Don’t swallow pool water: Cryptosporidiosis outbreaks – United States, 2009-2017

The U.S. Centers for Disease Control reports that Cryptosporidium is the leading cause of outbreaks of diarrhea linked to water and the third leading cause of diarrhea associated with animal contact in the United States.

During 2009–2017, 444 cryptosporidiosis outbreaks, resulting in 7,465 cases were reported by 40 states and Puerto Rico. The number of reported outbreaks has increased an average of approximately 13% per year. Leading causes include swallowing contaminated water in pools or water playgrounds, contact with infected cattle, and contact with infected persons in child care settings.

What are the implications for public health practice?

To prevent cryptosporidiosis outbreaks, CDC recommends not swimming or attending child care if ill with diarrhea and recommends hand washing after contact with animals.

More Brits could still die from human form of mad cow disease

More Brits could be affected by mad cow disease as experts warn many could be infected without knowing. A second wave of deaths related to eating beef contaminated with Bovine Spongiform Encephalopathy (BSE) – or mad cow disease – could sweep the UK.

In 1993 Britain’s worst food scandal saw 4.4 million cows culled and claiming the lives of 177 people who had developed the human form of it, called Creutzfeldt-Jakob disease (vCJD). Since then, strict controls have been in place to prevent BSE contaminating food products and the use of meat and bone mix is illegal. But humans could be affected for up to 50 years, warn experts. Neurology professor, Richard Knight, of Edinburgh’s CJD Surveillance Unit, told a BBC investigation – airing July 11 – that it is still unclear how many could be affected. He said: ‘There is still so much uncertainty about this disease.

‘And one of the things that is uncertain is how many people in the UK are silently infected. ‘At the moment I have to say we are simply not sure, but every prediction suggests there are going to be further cases.’ vCJD is caused by prions, which are infectious agents made up mainly of proteins. A study of a similar disease in 2009, caused by prions, showed the disease may incubate undetected for much longer. All affected had carried the same MM genetic makeup, but in 2009 victim Grant Goodwin, 30, became the first person to die of vCJD, despite carrying the different gene type of MV. In 2014, a British man, 36, became the second MV carrier to die from the disease.

Cryptosporidiosis outbreaks – United States, 2009-2017

 

The U.S, Centers for Disease Control that Cryptosporidium is the leading cause of outbreaks of diarrhea linked to water and the third leading cause of diarrhea associated with animal contact in the United States.

During 2009–2017, 444 cryptosporidiosis outbreaks, resulting in 7,465 cases were reported by 40 states and Puerto Rico. The number of reported outbreaks has increased an average of approximately 13% per year. Leading causes include swallowing contaminated water in pools or water playgrounds, contact with infected cattle, and contact with infected persons in child care settings.

What are the implications for public health practice?

To prevent cryptosporidiosis outbreaks, CDC recommends not swimming or attending child care if ill with diarrhea and recommends hand washing after contact with animals.

Rashika Gharpure, Arian Perez, et al

https://www.cdc.gov/mmwr/volumes/68/wr/mm6825a3.htm?s_cid=mm6825a3_w&deliveryName=USCDC_921-DM3242

From the duh files: Here’s why consumers don’t use thermometers when cooking

I told Amy when I die and my brain is carved up in Sydney, my epitaph should be, improving food safety, one thermometer at a time.

I still feel naked when cooking without a thermometer.

According to a study conducted by researchers at Purdue University, few people use thermometers when they cook—even if they know how. 

One of the major reasons that consumers don’t use thermometers, researchers found, is because they tend to draw inspiration from outside sources—celebrity chefs, cookbook authors, magazines, restaurant managers, and food blogs. These outlets rarely ever mention or demonstrate the importance of cooking food to proper temperatures.

“We see that celebrity chefs simply rely on time estimates in their recipes or cut through the meat to show there is no blood or pink. That doesn’t always mean the food is safe, however,” says Yaohua “Betty” Feng, an assistant professor of food science at Purdue. “That affects the behaviors of home cooks and professional cooks. If their role models aren’t using thermometers, why should they? But if chefs preparing food on television or social media would include the use of a thermometer to ensure the food is thoroughly cooked, it would have an impact on their viewers.”

Feng worked with University of California’s Christine M. Bruhn to analyze 85 studies from over two decades to understand knowledge, attitudes, and behaviors associated with thermometer use. Despite it being considered a best practice in home and professional kitchens, thermometer use is low.

In one study, two-thirds of people reported owning a meat thermometer, but less than 20 percent used it all the time to check the temperature of chicken, and less than 10 percent used it all the time for hamburgers. About half of consumers say that thermometers aren’t necessary to check the doneness of egg or meat dishes.

Feng also noted that many people are unsure which type of thermometer to buy or how to correctly use them, including where to place the thermometer in the food, the correct endpoint temperatures, proper temperature calibration for the thermometer, and proper cleaning and sanitation. About 95 percent of people in one study did not clean their thermometers after use.

The U.S. Department of Agriculture National Institute of Food and Agriculture’s Agriculture and Food Research Initiative supported this research. The results were published in the Journal of Food Protection in January 2019.

Pig inspection in Europe

The main goal of the present paper is to overview, using the example of pigs/pork, the developments in official meat inspection in the European Union that occurred from 2000 onwards. The developments aim at transition from traditional, macroscopic examination of slaughtered animals to a risk and meat-chain based, comprehensive meat safety assurance system.

pig

The scientific reasoning for those developments and the generic framework of a modernised system as proposed by the European Food Safety Authority, as well as the current status and future perspectives of related changes, are considered. Also, the main factors hampering the implementation of the changes in practice and possible directions for further work needed to overcome them are outlined.

From traditional meat inspection to development of meat safety assurance programs in pig abattoirs- the European situation

Dec.19Food Control, Volume 106

Sava Buncic, Lis Alban, Bojan Blagojevic

https://www.sciencedirect.com/science/article/pii/S0956713519302798

Petting zoo illnesses make me sad because the food and ag community has failed

I’m a fan of agritourism, whether that’s touring a bunch of backyard chicken coops or learning about animals, I see value in this stuff. It’s not without risk though – and managing that risk is imperative. A while ago someone asked me about the types of food businesses I like to frequent, from a food safety perspective, and I thought about it a while and came up with this: I like to eat food from places where the people involved in making decisions are constantly worried about making people sick. Like it’s their nightmare. Not places that tell me not to worry about stuff.

My petting zoos/animal interaction wants are the same.

A few years ago my friend (and Carolina Hurricane superfan), Dr. Megan Jacob and I took a couple of visits to animal education/interaction sites to get some ideas about what people do (visitors and organizers). From those visits we saw a lot of stuff that made us think we need to take a different approach. Lots of signs saying to wash hands. Don’t bring food around the animals, don’t bring strollers.

And not a lot of people following the messages. I don’t blame the visitors. I blame us (or at least the collective us) for not doing a better job at saying why it’s important, not having enough people there with reminders and actively helping visitors reduce their risks.

A couple of years ago Gonzalo Erdozian esteemed member of the barfblog team, looked at what was available at a bunch of small petting zoo sites/events in Kansas and Missouri – and came up with some great suggestions after finding lots of risky practices (abstract is below). Reducing risks at fairs and petting zoos isn’t a simple thing – it’s a mix of having the tools, people to point patrons to them, and explaining the risks (without being jerks).

Gonzo found that the reminders really worked.

After those visits, Megan and I, with the help from some others put together a workshop for NC folks who run these events and sites. We learned a whole bunch more from the participants – one of the biggest takeaways for me was that organizers were reluctant to engage in these discussions because although they knew that there was a risk, they didn’t want to alert people who were there that it was risky because maybe they wouldn’t come. I’m not sure what the correct word for that is, but it seems paternalistic or something. One philosophy we’ve followed at barfblog is that people can handle risk discussions and we’re kinda responsible to have them. And let the participants choose.

I home almost daily past the Kelley Building, ground zero for an E. coli O157:H7 outbreak in 2011 linked to 25 illnesses at  the NC State Fair. The building wasn’t considered to be an animal contact area – a petting zoo – but was a spot that was a popular cut-through from an entrance gate to the midway area. Organizers of the fair led a commission to look at what happened, and made changes – having more handwashing stations, passive reminders and actively having actual people reminding; further limiting access to non-petting zoo animal buildings; and, increasing cleaning and sanitation.

People brought food, strollers, and their hands touched a lot of likely contaminated handles and rails.

Over the weekend news broke of another tragic cluster of illness linked to fair/animal interactions. 

A 2-year-old boy died and three others were sickened upon contracting the E. coli virus after coming into contact with farm animals at the San Diego County Fair, according to authorities.

The child was hospitalized after visiting the county fair two weeks ago, and died Monday after complications stemming from the virus, the San Diego County Health and Human Services Agency confirmed on Friday. The other three children did not need medical attention.

A 2-year-old boy died and three others were sickened upon contracting the E. coli virus after coming into contact with farm animals at the San Diego County Fair, according to authorities.

The child was hospitalized after visiting the county fair two weeks ago, and died Monday after complications stemming from the virus, the San Diego County Health and Human Services Agency confirmed on Friday. The other three children did not need medical attention.

The frustrating nexus of these (and all the other illnesses) is that it’s good for folks to learn about agriculture and farming and food by seeing and interacting – and that very situation is risky.

What doesn’t help is when the agricultural community scoffs at these illnesses (I haven’t heard it on this one, but have in the past) essentially saying that handwashing is common sense, so these illnesses happen because people are ignorant. Except that all falls apart because we (the folks in the know) haven’t done our job telling folks how they can manage some of the risk of getting sick, and how organizers are also trying to reduce the risk to patrons. By missing that, we’re not doing everything we can to ensure that the safe behaviors take place. And that makes me sad.

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

 

 

Papayas linked to outbreak of salmonellosis; over 60 ill

I really like fruits and berries. All kinds of fruits are my go-to snacks and over the past few years I’ve discovered how much I like tropical fruits like mango and papaya.

My favs aren’t immune from outbreaks. In 2017, an outbreak of Salmonella Anatum was linked to papaya.

And today CDC and FDA announced another outbreak of Salmonella (this time Uganda) traced to the fruit, causing at least 62 illnesses to date (with 23 hospitalizations).

According to the CDC release, there’s some notable stuff:

  • Of 33 ill people with available information, 22 reported being of Hispanic ethnicity.
  • The hospitalization rate in this outbreak is 66 percent among people with information available. The hospitalization rate in Salmonella outbreaks is usually around 20 percent.
  • Most of the sick people in this outbreak are adults over 60.

Vaccines work: Widespread outbreaks of Hepatitis A across the U.S.

Since March 2017, the U.S. Centers for Disease Control Division of Viral Hepatitis (DVH) has been assisting multiple state and local health departments with hepatitis A outbreaks, spread through person-to-person contact.

The hepatitis A vaccine is the best way to prevent HAV infection.

The following groups are at highest risk for acquiring HAV infection or developing serious complications from HAV infection in these outbreaks and should be offered the hepatitis A vaccine in order to prevent or control an outbreak:

People who use drugs (injection or non-injection)

People experiencing unstable housing or homelessness

Men who have sex with men (MSM)

People who are currently or were recently incarcerated

People with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C

One dose of single-antigen hepatitis A vaccine has been shown to control outbreaks of hepatitis A and provides up to 95% seroprotection in healthy individuals for up to 11 years.1,2

Pre-vaccination serologic testing is not required to administer hepatitis A vaccine. Vaccinations should not be postponed if vaccination history cannot be obtained or records are unavailable.

CDC has provided outbreak-specific considerations for hepatitis A vaccine administration.

At A Glance

Since the outbreaks were first identified in 2016, 24 states have publicly reported the following as of June 21, 2019

Cases: 20,512

Hospitalizations: 11,776 (57%)

Deaths: 194

State-Reported Hepatitis A Outbreak Cases as of June 21, 2019

State-Reported Hepatitis A Cases and Clinical Outcomes
State Case Total Hospitalizations
n (%)
Deaths Outbreak
Start Date
Data Current
Through
Total 20512 11776 (57%) 194
States with an ongoing outbreak
Alabamaexternal icon 84 NR (NR) NR 9/1/2018 6/19/2019
Arizonaexternal icon 396 309 (78%) 2 11/1/2018 6/20/2019
Arkansasexternal icon 343 NR (NR) NR 2/7/2018 6/7/2019
Coloradoexternal icon 74 47 (64%) 0 10/1/2018 6/19/2019
Floridaexternal icon 1876 1353 (72%) 21 1/1/2018 5/31/2019
Georgiaexternal icon 437 292 (67%) 1 6/1/2018 6/14/2019
Idahoexternal icon 26 14(54%) 1 1/1/2019 6/20/2019
Illinois external icon 126 75(60%) 0 9/1/2018 6/19/2019
Indianaexternal icon 1581 851 (54%) 4 11/1/2017 6/21/2019
Kentuckyexternal icon 4715 2277 (48%) 58 8/1/2017 6/8/2019
Louisiana external icon 302 178 (59%) 1 1/1/2018 6/21/2019
Massachusettsexternal icon 363 298 (82%) 5 4/1/2018 6/14/2019
Michiganexternal icon 916 735 (80%) 28 8/1/2016 6/19/2019
Missouriexternal icon 323 163(50%) 2 9/1/2017 6/19/2019
New Hampshireexternal icon 138 83 (60%) 1 11/1/2018 6/18/2019
New Mexicoexternal icon 126 100 (79%) 2 11/8/2018 6/20/2019
North Carolinaexternal icon 85 60 (71%) 1 1/1/2018 6/17/2019
Ohioexternal icon 3070 1841 (60%) 10 1/1/2018 6/17/2019
South Carolinaexternal icon 147 108 (73%) 1 11/1/2018 6/14/2019
Tennesseeexternal icon 1791 1085 (60%) 10 12/1/2017 6/21/2019
Virginiaexternal icon 71 45 (63%) 0 1/1/2019 6/20/2019
West Virginiaexternal icon 2533 1249 (49%) 23 3/19/2018 6/21/2019
States with a declared end to their outbreak
Californiaexternal icon 708 464 (66%) 21 11/1/2016 4/11/2018
Utahexternal icon 281 152 (54%) 3 5/8/2017 2/12/2019

NR: not publicly reported

“Outbreak-associated” status is currently determined at the state level in accordance with each state’s respective outbreak case definition.

Outbreak-related hepatitis A deaths are defined at the state level in accordance with each state’s respective hepatitis A-related death definition. Some states are reviewing death certificates on a regular basis to actively find hepatitis A-related deaths, while other states are utilizing passive surveillance.

Outbreak start date is defined at the state level and may represent the earliest onset date of an outbreak case (AR, AZ, UT), the left censor date for which cases are considered part of the outbreak based on the state outbreak case definition (AL, CA, CO, FL, GA, ID, IL, IN, KY, LA, MA, MI, MO, NC, NH, OH, SC, TN, VA), or when a state declared a hepatitis A outbreak (NM, WV).

CDC’s Response

In response to all hepatitis outbreaks, CDC provides ongoing epidemiology and laboratory support as well as support on vaccine supply and vaccine policy development. When requested, CDC sends “disease detectives” to affected areas to evaluate and assist in an outbreak response. CDC alerts other public health jurisdictions of any increases in disease. All jurisdictions are encouraged to be watchful for increases in hepatitis A cases. CDC also works with state and local health officials to ensure hepatitis A vaccine is targeted to the correct at-risk populations and that supply is adequate.

Postexposure Prophylaxis

Postexposure prophylaxis (PEP) is recommended for unvaccinated people who have been exposed to hepatitis A virus (HAV) in the last 2 weeks; those with evidence of previous vaccination do not require PEP.

PEP consists of:

Hepatitis A vaccine for people aged ≥12 months

Hepatitis A virus-specific immunoglobulin (IG) for specific populations

PEP Recommendations:

ACIP Recommendations for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel

Supplement 1. Provider Guidance on Risk Assessment and Clinical Decision-making for Hepatitis A Postexposure Prophylaxis

NOTE: CDC recommends that all children be vaccinated against hepatitis A at age 1 year. Parents or caregivers who are unsure if a child has been vaccinated should consult the child’s health-care provider to confirm vaccination status.

HAV Specimen Requests

State health departments wanting to submit specimens must contact CDC at hepaoutbreaklab@cdc.gov for approval before shipping specimens to CDC.  Only specimens that that have tested positive for anti-hepatitis A IgM and meet any of the following criteria will be considered.

Specimen from a case patient in a county that has not yet reported a hepatitis A case in an at-risk population;

Specimen from a case patient who doesn’t report any known risk factors or contact with at-risk populations (e.g., household or sexual contact, volunteering at a homeless shelter);

Specimen from a case patient suspected to be associated with foodborne transmission;

Archived/stored specimen from a patient who has died, and whose classification as an outbreak-related death requires nucleic acid testing beyond anti-HAV IgM-positivity; or

Other patient specimens not meeting the above criteria that require nucleic acid testing or molecular characterization (to be discussed on a case-by-case basis).

Dear Colleague Letter pdf icon[PDF – 6 MB] from CDC Division of Viral Hepatitis Director regarding Submission of Patient Specimens to CDC for Hepatitis A Testing.

Additional Vaccination Information

Outbreak-specific considerations for hepatitis A vaccine administration

MMWR – The dose of GamaSTAN™ S/D has recently been changed

Current Vaccine Shortages & Delays – Information on Vaccine Supply

For Immunization Managers – Information on Vaccines Purchased with 317 Funds

Professional Resources

Medscape Commentary: Hepatitis A: Breaking Out All Overexternal icon

Archived webinar: Preventing and Controlling Hepatitis A in Jails and Prisons from the National Institute of Corrections, BOP and CDCexternal icon

HAN: Update: Widespread Outbreaks of Hepatitis A among People Who Use Drugs and People Experiencing Homelessness across the United States – March 2019

COCA Call On-Demand Webinar for Clinicians: Hepatitis A Outbreaks in Multiple States – CDC Recommendations and Guidance – Nov. 2018

HAN: Outbreak of Hepatitis A Virus (HAV) Infections among Persons Who Use Drugs and Persons Experiencing Homelessness– June 2018

MMWR: Hepatitis A Virus Outbreaks Associated with Drug Use and Homelessness — California, Kentucky, Michigan, and Utah, 2017

Posters on how to clean up and disinfect to help prevent spread of hepatitis A virusexternal icon from Water Quality & Health Council

Updated CSTE clinical case definition for acute viral hepatitis A

CDC guidance on viral hepatitis surveillance and case management

CDC training on hepatitis A serology 

Hepatitis A general FAQs for Health Professionals

Educational Resources

CDC is developing educational materials to support the outbreak at the state and local levels. Most materials include an area where local information can be inserted. Your organization’s contact information can be typed into the blue colored rectangle. To upload your logo, click on the white space below the blue colored rectangle. In the pop-up box, select browse and upload a PDF version of your logo.

Fact Sheets

One page visual fact sheets encouraging vaccination for:

people who use drugs pdf icon[PDF – 244 KB]

gay and bisexual men pdf icon[PDF – 332 KB]

people experiencing unstable housing or homelessness pdf icon[PDF – 282 KB]

people who are or were recently in jail or prison pdf icon[PDF – 282 KB]

Two page visual fact sheet pdf icon[PDF – 615 KB] that includes information on hepatitis A prevention, transmission, symptoms and encourages multiple populations to get vaccinated

Pocket Cards

Outbreak of hepatitis A Pocket Card pdf icon[PDF – 786 KB] to localize with organization information and outlines who should get vaccinated and the symptoms of hepatitis A

Printing Instructions: These cards should be printed double-sided on 4.25” x 5.5” perforated postcard templates that print four double-sided cards per page. The print settings must be set to “Actual size” or “Custom Scale 100%” to ensure accurate alignment of the two sides of the cards.

Get Vaccinated Pocket Card pdf icon[PDF – 455 KB] to localize with information where to go to get the vaccine and who should get vaccinated

If You’re Sick Pocket Card pdf icon[PDF – 470 KB] to localize with information on where to go for medical care and the symptoms of hepatitis A

Pocket Card Printing Instructions: These cards should be printed double-sided on business card templates that print six double-sided cards per page. The print settings must be set to “Actual size” or “Custom Scale 100%” to ensure accurate alignment of the two sides of the cards.

‘Dad a chick pooped on me’

Scott Weese of the Worms and Germs Blog, a prof, vet, from the University of Guelph, and more importantly, a dude I played hockey with all those years ago, writes, as I was writing the post below, my youngest daughter walked in the door and said “a chick pooped on me today.”

(He’s one of the bald dudes in this pic from 2005: hint, leave when you’ve won, and have a full head of hair, which I did)

It wasn’t a total surprise since I’d heard a vague statement from her about maybe having chicks in the class for the end of the year.

Is it potentially fun and/or educational?

Sure. If it’s done right.

Is it done right?

Doesn’t sound like it.

Chicks are cute and can be entertaining. They can also be educational. Yet, contact with them is clearly associated with disease. While I get an infosheet from the school and have to sign something every time one of my kids does any other type of activity, there was no notice about this particular activity, no information about risks and preventive measures, nothing about what to do if a child is at high risk for severe disease, or anything else.

Just my kid telling me she got pooped on.

I’m not overly concerned. She’s healthy, outside of the main high risk groups, and washed her hands after the incident. Yet, I don’t know (and doubt the school knows) whether that applies to everyone in the class or other kids that might have contact with the chicks. The chicks are also being kept in a classroom where the students eat.

A lot could be done to minimize and communicate the risks. We tried approaching the provincial Ministry of Education and school boards quite a few years ago to look into animal exposures in schools, and there was basically zero interest in the subject. Whether that’s because there was no awareness of the issues or no desire to find out what’s actually going on is hard to say.

Now on to the post I was writing…

CDC has related an updated investigation notice about Salmonella from backyard poultry. As of June 13th, 279 infected people have been identified in 41 states, with cases dating back to January 1st, 2019.. That probably means a few thousand people have actually been infected, since reported disease numbers are typically dwarfed by the real number of cases.

The strains that have been linked to the outbreak are Salmonella Agona, Anatum, Braenderup, Infantis, Montevideo and Newport

30% of infected people were children younger than 5 years old, which is the group that typically gets sick or seriously ill from Salmonella.

26% of people were hospitalized. Fortunately, no deaths were reported.

About 40% of isolates were multidrug-resistant.

77% of infected individuals reported contact with chicks or ducklings from places like agricultural stores, mail order supplies and hatcheries.

One of the outbreak strains has also been found in backyard poultry in Ohio.

I’m not against animals in schools or backyard poultry. I’m just against being stupid. There are lots of things that can be done to reduce risks, and too often those easy, cheap and practical measures are ignored.

Frank talks about sprouts

Frank didn’t waste any time after leaving Wal-Mart for government.

Good on ya.

But guidance is not enforcement.

My group learned that the hard way 20 years ago.

And they still serve sprouts to immunocompromised people in Australian hospitals despite a ridiculous number of outbreaks.

“Over the past 22 years, the U.S. Food and Drug Administration (FDA) has investigated 50 reported outbreaks of foodborne illness associated with contaminated sprouts. Together, these outbreaks resulted in more than an estimated 2,600 cases of illness. Last year, there were two reported outbreaks associated with sprouts, resulting in more than an estimated 100 illnesses. Studies indicate that contaminated seed is the likely source of most sprout-related outbreaks, as this commodity is inherently more susceptible to these issues because they are grown in warm and humid conditions that are favorable for bacteria like Salmonella, Listeria and E. coli,” said FDA Deputy Commissioner for Food Policy and Response Frank Yiannas.

“The FDA is committed to taking swift action to respond to outbreaks related to sprouts and keep our food supply safe, but we also know that measures to prevent issues from happening in the first place are an important element of protecting consumers. By studying outbreaks related to sprouts over the years, we have been able to recommend changes in the industry to help lower the incidence of sprout-related outbreaks. Today’s new draft guidance is another critical step, like the Sprout Safety Alliance or sprout-specific requirements of the Produce Safety Rule, the agency is taking to prevent illnesses related to sprouts.”

FDA today released a proposed draft guidance, “Reducing Microbial Food Safety Hazards in the Production of Seed for Sprouting,” intended to make the sprout seed industry (seed growers, conditioners, packers, holders, suppliers, and distributors) aware of the agency’s serious concerns with the continuing outbreaks of foodborne illness associated with the consumption of raw and lightly-cooked sprouts.

Incorporating aspects of the Codex Code of Hygienic Practice for Fresh Fruits and Vegetables Annex II, Annex for Sprout Production; the International Sprout Growers Association-Institute for Food Safety and Health’s “U.S. Sprout Production Best Practices”; and Good Agricultural Practices, the FDA’s draft guidance issued today provides the agency’s recommendations to firms throughout the production chain of seed for sprouting. It states that if a grower, holder, conditioner, or distributor reasonably believes that its seeds are expected to be used for sprouting, we recommend that the grower, holder, conditioner, or distributor take steps that are reasonably necessary to prevent those seeds from becoming contaminated. We also recommend that firms throughout the supply chain – from seed production and distribution through sprouting – review their current operations related to seeds for sprouting.

During the 60-day comment period for this draft guidance, stakeholders will be able to provide comments on the draft provisions. For more information on this guidance, as well as instructions on how to submit your comments, please visit Draft Guidance for Industry: Reducing Microbial Food Safety Hazards in the Production of Seed for Sprouting.