Public was never told: 4 dead, 30 sickened from Listeria in pasteurized chocolate milk in Ontario, Nov. 2015—June 2016

The Public Health Agency of Canada (PHAC) really sucks at this communication thing. They sucked during the 2008 Listeria outbreak linked to Maple Leaf cold cuts that killed 24 and sickened a further 33, they have always sucked when discussing numerous outbreaks of Cyclospra, and I guess they realized they suck so bad they didn’t even try during an outbreak spanning 2015-2016 linked to Listeria in milk.

Now, over three years since residents of Ontario (that’s in Canada) began reporting illnesses from Listeria in pasteurized chocolate milk produced at a dairy in Georgetown, Ontario, investigators have gotten around to saying just how many people got sick.

According to health-types writing in Emerging Infectious Disease, 11 case-patients had an onset date during November 14, 2015–February 14, 2016. Onset dates ranged from April 11 to June 20, 2016, for 21 case-patients in the second wave; the remaining 2 case-patients were outliers. Median age was 73 years (range <1 years–90 years). More than half of the case-patients were female (20/34, 59%). Hospitalizations occurred for 32 (94%) case-patients, and 4 deaths (12%) were reported.

In Ontario, local public health professionals complete the national invasive listeriosis questionnaire and collect food samples. We conducted a case–case analysis by using Ontario case-patients listed in the national listeriosis database as controls. We used a variety of methods to support hypothesis generation, including supplemental questionnaires, centralized interviewing, and reviewing purchase records collected through shoppers’ loyalty card programs. A meeting was also held with representatives from a grocery chain that was common for case-patients (retail chain A) for insights into possible sources.

PFGE and whole-genome sequencing were performed at the Public Health Ontario Laboratory, in accordance with PulseNet Canada protocols (Table). Food safety investigations, including targeted retail sampling, were conducted by the Canadian Food Inspection Agency and Ontario Ministry of Agriculture and Food and Rural Affairs. Laboratory analyses of food samples were conducted by the Canadian Food Inspection Agency and the Public Health Ontario Laboratory.

Several hypotheses were generated during the course of this outbreak. In the first wave, a concurrent listeriosis outbreak associated with leafy greens was ongoing in the United States and Canada. However, product testing did not establish a relationship between the 2 outbreaks. Cheddar cheese was also suspected, but a food safety investigation, including sampling at the manufacturer, did not support a link to this outbreak (6,7). Although leafy greens and cheddar cheese were ruled out, 1 commonality remained; shopping at retail chain A was reported frequently by case-patients.

A second wave began in April 2016 in which 10 of 17 case-patients reported consuming coleslaw. Six case-patients ate coleslaw from the same manufacturer, which supplied retail chain A and a fast food restaurant chain. However, the food safety investigation, including sampling at the manufacturer and supplier, did not support this hypothesis.

On May 24, 2016, L. monocytogenes isolated from expired bagged chocolate milk collected from the home of 1 case-patient was confirmed to have the outbreak strain PFGE pattern. Fluid milk in Canada is often sold in plastic bags. In this instance, the outer packaging, which is the only area that contains the brand name, was discarded. Thus, the brand name was uncertain, and efforts were undertaken to confirm the source of the chocolate milk. Because the proxy of the case-patient reported purchasing brand B milk, samples of brand B chocolate and white milk were collected from retail for testing. Brand B was the main brand of chocolate milk sold by retail chain A, and it is distributed only in Ontario.

Although the hypothesis-generating questionnaire used stipulated milk, with flavored milk as a prompt, chocolate milk was not specified, and as a result this type of milk might have been underreported. Exposure to pasteurized milk was reported by 60% of case-patients in the first wave compared with 76% of controls. Thus, milk was not originally pursued as a source. However, this new positive isolate led to re-interviewing of case-patients from the second wave and resulted in 9 (75%) of 12 case-patients reporting consuming brand B when asked specifically about chocolate milk.

On June 3, a retail sample of brand B chocolate milk was confirmed positive for L. monocytogenes. This finding led to a class I recall of 1 lot of brand B chocolate milk. On June 5, the recall was expanded to all lots of brand B chocolate milk processed at that facility because of the result of extensive retail sampling. Isolates from the original sample and 3 subsequent positive samples of chocolate milk matched the outbreak strain by PFGE and whole-genome sequencing. No white milk samples were positive for L. monocytogenes.

Environmental sampling at the manufacturer confirmed the presence of the outbreak strain within a post-pasteurization pump dedicated to chocolate milk and on nonfood contact surfaces. This post-process contamination of the chocolate milk line was believed to be the root cause of the outbreak. A harborage site might have been introduced by a specific maintenance event or poor equipment design. The equipment was subsequently replaced, and corrective measures were implemented to prevent reoccurrence. Chocolate milk production was resumed after vigorous testing for L. monocytogenes under regulatory oversight.

Conclusions

This outbreak lasted 7 months and resulted in 34 confirmed listeriosis case-patients. Discovering the cause of this listeriosis outbreak was challenging because pasteurized chocolate milk is a commonly consumed product. Although there have been previous outbreaks outside Canada caused by chocolate milk, pasteurized milk products are generally not expected to be the source. This outbreak highlights that even pasteurized products can be contaminated by and support the proliferation of L. monocytogenes when contamination is introduced post-pasteurization. The possibility of post-processing contamination indicates an ongoing need for regulatory oversight and robust quality assurance processes, which include routine sampling of the environment and finished products.

Brand B chocolate milk is a widely distributed product in Ontario, and contamination of this product could have resulted in >34 case-patients. It is possible that a lower number of case-patients were reported because chocolate milk may primarily be consumed by younger, healthier persons, in whom invasive listeriosis is less likely to develop. Another possible explanation is that the contamination in the milk appeared to be intermittent, with some samples testing positive while others tested negative. As such, careful attention should be given to equipment design and maintenance programs, as harborage sites could result in recurring contamination that goes undetected by routine monitoring. Targeted retail and environmental sampling was instrumental in identifiying the root cause in the facility and the breadth of potentially implicated products in the marketplace. Thus, this type of sampling should be considered during outbreak investigations.

Ultimately, the implicated product was determined on the basis of testing of food items obtained from the home of 1 case-patient. This finding highlights the necessity of obtaining a thorough food history and collecting and testing available samples of food that case-patients consumed during the incubation period. In Canada, where bagged milk is common, labeling of the inner and outer bags with the brand name would facilitate product identification by consumers. This recommendation could extend to other food products in North America (e.g., frozen hamburger patties) that have multiple layers of packaging.

That is a lucid, thought provoking summary of a complex foodborne outbreak, fraught with uncertainties.

When the Canadian Food Inspection Agency announced the recall on June 4, 2016, Chapman wrote it up for the blog, reminiscing about his childhood innocence in southern Ontario, and noted, as has become the pattern, that CFIA reports recalls, but it’s up to PHAC or provincial health ministries to identify the number of sick people. As far as I can tell, no public statement about illnesses was ever made, until now.

What the fuck do these people do, especially the communication hacks? Do they have a responsibility to the public? Why didn’t epidemiology count and a public warning issued rather than waiting for a positive sample in an unopened package, which has apparently become the Canadian standard for going public?

If that’s the standard, that sucks.

Listeria monocytogenes associated with pasteurized chocolate milk, Ontario, Canada

March 2019

Emerging Infectious Diseases vol. 25 no. 3

Heather Hanson , Yvonne Whitfield, Christina Lee, Tina Badiani, Carolyn Minielly, Jillian Fenik, Tony Makrostergios, Christine Kopko, Anna Majury, Elizabeth Hillyer, Lisa Fortuna, Anne Maki, Allana Murphy, Marina Lombos, Sandra Zittermann, Yang Yu, Kristin Hill, Adrienne Kong, Davendra Sharma, and Bryna Warshawsky

https://wwwnc.cdc.gov/eid/article/25/3/18-0742_article

In an investigation of a listeriosis outbreak in Ontario, Canada, during November 2015–June 2016, Public Health Ontario identified pasteurized chocolate milk as the source. Because listeriosis outbreaks associated with pasteurized milk are rare in North America, these findings highlight that dairy products can be contaminated after pasteurization.

529 now sick with Salmonella in Canada: Crisp & Delicious brand chicken breast nuggets recalled

Over a decade ago, when I went to Kansas State, me and Chapman and Phebus came up with a project to see how people cooked raw, frozen chicken thingies.

The American Meat Institute funded it.

Some of these chicken thingies are frozen raw, which means they have to be cooked in an oven and temperature verified with a tip-sensitive digital thermometer, and some of these thingies are pre-cooked, so can be thawed in a microwave.

Labelling has changed over the years, but it’s still necessary to know what you’re buying.

Some of the frozen raw products may appear to be pre-cooked or browned, but they should be handled and prepared with caution.

Through whole genome sequencing, health types in Canada had, by Nov. 2, 2018, identified 474 laboratory-confirmed cases of Salmonella linked to 14 national outbreaks involving raw chicken, including frozen raw breaded chicken products.

The Canadian Food Inspection Agency issued food recall warnings for ten products linked to some of these outbreak investigations.

Make that 11 products.

Sofina Foods Inc. is now recalling Crisp & Delicious brand Chicken Breast Nuggets from the marketplace due to possible Salmonella contamination.

As of January 25, 2019, there have been 529 laboratory-confirmed cases of Salmonella illness investigated as part of the illness outbreaks across the country: British Columbia (42), Alberta (81), Saskatchewan (18), Manitoba (25), Ontario (187), Quebec (111), New Brunswick (27), Nova Scotia (17), Prince Edward Island (5), Newfoundland and Labrador (12), Northwest Territories (1), Yukon (1), and Nunavut (2). There have been 90 individuals hospitalized as part of these outbreaks. Three individuals have died; however, Salmonella was not the cause of death for two of those individuals, and it was not determined whether Salmonella contributed to the cause of death for the third individual. Infections have occurred in Canadians of all ages and genders.

All active and future Salmonella outbreak investigations linked to raw chicken, including frozen raw breaded chicken products, and related food recall warnings will be listed in the next section of the public health notice to remind Canadians of the ongoing risk associated with these types of food products.

Active investigations

As of January 25, 2019, there is one active national Salmonella outbreak investigation linked to raw chicken including frozen raw breaded chicken products, coordinated by the Public Health Agency of Canada.

January 25, 2019 (NEW) – Salmonella Enteritidis

  • Currently, there are 54 cases of illness in ten provinces linked to this outbreak: British Columbia (4), Alberta (11), Saskatchewan (1), Manitoba (3), Ontario (20), Quebec (4), New Brunswick (2), Nova Scotia (5), Prince Edward Island (3) and Newfoundland and Labrador (1). None of the ill individuals have been hospitalized. No deaths have been reported. Frozen raw breaded chicken products have been identified as a source of this outbreak.

Product recall on January 25, 2019

  • Crisp & Delicious Chicken Breast Nuggets (1.6kg) with a best before date of July 19, 2019. UPC – 0 69299 11703 5. The product was distributed in British Columbia, Manitoba, Ontario, and Quebec, and may have been distributed in other provinces or territories

Self-reported and observed behavior of primary meal preparers and adolescents during preparation of frozen, uncooked, breaded chicken products
01.nov.09
British Food Journal, Vol 111, Issue 9, p 915-929
Sarah DeDonder, Casey J. Jacob, Brae V. Surgeoner, Benjamin Chapman, Randall Phebus, Douglas A. Powell
http://www.emeraldinsight.com/Insight/viewContentItem.do;jsessionid=6146E6AFABCC349C376B7E55A3866D4A?contentType=Article&contentId=1811820
Abstract:
Purpose – The purpose of the present study was to observe the preparation practices of both adult and young consumers using frozen, uncooked, breaded chicken products, which were previously involved in outbreaks linked to consumer mishandling. The study also sought to observe behaviors of adolescents as home food preparers. Finally, the study aimed to compare food handler behaviors with those prescribed on product labels.
Design/methodology/approach – The study sought, through video observation and self-report surveys, to determine if differences exist between consumers’ intent and actual behavior.
Findings – A survey study of consumer reactions to safe food-handling labels on raw meat and poultry products suggested that instructions for safe handling found on labels had only limited influence on consumer practices. The labels studied by these researchers were found on the packaging of chicken products examined in the current study alongside step-by-step cooking instructions. Observational techniques, as mentioned above, provide a different perception of consumer behaviors.
Originality/value – This paper finds areas that have not been studied in previous observational research and is an excellent addition to existing literature.

Is it BS? Restaurant issues an apology after customer finds a rat in their soup

I never liked Vancouver.

People in Brisbane, they think Canada ends at Banff and Vancouver is some idyllic Canadiana, but to me it’s junkie haven.

Never liked it.

And what kind of popular eatery would serve a rat in a customer’s soup?
Or have some bullshit where a customer would fake a ploy?

That’s the Vancouver I’m familiar with.

The customer posted a video of the rodent in their soup on Instagram.


The Vancouver Sun reports the customer posted the video on Instagram Thursday after they discovered the rodent in their soup at Crab Park Chowdery. The restaurant is well known for serving soups and clam chowder in a sourdough bread bowls. Its owner, Ashton Phillips, says he does not understand how the rodent got into the soup and that the restaurant follows strict health code regulations. He added that a female customer was the one who found the rat in her soup.

We are doing everything we can to figure out what happened. You have to lid soup. This is a food safety measure and we always take it. It’s just impossible that a rat got in there. We are baffled.”

55 sick from Salmonella linked to long English cucumbers (the looooonnnnnggg ones)

The stories I have about cucumbers.

Especially the long ones.

But I’ve already been threatened with one lawsuit, and will not indulge further, other than the facts.

The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of Salmonella infections involving five provinces: British Columbia, Alberta, Saskatchewan, Manitoba, and Quebec. The illness reported in Quebec was related to travel to British Columbia. At this time, there is no evidence to suggest that residents in eastern Canada are affected by this outbreak.

Based on the investigation findings to date, exposure to long English cucumbers has been identified as the likely source of the outbreak. Many of the individuals who became sick reported eating long English cucumbers before their illness.

(Those would be the ones grown in greenhouses, but I’m just speculating, rather than inviting a lawsuit from the Ontario Greenhouse Vegetable Growers who like to intimidate with threats of lawsuits, but know shit about growing up in Southern Ontario; bring it on).

As of November 27, 2018, there have been 55 laboratory-confirmed cases of Salmonella Infantis illness investigated in the following provinces: British Columbia (47), Alberta (5), Saskatchewan (1), Manitoba (1), and Quebec (1). The individual from Quebec reported traveling to British Columbia before becoming ill. Individuals became sick between mid-June and late-October 2018. Eleven individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 1 and 92 years of age. The majority of cases (60%) are female.

5 sick raw is risky: Unpasteurized cheese made on Vancouver Island recalled for E. coli concerns

A voluntary recall has been issued for a Vancouver Island-produced cheese linked to an E. coli outbreak that infected five people.

Little Qualicum Cheeseworks’ Qualicum Spice cheese should be discarded or returned to the place of purchase, according to the BC Centre for Disease Control.

The E. coli outbreak occurred between August and October and was traced back to the unpasteurized product, which has a best before date up to and including April 24, 2019.

An investigation is ongoing “to determine the source and extent of contamination,” the BCCDC said.

Everyone’s got a camera: Toronto man complains of ‘unsanitary’ meat storage at real Canadian superstore

Michael Pearl says he goes grocery shopping every Sunday at the Real Canadian Superstore near Dufferin Street and Steeles Avenue West.

But on Oct 5, he says he got a disturbing sneak peek behind the deli counter.

“It just seemed like it was a very unsanitary way of storing meat,” Pearl told CBC Toronto.

Pearl was planning on purchasing some steaks but changed his mind when he saw a pile of raw meat in a shopping cart behind the counter.

“Fifty or 60 steaks in there, sitting in the cart without any wrapping that I had seen,” he said. “It just seemed very, you know, very unhygienic and it looked disgusting, to be honest with you.”

Pearl says he took out his phone and snapped a picture, which he brought to a woman he says claimed to be the store manager.  

“I showed her the picture. She seemed aghast at it all,” Pearl said.

In addition to that, Pearl says he sent the photo to the Toronto Board of Health, and filed a complaint with them.  

“They got back to me and said they were going to be looking into it.”

Loblaw Companies director of public relations Karen Gumbs also saw the picture and gave a statement to CBC Toronto, saying this “absolutely should not have happened” because it does not follow the company’s food safety procedures.

“The store immediately addressed this with the colleague,” Gumbs said. “We’ve reminded all departments of our protocols to ensure nothing like this happens again.”

Pearl says he will continue to shop at the Real Canadian Superstore because it’s close and convenient.

When asked if he plans to buy meat from the deli counter again he simply said, “Yeah, why not?”

Could this be the most Canadian food safety story?

Just cook it doesn’t cut it: 474 sick from Salmonella linked to raw frozen chicken thingies in Canada

The Public Health Agency of Canada says 474 people have gotta sick from raw frozen chicken thingies over the past year and a half.

Over a decade ago, when I went to Kansas State, me and Chapman and Phebus came up with a project to see how people cooked these thingies.

Why not cook all these thingies to reduce risk, because it costs about $0.01 a pound too cool these things with electricity.

The American Meat Institute funded it.

Some of these thingies are frozen raw, which means they have to be cooked in an oven and temperature verified with a tip-sensitive digital thermometer, and some of these thingies are pre-cooked, so can be thawed in a microwave.

Labelling has changed over the years, but it’s still necessary to know what you’re buying.

Some of the frozen raw products may appear to be pre-cooked or browned, but they should be handled and prepared with caution

I’d understand Australia, with its massive coal investments, but Canada and the U.S. where nuclear is readily available?

In May 2017, Government of Canada scientists began using a new technology called “whole genome sequencing” to help identify and respond to outbreaks. Over the past year and a half, federal, provincial and territorial health and food safety partners have investigated 14 national outbreaks linked to raw chicken, including frozen raw breaded chicken products. The Canadian Food Inspection Agency has issued food recall warnings for ten products linked to some of these outbreak investigations.

As of November 2, 2018, there have been 474 laboratory-confirmed cases of Salmonella illness investigated as part of the illness outbreaks across the country.

All active and future Salmonella outbreak investigations linked to raw chicken, including frozen raw breaded chicken products, and related food recall warnings will be listed in the next section of the public health notice to remind Canadians of the ongoing risk associated with these types of food products.

Do not eat raw or undercooked frozen breaded chicken products. Cook all frozen raw breaded chicken products to an internal temperature of at least 74°C (165°F) to ensure that they are safe to eat. Use a digital food thermometer to verify the temperature. Insert the digital food thermometer through the side of the product, all the way to the middle. Oven-safe meat thermometers that are designed for testing whole chicken and roasts during cooking are not suitable for testing nuggets, strips or burgers.

Microwave cooking of frozen raw breaded chicken products—including chicken nuggets, strips, burgers, popcorn chicken or chicken fries—is not recommended because of the possibility of uneven heating.

Always follow the cooking instructions on the package, including for products labelled Uncooked, Cook and Serve, Ready to Cook, and Oven Ready.

Wash your hands thoroughly with soap and warm water before and after handling frozen raw breaded chicken products (the water does not need to be warm).

Always follow the cooking instructions provided on the package. Cook chicken to a safe internal temperature that has been checked using a digital thermometer. Raw chicken pieces should be cooked to an internal temperature of 74°C (165°F). Whole chicken should be cooked to an internal temperature of 82°C (180°F).

Keep raw chicken away from other food while shopping, storing, repackaging, cooking and serving foods.

A table of raw frozen chicken thingies outbreak is available at https://barfblog.com/wp-content/uploads/2014/06/Outbreaks-Associated-with-Raw-Frozen-Meals-4-13.xlsx.

Self-reported and observed behavior of primary meal preparers and adolescents during preparation of frozen, uncooked, breaded chicken products
01.nov.09
British Food Journal, Vol 111, Issue 9, p 915-929
Sarah DeDonder, Casey J. Jacob, Brae V. Surgeoner, Benjamin Chapman, Randall Phebus, Douglas A. Powell
http://www.emeraldinsight.com/Insight/viewContentItem.do;jsessionid=6146E6AFABCC349C376B7E55A3866D4A?contentType=Article&contentId=1811820
Abstract:
Purpose – The purpose of the present study was to observe the preparation practices of both adult and young consumers using frozen, uncooked, breaded chicken products, which were previously involved in outbreaks linked to consumer mishandling. The study also sought to observe behaviors of adolescents as home food preparers. Finally, the study aimed to compare food handler behaviors with those prescribed on product labels.
Design/methodology/approach – The study sought, through video observation and self-report surveys, to determine if differences exist between consumers’ intent and actual behavior.
Findings – A survey study of consumer reactions to safe food-handling labels on raw meat and poultry products suggested that instructions for safe handling found on labels had only limited influence on consumer practices. The labels studied by these researchers were found on the packaging of chicken products examined in the current study alongside step-by-step cooking instructions. Observational techniques, as mentioned above, provide a different perception of consumer behaviors.
Originality/value – This paper finds areas that have not been studied in previous observational research and is an excellent addition to existing literature.

51 sick in Canada and U.S. from Salmonella linked to cucumbers

I’ve been waiting for more info on this outbreak but it’s not there.

Cucumbers have been linked to at least 45 Salmonella illnesses in western Canada.

A further six people in Washington state – that’s also in the west – have been stricken by what seems to be the same bacterium linked to cucs, sold at Costco.

Happy Thanksgiving and a sheep riding on a truck

To my Canadian brethren, who have consumed the 165F minimum temped bird and are now plopped on the couch watching hockey, including reruns of last night’s barnburner of a hockey game where our beloved but hapless (sorta like me) Toronto Maple Leafs pulled out a 7-6 overtime win against Chicago, I can say we did nothing to celebrate this year.

For every day is … never mind.

The house renovations just got finished, the bank account is empty, maybe we’ll pull something off for American Thanksgiving.

And now, a sheep riding on a truck in New Zealand.

“This is a highly unusual incident and not representative of how sheep are transported in New Zealand,” Ministry for Primary Industries spokesman Peter Hyde said.

Ellerslie resident Ada Rangiwai captured the sight on a cellphone while travelling along the city’s southern motorway. The sheep didn’t seem nervous and it was just standing there, unfazed by the attention.

“It was surfing,” she said.

And if you get a facebook request from me to be friends, ignore it. I, like millions of others, have been hacked.