Raw is risky: Why salads are the biggest source of food poisoning and what to do to avoid it

Brian Adam of Intallght writes just over a year ago, the United States saw the largest outbreak of E. coli since 2006; affecting at least 98 people in more than 20 states. The origin wa bagged romaine lettuce. Unfortunately, this is not an isolated case. Vegetables and fresh fruit have become a real headache for food safety experts.

 Today in the United States, fresh vegetables are the largest source of food poisoning. In Europe, the figures are not so pristine, but the bacteria and viruses associated with this type of food also are to blame for the vast majority of poisonings. We are facing a real danger for food safety: salads.

The numbers speak for themselves

In 1990, more than 400 epidemic outbreaks associated with fresh fruits and salads were detected. Between 2001 and 2013 we are not even able to know in its entirety, some experts explain, how many related outbreaks appeared, but they are many, increasing since 2008. Arrived in 2013, in Europe these epidemics seem to reduce their growth, stagnating in number per year, as explained in this article by EFSA, the European authority on food safety.

Despite the fact that Europe the number of appearances seems to have stabilized, in the United States they have continued to increase. The danger is still lurking, hidden between “romaine lettuce and Brussels sprouts.” The reason is in “cool” words.

According to some independent experts, this increase could be related to the increased consumption of vegetables and fresh fruit in the diet. This is a consequence of the search for a better, healthier diet. But, not being processed, these foods can also bring unexpected and unpleasant surprises.

But what is the problem? What’s wrong with fresh vegetables? It is not that strict food safety controls do not pass, as it happens with everything that arrives at our supermarkets but fresh food, especially if we put it in a plastic bag, is cannon fodder for microorganisms.

Raw is still risky: Six years after a toddler died, Australian advocates want raw milk back on the table

In late 2014, three children in the Australian state of Victoria developed hemolytic uremic syndrome linked to Shiga-toxin toxin producing E. coli in unpasteurized bath milk produced by Mountain View Dairy Farm. One child died, and two others developed cryptosporidiosis.

The Victorian government quickly banned the sale of so-called bath milk, which although labeled as not fit for human consumption, was a widely recognized way for Australian consumers to access raw milk.

What followed was a despicable whisper campaign that the child who died had an underlying medical condition, it wasn’t Shiga-toxin producing E. coli (STEC), farmers were losing access to lucrative markets – anything but the basic and sometimes deadly biology of STECs and everything involving fantasy and fairytales.

Victorian Dairy farmer Vicki Jones was told in 2014 by the coroner that raw milk was the likely cause of death of a three-year-old boy in 2014.

The milk was ‘raw’, or unpasteurised, and Ms Jones’ Mountain View Dairy Farm had been selling it as bath milk — a cosmetic product labelled ‘not fit for drinking’. 

Ms Jones said she told the officer she would immediately remove the milk from the shelves of local stores. 

“And he said to me, ‘No, no, no, don’t do that. You’ve done nothing wrong and all your labelling is right’.”

In hindsight, Ms Jones said this response “was really bizarre” — as was the decision to wait months before telling her about the cases.

But then the health officer told her a three-year-old boy had died after drinking the bath milk. 

“It was the most devastating news that you could possibly imagine ever getting,” she said.

“I was mortified, we were doing the raw milk because people wanted it.”

Or because you contributed to promoting BS.

A Gippsland MP, the father of the child who died, and evidence presented to the coroner have all questioned how the cases were managed and suggested other contributing factors were overlooked.

Mark Wahlqvist, an Emeritus professor of medicine at Monash University and former president of the international union of nutrition sciences, said, “Raw milk, unpasteurised milk, is not safe enough to be in the public domain.”

Professor Wahlqvist said he was open to new research but at present, found campaigners for raw milk to be more than unconvincing.

“When people for conspiratorial reasons rather than scientific reasons, think that vaccination is a problem or that pasteurisation is a problem,” he said.

“We have a science communication problem in this country and it needs science leaders.”

Raw is risky: Yes, for dogs too

There’s a subset of pet guardians who feverishly believe raw food is the only food for dogs and cats and other pets because that’s all that was available in the wild.

As Hobbes noted in 1651, nature is “solitary, poor, nasty, brutish, and short.”

Dogs too.

The Canadian Food Inspection Agency announced last week that Carnivora Fresh Frozen Patties for Dogs and Cats may be contaminated with Escherichia coli O157 (E. coli) and there is risk of cross contamination and illness after handling.

Consumers should immediately stop using any of the affected pet food products and contact the retailer where they purchased the affected product for a full refund or exchange.

As of June 12, 2020, the company has been made aware of 4 reports of illnesses in Canada – in people.

Consumers are advised to always wash hands, surfaces and utensils thoroughly with soap and water after feeding, handling or cleaning up after pets. Clean surfaces that come into contact with pet food or ill pets.

One of daughter Sorenne’s daily tasks is to give stress-reducing wet food to our neurotic cat, and she absolutely knows to wash her hands after handling the food.

Scott Weese over at the Worms and Germs blog writes that while people were presumably not eating the pet food (I wouldn’t presume that), there is the potential for cross-contamination of human food when handling raw pet food, as well as potential for exposure to pathogens through things like contact with pet food bowls and pet feces.

The main concern with raw pet food tends to be Salmonella; however, E. coli O157 is another significant concern because of the  potential severity of disease. A death was reported in a UK a couple years ago from exposure to E. coli O157 from contaminated pet food.

While most dogs and cats that eat raw diets are fine, and most owners don’t get sick, it’s clear that feeding raw diet or raw animal-based treats (e.g. pig ears) is associated with risks to the pet and any human contacts. I’d rather people not feed raw diets to their pets, particularly when the pet or household members are very young, elderly, pregnant or have compromised immune systems. If none of those risk factors are present and someone wants to feed a raw diet, I’d still rather they didn’t, but there are some things that can reduce the risks, as outlined on the Worms & Germs infosheet on raw diets available on our Resources – Pets page.

Oh, and don’t go to the company’s website for accurate information about risk and risk mitigation. They bury some good prevention recommendations in a pile of often out-of-context dialogue to try to deflect any concerns and the typical raw diet misinformation. Some other raw pet food companies are up front about the risks and prevention measures – I have a lot more confidence in companies like that.

Good on ya, Dr. Weese.

Raw milk cheese still risky – even in France

Raw milk cheeses are commonly consumed in France and are also a common source of foodborne outbreaks (FBOs). Both a FBO surveillance system and a laboratory-based surveillance system aim to detect Salmonella outbreaks.

In early August 2018 5 familial FBOs due to Salmonella spp. were reported to a regional health authority. Investigation identified common exposure to a raw goats’ milk cheese, from which Salmonella spp. were also isolated, leading to an international product recall. Three weeks later, on 22 August, a national increase in Salmonella Newport ST118 was detected through laboratory surveillance. Concomitantly isolates from the earlier familial clusters were confirmed as S. Newport ST118. Interviews with a selection of the laboratory identified cases revealed exposure to the same cheese, including exposure to batches not included in the previous recall, leading to an expansion of the recall. The outbreak affected 153 cases, including 6 cases in Scotland. S. Newport was detected in the cheese and in milk of one of the producer’s goats.

The difference in the two alerts generated by this outbreak highlight the timeliness of the FBO system and the precision of the laboratory-based surveillance system. It is also a reminder of the risks associated with raw milk cheeses.

Outbreak of salmonella Newport associated with internationally distributed raw goats’ milk cheese, France, 2018, 04 May 2020

Epidemiology & Infection pp.1-23

Robinson(a1)(a2)M. Travanut (a3)L. Fabre (a4)S. Larréché (a5)L. Ramelli (a6)L. Pascal (a6)A. Guinard (a7)N. Vincent (a8)C. Calba (a8)L. Meurice (a9)MA. Le Thien (a10)E. Fourgere (a10)G. Jones (a1)N. Fournet (a1)A. Smith Palmer (a11)D. Brown (a12)S. Le Hello (a4)M. Pardos de la Gandara (a4)FX. Weill (a4) and N. Jourdan Da Silva (a

DOI: https://doi.org/10.1017/S0950268820000904

https://www.cambridge.org/core/journals/epidemiology-and-infection/article/outbreak-of-salmonella-newport-associated-with-internationally-distributed-raw-goats-milk-cheese-france-2018/528E4E70FB25CDBB293627227740E39D
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Brucellosis and raw milk, again

In December 2018, the Pennsylvania Department of Agriculture (PDA) and Pennsylvania Department of Health (PADOH) were notified of a New York patient with brucellosis caused by infection with Brucella abortus RB51, the live attenuated vaccine strain of B. abortus used to prevent brucellosis in cattle (1). Brucellosis is a serious zoonotic infection caused by the bacteria Brucella spp. The most common sign is fever, followed by osteoarticular symptoms, sweating, and constitutional symptoms (2). Without proper treatment, infection can become chronic and potentially life-threatening (2).

The patient had consumed raw (unpasteurized) milk from dairy A in Pennsylvania.* In July 2017, Texas health officials documented the first human case of domestically acquired RB51 infection associated with raw milk consumption from a Texas dairy (3). In October 2017, a second RB51 case associated with raw milk consumption was documented in New Jersey; the milk source was not identified at the time.

To determine the RB51 source for the New York case, PDA conducted an environmental investigation at dairy A in December 2018. PDA collected individual milk samples from all cows, excluding those known not to have been vaccinated against B. abortus, and from the bulk milk tank, which included milk pooled from all cows. All milk samples underwent polymerase chain reaction (PCR) testing and culture; whole-genome sequencing (WGS) was performed on patient and milk sample isolates. PDA conducted a traceback investigation of any cow with a milk sample that tested positive for RB51. PADOH worked with the raw milk cooperative that distributed dairy A’s milk to notify potentially exposed consumers and distributed notifications through Epi-X§ to identify cases.

Dairy A sold only raw milk and did not provide RB51 vaccination to cows born there (16 of the 30-cow herd). The remaining 14 cows were born outside the dairy and had inadequate vaccination records to determine whether they had received RB51. Because these cows might have been vaccinated, milk samples were collected from them. RB51 was detected by PCR and isolated in milk samples collected from the bulk tank and a single cow (cow 122). WGS identified two distinct RB51 strains shed by cow 122: one matched the 2018 New York patient’s isolate (3 single nucleotide polymorphisms [SNPs] different) and one, unexpectedly, matched the 2017 New Jersey patient’s isolate (1 SNP different). The two different RB51 strains were also shed from different quarters of cow 122’s udder.

Traceback revealed that cow 122 had received RB51 in 2011 and was purchased by dairy A in 2016. During 2016–2018, dairy A distributed raw milk potentially contaminated with RB51 to 19 states; PADOH notified those states’ public health veterinarians. PADOH provided a letter with RB51 information and brucellosis prophylaxis recommendations to the cooperative, which they distributed to dairy A customers. No additional cases were identified. Cow 122 was excluded from milk production, and serial PCR testing of bulk milk samples were subsequently negative for RB51.

Isolation of two different RB51 strains from different quarters of a cow’s udder has not previously been reported. These infections highlight the need to prevent RB51 infections. Raw milk consumption is also associated with serious illnesses caused by other pathogens, including Campylobacter spp., Shiga toxin–producing Escherichia coli, and Salmonella spp. (4). During 2007–2012, the number of raw milk outbreaks in the United States increased; 66 (81%) of 81 reported outbreaks occurred in states where raw milk sale is legal (5). Pregnant women, children, older adults, and persons with immunocompromising conditions are at greatest risk for infection.

To eliminate infection risk from milkborne pathogens, including RB51, all milk should be pasteurized. Because limited information is available about intermittent or continuous RB51 shedding among dairy cows, more research is needed to more fully understand this emerging public health threat for milk consumers. States can also consider the United States Animal Health Associations’ recommendations regarding the need for RB51 vaccination in areas where B. abortus is not endemic in wildlife.

Notes from the field: Brucella abortus RB51 infections associated with consumption of raw milk from Pennsylvania—2017 and 2018, 17 April 2020

Morbidity and Mortality Weekly Report

Joann F. Gruber, PhD1,2; Alexandra Newman, DVM3; Christina Egan, PhD3; Colin Campbell, DVM4; Kristin Garafalo, MPH4; David R. Wolfgang, VMD5; Andre Weltman, MD2; Kelly E. Kline, MPH2; Sharon M. Watkins, PhD2; Suelee Robbe-Austerman, DVM, PhD6; Christine Quance6; Tyler Thacker, PhD6; Grishma Kharod, MPH1; Maria E. Negron, DVM, PhD1; Betsy Schroeder, DVM2

https://www.cdc.gov/mmwr/volumes/69/wr/mm6915a4.htm

More Tragically Hip, with fellow Kingston, Ontario (that’s in Canada) native Dan Aykroyd blowing the harp.

Raw is risky: Study finds raw-type dog foods as a major source of multidrug-resistant bacteria that could potentially colonize humans

I’m nervous this is not peer-reviewed, has a small sample size, but thought I’d share anyway.

I’ve never fed any of my pets a raw-food diet.

New research due to be presented at this year’s European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) reveals that raw-type dog foods contain high levels of multidrug-resistant bacteria, including those resistant to last-line antibiotics. The potential transfer of such bacteria between dogs and humans is an international public health risk, conclude the authors who include Dr. Ana Raquel Freitas and colleagues from the Faculty of Pharmacy, UCIBIO/REQUIMTE, University of Porto, Portugal.

Enterococci are opportunistic pathogens—so they are part of our normal internal microbiota but can cause infections (for example in patients who are immunosuppressed or hospitalised).

Raw-food-based diets for dogs have grown popularity recently as a healthier choice. Increasing controversy regarding their safety is emerging, with some scientific evidence showing their role as vehicles for transmission of antibiotic-resistant bacteria. In addition, dogs have been described as reservoirs of clinically-relevant ampicillin-resistant (AmpR) Enterococcus faecium, but the source remains unknown.

In this study, the authors analysed enterococci obtained from processed (both dry and wet types) and non-processed (raw-frozen) foods of the main brands commercialised in Portugal. The study included 46 samples (22 wet, 15 dry, 9 raw-frozen) from 24 international brands, sourced from 8 supermarkets and one veterinary clinic. Samples were obtained during September to November, 2019.

Raw-frozen samples were mainly constituted of salmon, chicken, turkey, calf, deer or duck, being a mixture of different meat types, fruits and vegetables.

Samples were cultured and then tested with a range of antibiotics. Enterococci (n=163) were identified in 19/46 (41%) of the samples: 8 of 15 (53%) in the dry foods; 2 of 22 (9%) of the wet samples, and 9 of 9 (100%) in the raw-frozen samples, and identified as the Enterococcus species E. faecium (91 isolates), E. faecalis (59 isolates) or other species (13 isolates).

Across the 9 raw-frozen meat samples, there were 30 E. faecium and 30 E. faecalis recovered. All nine carried multidrug-resistant (MDR) enterococci (20 E. faecium and 22 E. faecalis), including those resistant to a wide range of antibiotics, while only one MDR- E. faecium (resistant to erythromycin/tetracycline/gentamicin) was detected in one of the wet food samples and none in the dry food samples.

Resistance was found to the antibiotics ampicillin, ciprofloxacin, erythromycin, tetracycline, streptomycin and chloramphenicol in all 9 raw-type samples; seven of nine contained enterococci resistant to the last line antibiotic linezolid (78%), and six of nine contained enterococci resistant to gentamicin or quinupristin-dalfopristin. Resistance to clinically-relevant antibiotics such as linezolid, ampicillin or ciprofloxacin was only detected in raw-frozen samples.

The authors conclude: “Our study demonstrates that raw-frozen-foods for dogs carry MDR enterococci including to last-line antibiotics (linezolid) for the treatment of human infections. The close contact of pets with humans and the commercialisation of the studied brands in different EU countries pose an international public health risk if transmission of such strains occurs between dogs and humans. There is strong past and recent evidence that dogs and humans share common multidrug-resistant strains of E. faecium, and thus the potential for these strains to be transmitted to humans from dogs.”

Dr. Freitas adds: “These raw-frozen foods are supposed to be consumed after being thawed and could at least be cooked, to kill these drug-resistant and other bacteria. Although these foods seem to be regulated regarding their microbiological safety by EU authorities, risk assessment of biological hazards should also include antibiotic-resistant bacteria and/or genes besides only establishing the presence of bacterial pathogens, such as Salmonella.”

Salmonella outbreak sickens dozens in Chile, linked to

Outbreak News Today reported in Nov. 2019, a Salmonella outbreak in Maipú commune in Santiago Province has now affected 80 people, according to the Chile news source, T13 (computer translated).

This is up from 45 cases reported ill at the El Carmen Hospital with symptoms of Salmonella on Tuesday.

Health officials have linked to outbreak to the consumption of sushi at a Bokado sushi store.

“This is an important call for the preparation of these products, they must be cooked.  They must not use salmon or raw seafood, they  must use cooked products , ” said Health Seremi, Rosa Oyarce.

Raw is risky: UK Happy Hounds recalls frozen raw dog food products due to Salmonella

The Food Standards Agency reports Happy Hounds is recalling certain types of frozen raw dog food because salmonella has been found in the products.

Product details

Frozen Chicken & Beef Sleeve Dog Food
Pack size 1kg
Batch code 1205
Best before 3 September 2020
Frozen Chicken Mince Sleeve Dog Food
Pack size 1kg
Batch code 1205
Best before 3 September 2020

 

Frozen Chicken Mince Dog Food
Pack size 2.5kg (bag of 4)
Batch code 1205
Best before 3 September 2020

Risk statement

The presence of salmonella in the products listed above. Salmonella is a bacterium that can cause illness in humans and animals. The product could therefore carry a potential risk because of the presence of salmonella, either through direct handling of the pet food, or indirectly, for example from pet feeding bowls, utensils or contact with the faeces of animals.

In humans, symptoms caused by salmonella usually include fever, diarrhoea and abdominal cramps. Infected animals may not necessarily display signs of illness, but symptoms can include diarrhoea.

Action taken by the company

Happy Hounds is recalling the above products. Point of sale notices will be displayed in all retail stores that are selling these products. These notices explain to customers why the products are being recalled and tell them what to do if they have bought the product.

Our advice to consumers

Our advice to pet owners: If you have bought any of the above products do not use them. Instead, return them to the store from where they were bought for a full refund. When handling and serving raw pet food it is always advised to clean utensils and feeding bowls thoroughly after use. Consumers should wash hands thoroughly after handling raw pet food, bowls, utensils or after contact with the faeces of animals. Raw pet food should be stored separately from any food (especially ready to eat foods). Care should be taken when defrosting to avoid cross contamination of foods and surfaces.

Norovirus outbreak leads to shellfish harvesting ban on stretch of Virginia river

WTVR reports health officials announced Saturday an extension of the ban on shellfish harvesting in the waters off Parrot Island in the Rappahannock River in Middlesex County.

The news comes after Virginia Department of Health officials banned the harvesting of oysters and clams in that stretch of the river on Dec. 27 following a Norovirus outbreak in Colorado linked to shellfish harvested from the area.

As a result, oysters harvested between Dec. 1, 2019 through Jan. 11, 2020 are being recalled.

The only oysters affected by the recall were shipped by Rappahanock River Oyster Company from lease numbers 18403, 18417, and 19260 in the Rappahanock River, according to the Virginia Department of Health. The company said the oysters were sold under the Emersum brand name.

Officials noted crabs and fin fish in the river are still safe to catch.

Raw is risky: 179 sick from oysters in France

Outbreak News Today reports that French health authorities (Santé publique France) say since December 2019, 179 compulsory declarations (DO) of collective food poisoning ( toxi-infection alimentaire collective-TIAC) ​​suspected of being linked to the consumption of raw shellfish, mainly oysters.

The reports come from the majority of regions in mainland France.

Seventy-seven percent of cases occurred since December 23, with the peak of patients being observed around December 25-27.

The symptoms, mainly diarrhea and vomiting, as well as the incubation times, are compatible with infections with norovirus or other enteric viruses. Stool tests performed to date by the National Reference Center for Gastroenteritis Viruses have confirmed the presence of norovirus and other enteric viruses.

The number of TIAC suspected of being linked to the consumption of raw shellfish is significantly higher than in previous years. Each year between 25 and 120 TIAC suspected of being linked to the consumption of shellfish are reported to Public Health France, of which between 4 and 30 occurred during the December-January periods.