review predicts concerns that have emerged from the current Maple Leaf listeria outbreak that has claimed 18 lives.

"There is no clear policy on when a recall requires public warning," the report states.

Timely public disclosure of food risks re-emerged as an issue last month when it took three weeks for officials to warn the public of tainted Maple Leaf meat. …

In the aftermath of the outbreak, public health officials and politicians were quick to reassure Canadians that the country has one of the best food safety systems in the world. But behind the scenes, the review documents a history of serious internal concerns: "Most findings in this report have previously been identified by the various parties involved in food recalls."

The CFIA audit paints a picture of a sometimes-chaotic system where turf wars can impact the public’s need to know about food warnings. …

Doug Powell, a Canadian food safety expert working at Kansas State University, said any warnings officials received from the review appear to have been ignored. "It’s contentment with mediocrity. The bureaucrats don’t seem to care very much. They all talk a good game, but they never think it will happen to them, so they just go on."

I can imagine Dr. Phil asking in his Texas drawl "How’s that working out for ya’ll?"

The most frustrating part is that CFIA is staffed with individuals who are excellent public advocates and spokespeople. On issues relating to mad cow disease or avian influenza, CFIA goes out of its way to communicate with Canadians, perhaps fearing that any crisis of confidence will reduce sales and impact Canadian farms.???

Yet when it comes to the 11 to 13 million foodborne illnesses in Canada each and every year, CFIA has adopted a policy of don’t ask, don’t tell. ???Maybe Dr. Phil can get the public and CFIA into a relationship based on open communication, trust, and respect, but I doubt it. Time to move on.