Cook and reheat the damn ham; don’t hire unlicensed caterers; Clostridium perfringens strikes Las Vegas lunch

 On Dec. 8, 2011, a biz in Las Vegas had a catered lunch.

Less than a day later, a bunch of them were barfing.

The Southern Nevada Health District (SNHD) began an investigation the next day after receiving numerous reports of barfing among attendees; excerpts from their report are below.

Approximately 150 people work at Business A. Of the 63 employees who replied to the electronic survey, 50 reported they consumed food and/or drinks at the luncheon. Of the 50 luncheon attendees, 21 (42%) people met the case definition. An additional 29 people who ate at the luncheon but did not become ill served as non-case study participants. No ill person sought medical attention from a healthcare provider.

The caterer had a health card that is issued by the SNHD to food handlers. However, the caterer did not hold a catering permit issued by the SNHD, so health types don’t know if the same caterer sickened others at others meals because SNDH only tracks complaints against licensed businesses.

Both the caterer and a representative from Business A reported that the caterer
arrived at 9:00 am on December 8, and lunch service started at approximately 1230 hrs
(meal start time among ill persons ranged from 1130 to 1900 hrs) (Fig. 1). The duration
of the luncheon was unknown.

The caterer reported that all foods served were pre-cooked and ready-to-eat. The ham and turkey breasts were transported to Business A in a cooler with ice. Both meats were further sliced onsite, placed in bowls and re-heated in 5-6 batches per meat in two small non-commercial microwave ovens that were provided by Business A at the catering site. The caterer reported that food batches were stirred during heating. The caterer alleged the temperature of the meat was 170°F (76.7°C) after heating, but it was unclear where the temperature was taken in the meat. Heated ham slices were pooled in one chafing pan and canned pineapple with its juice was added.

Heated turkey meat was pooled in another pan and heated canned gravy was added. The
chafing dishes containing the ham and turkey were warmed by pans of hot water that was heated with Sterno heaters. Both meats were stored in their respective chafing dishes for about 0.5 hr prior to eating, but the duration of time foods were stored in the chafing dishes was not known.

Upon collecting foods for testing, EH staff observed that leftover foods were stored in a refrigerator that displayed the temperatures of <40°F, with the bulk of the food stored in covered consumer-grade plastic containers. All remaining food in their original containers was collected for testing and included: Mashed potatoes, ham and pineapple topping, green beans, salad with fruits, and two mixed-food plates containing 1) Ham, turkey, mashed potatoes, stuffing, green beans, and 2) Stuffing, mashed potatoes, green beans.

I’m getting hungry.

The EH staff sent a formal notice to the caterer requiring all food operations to immediately cease and desist. They also required that the website which advertises the catering business be modified to announce that a permitted food facility will be providing the food to future events that are planned by the catering company. Additionally, EH also issued a bill to the caterer charging for the time that EH staff had spent in investigating the outbreak.

The isolation of C. perfringens was strongly suggestive that ham was the vehicle of transmission, and an error likely occurred during its re-heating and hot holding during the luncheon service. The heat generated by a small microwave oven might be insufficient to bring all portions of the ham to above 165°F (74°C) to destroy the C. perfringens bacteria. When the heating process is not evenly accomplished, the surviving C. perfringens bacteria can multiply and undergo sporulation. During the holding period where food is kept warm in covered chafing pans for extended periods of time, the spores can germinate to produce vegetative cells and multiply rapidly to large numbers. Ingestion of the bacteria during the luncheon may have resulted in further multiplication and sporulation in the intestine. The release of enterotoxin when C. perfringens sporulates can cause acute diarrhea. To prevent the proliferation of pathogens in potential hazardous food, the US FDA Food Code 2009 recommends that food that are reheated in a microwave for hot holding shall be reheated so that all parts of the food reach a temperature of at least 74oC (165oF) and the food is rotated or stirred, covered, and allowed to stand covered for 2 minutes after reheating (Section
3-403.11.B). Also, hot holding of such foods should occur at 57oC (135oF) or above
(Section 3-501.16.A1).

The majority of C. perfringens outbreaks are often the results of improperly cooled food or food held at room temperature for extended periods. Coupled with concurring epidemiological findings that the contamination and proliferation of the bacteria may have occurred at the luncheon, no further food traceback or recall action of the ham was implemented by the FDA.

Stock on the counter invites microbiological trouble

I’m in Brisbane one day and I cook a whole chicken and then make stock.

It’s my go-to food.

Back in Manhattan I had a groovy measuring cup similar to the one, right, that easily separates the fat. Overnight in the refrigerator also works (I have 3 containers biding their time in the fridge).

A well-flavored – careful not to over-salt — chicken stock is a key ingredient, not just for soups and stews, but a meal of shrimp and red pepper over rotini, stir-fried veggies, even some kinds of bread.

So when Michael Ruhlman, some sort of cookbook author, said on his blog that he likes to make chicken stock and leave it out on the stovetop all week, using portions day to day to make quick soups and sauces, Harold McGee of The New York Times decided to check with a real expert: O. Peter Snyder, a food scientist and veteran educator and consultant to the food-service industry, who has at times taken issue with government guidelines he considers unnecessarily conservative.

“The process described by Mr. Ruhlman is a very high-risk procedure,” wrote Dr. Snyder. “It depends totally on reheating the stock before it is used to be sure that it doesn’t make anyone ill or possibly kill them.”

Boiling does kill any bacteria active at the time, including E. coli and salmonella. But a number of survivalist species of bacteria are able to form inactive seedlike spores. These dormant spores are commonly found in farmland soils, in dust, on animals and field-grown vegetables and grains. And the spores can survive boiling temperatures.

After a food is cooked and its temperature drops below 130 degrees, these spores germinate and begin to grow, multiply and produce toxins. One such spore-forming bacterium is Clostridium botulinum, which can grow in the oxygen-poor depths of a stockpot, and whose neurotoxin causes botulism.

Once they’ve germinated, bacteria multiply quickly in nourishing stock. They can double their numbers every 90 minutes at room temperature, every 15 minutes at body temperature. A single germinated spore can become 1,000 bacteria in a matter of hours, a billion in a few days.

As Dr. Snyder put it, “After sitting on the stove and growing bacteria for two or three days, Mr. Ruhlman’s stock almost certainly has high levels of infectious Clostridium perfringens cells, or Clostridium botulinum or Bacillus cereus cells and their toxins, or some combination thereof.”

Why has the Ruhlman family survived? Because Mr. Ruhlman boils the stock before he serves it, Dr. Snyder wrote. Any active bacteria are killed by holding the stock for a minute at 150 degrees or above, and botulism toxin is inactivated by 10 minutes at the boil.

But quickly reheating a contaminated stock just up to serving temperature won’t destroy its active bacteria and toxins, and the stock will make people sick.

In 2008, a 26-year-old Japanese mother in the Osaka region shared a meal of leftover fried rice with her two children, ages 1 and 2. She had prepared and served the rice the day before and kept it at room temperature.

All three became ill 30 minutes after eating the leftovers, and were hospitalized. Both children lost consciousness, and the youngest died seven hours after the meal. Pathologists later reported in the journal Pediatrics that the rice contained a very common spore-forming bacterium, Bacillus cereus, along with a heat-resistant toxin that the bacterium tends to make on starchy foods, and that can cause vomiting even after being heated to the boil.

Dr. Snyder agreed that official pronouncements on food safety can be inconsistent and self-defeating. “The F.D.A. Food Code is very conservatively written,” he wrote. “Four hours after it’s cooked is plenty fast enough to get food into the refrigerator.” And slow enough to relax and enjoy the meal.

I’m with Pete.

Nuevo Folleto Informativo: Mas de 30 personas se enferman con Clostridium perfringens en 
una conferencia de padres 
y maestros en Evanston, Ill.***

Traducido por Gonzalo Erdozain

Resumen del folleto informativo mas reciente:
– El brote fue causado por barbacoa mantenida a temperaturas inadecuadas.
– Según el reporte, la comida fue entregada por el ahumadero y se mantuvo a temperatura ambiente toda la tarde y noche.
– Tenga a su disposición las herramientas adecuadas para mantener los alimentos 
a temperaturas de, o mayores a, 135°F.

Los folletos informativos son creados semanalmente y puestos en restaurantes, tiendas y granjas, y son usados para entrenar y educar a través del mundo. Si usted quiere proponer un tema o mandar fotos para los folletos, contacte a Ben Chapman a

Puede seguir las historias de los folletos informativos y barfblog en twitter
@benjaminchapman y @barfblog.

Mum says ‘I didn’t know;’ UK infant recovers from botulism

Logan Douglas was temporarily blinded and paralyzed as the botulism he contracted at 16-weeks-old ravaged his body.

Six months after his parents, Theresa Fitzpatrick and Alex Douglas, were faced with the decision of whether to turn off his life support as baffled medics feared the worst, Logan is doing great (right, photo from The Sun).

When a limp and ill Logan was first taken to physicians, he was admitted to hospital and, after a battery of tests, a Glasgow-based doctor ordered a test for infantile botulism for Logan.

Devastated Theresa has revealed she still blamed herself after feeding her baby honey.

She wasn’t aware that the food wasn’t suitable for children so young – and unwittingly placed his health in danger.

"Logan’s big sister, Taylor, loves honey on toast and one day I was spreading some honey for her and Logan was a bit grizzly. So I just dipped his dummy in the honey and he loved it. He got some every now and again. None of the baby books I had mentioned infantile botulism or said honey was dangerous for babies under a year old. I’d been at my auntie’s house with Taylor and she said to take a pot of honey she had home with me for Taylor. I wish I hadn’t now. Taylor hasn’t ever asked for honey again and it’s banned from the house now. It was just an ordinary supermarket’s own-brand honey bought off the shelf. The environmental health people tested the actual pot and it was confirmed as the source."

Kudos to Thersa, Logan’s mum, for admitting she didn’t know about the potential risks. I, and other food safety types, hear everyday, “I didn’t know” about E. coli, or Salmonella, or botulism or whatever. That’s OK. It underscored the need to be creative and compelling when talking about … anything.

Clostridium botulinum can cause sickness in very young children, and infants under the age of 1 years old are most at risk. Honey may contain Clostridium botulinum spores which can grow in the digestive tract of children less than one-year-old because their digestive system is less acidic. The bacteria produces toxin in the body and can cause severe illness. Even pasteurized honey can contain botulism spores and should be not be given to children under the age of 12 months.

New Zealand Food Safety Authority nails restaurant — no one wins when people barf

A New Zealand restaurateur whose poor food safety practices caused more than 50 Christmas Day diners to fall ill has had his appeal thrown out.

Robin Pierson, the owner-operator of Bushmere Arms, was ordered to pay $400 in fines, along with $850 in reparation to victims and $10,414 in costs to the Crown in a case brought by the New Zealand Food Safety Authority (NZFSA).

The court heard that on 25 December 2006, Pierson’s restaurant provided a Christmas Day buffet luncheon for about 110 diners, with a selection of ham, beef and turkey. The next day some of the diners called him complaining of illness after the luncheon. Fifty-seven reported varying degrees of stomach pain, abdominal cramps and diarrhoea.

A Health Protection Officer found the symptoms of illness described by the complainant diners were consistent with food poisoning caused by Clostridium perfringens. C. perfringens was also found in samples of the leftover turkey, and the enterotoxin form of the bacteria in faecal samples from two of the ill diners.
While C. perfringens can be found in the stools of normal people, the enterotoxin is only found in people with C. perfringens food poisoning.

NZFSA’s Assistant Director of Compliance and Investigation Justin Rowlands, said the luncheon had all the hallmarks of an outbreak in waiting.

“The turkey was inadequately thawed, cooked, and reheated. The person serving meats at the buffet also used the same knife to carve the turkey, meat and ham, raising the chance of cross contamination. Also, the restaurant did not have formal steps in place for operating safely during stressful periods.”

UK warning: When doing heroin, beware the Clostridium

The UK Health Protection Agency has sent an advisory to health service organizations and partners, including needle exchanges, to warn of the new Clostridium contamination in batches of heroin.

In 2001, there were a total of 108 cases – 60 in Scotland, including 50 in Glasgow, 26 in England and 22 in Dublin, including 43 deaths.

Extensive microbiological investigations led to the identification of Clostridium novyi Type A from 13 cases in Scotland, two in Dublin and two in England.
C novyi is most commonly associated with infection in farm animals and human battlefield victims.

Fancy restaurant didn’t know how to cool food; three sickened

In one of the lamest food safety excuses ever tabled, defence lawyer Adrian Gundelach told the Brisbane Magistrates Court yesterday — with a straight face — that Harem Restaurant, routinely left dishes out to cool at room temperature for eight hours, stating,

"It was something that my clients couldn’t have foreseen. They’d been following a practice that they’ve been following since the day the restaurant opened."

That practice led to three people barfing up Clostridium perfringens after dining at the upscale Brisbane eatery in July. An additional 16 people at the function also reported symptoms, but were not confirmed after failing to return health sample kits to Queensland Health.

The Harem restaurant in Brisbane, Australia, is listed in the Best Restaurants Guide of Australia as follows:

"Be an Ottoman prince for the evening: sit on sumptuous cushions shrouded by curtains, feast on finger food and enjoy a night of belly-shaking. There’s no confusion as to what type of restaurant Harem is; the dining room is a riot of handmade rugs, multi-coloured tablecloths, brass lamps and cushions, all imported from Turkey, and the carpeted floorspace is patrolled by fez-hatted wait staff."

The judge wasn’t amused and fined the restaurant $20,000.

The restaurant has since changed its cooling techniques.

Pay more attention to food safety basics and less food pornography.