60 sick with E. coli O157 in 10 states: it was Romaine lettuce (grown in California?) served at Schnucks salad bars by Mr. Green

A day after Missouri health types announced the source of the Schnucks-salad-bar-related E. coli O157 outbreak may never be found, the feds announced they found a source.

The U.S. Centers for Disease Control (CDC) reported today that as of Dec. 4, 2011, 60 persons infected with the outbreak strain of E. coli serotype O157:H7 had been reported from 10 states.

Collaborative investigative efforts of state, local, and federal public health and regulatory agencies indicate that romaine lettuce is the likely source of illnesses in this outbreak, and contamination likely occurred before the product reached retail stores.

CDC called Schnucks Chain A, and the farm the lettuce was traced to Farm A, without saying in what state the lettuce originated. But one of the Missouri health types did, saying a grower in California was suspected of being connected but records were “insufficient to complete the picture.”

The public reporting of this outbreak reeks of the Leafy Greens Cone of Silence – that the most noticeable achievement since the California Leafy Greens Marketing Agreement was created in the wake of the 2006 E. coli O157-in-spinach mess is the containment cone of silence that has descended upon outbreaks involving leafy greens.

Things didn’t sound quite right back on Oct. 28, 2011, when St. Louis County health officials first publicly confirmed that the source of the E. coli O157 strain that had sickened 23 people was foodborne, but that the investigation was ongoing. Though retailers have not been asked to pull any food, Schnucks voluntarily replaced or removed some produce in salad bars and shelves, beginning Oct. 26, 2011.

"Once we heard that the health department had declared an outbreak, we took some proactive steps with our food safety team to switch products out that recent history told us could be potential sources," said Schnucks spokeswoman Lori Willis.

A Schnucks store, Culinaria in downtown St. Louis, put a sign up on empty shelves that read in part, "Due to a voluntary recall on pre-packed lettuce, we will not be able to produce these pre-made salads. Be assured quality is our main concern. All of the lettuce on the salad bar is fresh and not involved with the recall."

As a retailer, Schnucks drew my attention earlier this year when it announced it was expanding its so-called Peace of Mind initiative from pricing to quality assurance with a new website, www.peaceofmindquality.com, that emphasizes the chain’s dedication to quality and food safety. Unfortunately, quality and safety are seemingly used interchangeably on the website when they are actually two different concepts.

A table of leafy green related outbreaks is available at http://bites.ksu.edu/leafy-greens-related-outbreaks.

I’m not feeling peace of mind.

More from the CDC report:

As of December 4, 2011, 60 persons infected with the outbreak strain of E. coli O157:H7 have been reported from10 states. The number of ill persons identified in each state is as follows: Arizona (1), Arkansas (2), Georgia (1), Illinois (9), Indiana (2), Kansas (3), Kentucky (1), Minnesota (3), Missouri (37), and Nebraska (1).

Among persons for whom information is available, illnesses began from October 10, 2011 to November 4, 2011. Ill persons ranged in age from 1 to 94 years, with a median age of 29 years old. Sixty-three percent were female. Among the 45 ill persons with available information, 30 (67%) were hospitalized, and 2 developed hemolytic uremic syndrome (HUS). No deaths have been reported.

Collaborative investigative efforts of state, local, and federal public health agencies indicate that romaine lettuce sold primarily at several locations of a single grocery store chain (Chain A) was the likely source of illnesses in this outbreak. Contamination likely occurred before the product reached grocery store Chain A locations.

Ill persons reported purchasing salads from salad bars at grocery store Chain A between October 5 and October 24, 2011. A total of 9 locations of grocery store Chain A were identified where more than one ill person reported purchasing a salad from the salad bar in the week before becoming ill. This included 2 separate locations where 4 ill persons reported purchasing a salad at each location. For locations where more than one ill person reported purchasing a salad from the salad bar and the date of purchase was known, dates of purchase were all within 4 days of other ill persons purchasing a salad at that same location. Chain A fully cooperated with the investigation and voluntarily removed suspected food items from the salad bar on October 26, 2011, out of an abundance of caution. Romaine lettuce served on salad bars at all locations of grocery store Chain A had come from a single lettuce processing facility via a single distributor. This indicates that contamination of romaine lettuce likely occurred before the product reached grocery store Chain A locations.

The FDA and several state agencies conducted traceback investigations for romaine lettuce to try to identify the source of contamination. Traceback investigations focused on ill persons who had eaten at salad bars at several locations of grocery store Chain A and ill persons at university campuses in Minnesota (1 ill person) and Missouri (2 ill persons). Traceback analysis determined that a single common lot of romaine lettuce harvested from Farm A was used to supply the grocery store Chain A locations as well as the university campus in Minnesota during the time of the illnesses. This lot was also provided to a distributor that supplied lettuce to the university campus in Missouri, but records were not sufficient to determine if this lot was sent to this university campus. Preliminary findings of investigation at Farm A did not identify the source of the contamination. Farm A was no longer in production during the time of the investigation.

Old timey: first UK salmonella-in-duck-eggs outbreak since 1949 sickens 81

Health types in the U.K. have published the epidemiological results of an outbreak of Salmonella Typhimurium DT8 in 2010 that sickened 81 people in 2010.

The authors write in Epidemiology and Infection:

Descriptive epidemiological investigation found a strong association with infection and consumption of duck eggs. Duck eggs contaminated with S. Typhimurium DT8 were collected from a patient’s home and also at farms in the duck-egg supply chain. Although duck eggs form a small part of total UK eggs sales, there has been significant growth in sales in recent years.

This is the first known outbreak of salmonellosis linked to duck eggs in the UK since 1949 and highlighted the impact of a changing food source and market on the re-emergence of salmonellosis linked to duck eggs.

Control measures by the duck-egg industry should be improved along with a continued need to remind the public and commercial caterers of the potential high risks of contracting salmonellosis from duck eggs.

These consumer reminders, like the one published by the U.K. Food Standards Agency in Sept. 2010 — Consumers reminded to follow good hygiene practice when handling and preparing duck eggs – advising folks to cook food until it is “steaming hot all the way through” are cute. And completely void of any evidence they work. Not so good for a science-based agency.

Anyone can armchair quarterback; dealing with uncertainty in real-time during foodborne outbreaks

It’s not easy being a food safety investigator in the face of deep uncertainty.

So says Ron Doering, a past president of the Canadian Food Inspection Agency who practices food law in the Ottawa offices of Gowling Lafleur Henderson, in his latest Food Law column.

In the U.S., the largest foodborne outbreak in the last decade involved a rare strain of Salmonella Saintpaul thought to originate from tomatoes. The Food and Drug Administration (FDA) acted quickly, providing a public warning to avoid eating tomatoes until its investigation was complete. After several weeks and hundreds of tests and interviews, the FDA concluded that the problem was likely not tomatoes but rather hot peppers. Politicians rushed to microphones attacking the FDA for “destroying” the tomato industry. Of course, these are the same people who would have been outraged if tomatoes had been the source of the Salmonella and the FDA had not acted quickly.

While the FDA probably did the right things in the face of so much uncertainty, they should have communicated better. Tracing the source of foodborne illnesses is very complicated, especially for produce like tomatoes where there are no bar codes, no packages, and they are quickly consumed, often with other produce.

In the EU, the largest foodborne illness outbreak in the last decade, and one of the developed world’s most severe in modern times, took place this summer when a very rare strain of E. coli (O104:H4) got into the European food supply.

The first death was reported on May 24. The next day, the Robert Koch Institute announced that the early epidemiology indicated that the likely culprit was cucumbers, tomatoes or green salads. And later that day German officials announced that the rare strain had been found in the stools of five of the sick patients. The following day a German state-level agency announced triumphantly that it had found E. coli on Spanish cucumbers, though it had not yet tested for the strain.

On May 31, after testing for the strain, it was announced that the cucumbers were not to blame, by which time, of course, the Spanish cucumber industry was destroyed and German vegetable growers were suffering losses of $2.8 million per day as consumers quit eating all salads. Finally, on June 5 it was reported that “initial tests” (it was not tests, it was the result of epidemiological tracing) revealed that sprouts grown on an organic farm in Germany were “likely” the source of the problem, even though they couldn’t find a smoking sprout on the farm. Then on June 12 several victims of the O104 strain fell ill in France. They had no connection to the German organic farm. Attention turned to seeds, with the French blaming the British (I’m not making this up). Finally, on June 29 tracing determined the source of the problem as sprout seeds imported from Egypt in 2009. By this time there had been more than 50 deaths and well over 4,300 people seriously ill, including approximately 900 cases of patients with permanent kidney damage.

In both cases, with the benefit of hindsight, academics and the media roundly criticized the regulators as incompetent.

In a detailed review of the EU sprouts case, Peter Sandman, an expert on risk communication, concluded that the main failure of the regulators was in not being more forceful in proclaiming in their risk messaging the level of uncertainty in the case.

To me it seems there is a more basic problem, and it flows from the use of the language of risk, because “risk” disguises the deep uncertainty inherent in complex cases like these. These regulators were dealing with uncertainty, not risk — they were engaged in crisis management, not risk management.

E. coli O157 linked to leeks sickens 250 and kills 1 in UK; 8-month outbreak only now being made public

An eight-month E coli O157:H7 phage-type 8 outbreak across the U.K. that left 250 people ill and one dead was not publicized at the time because its origins were unknown.

After six months of investigations the infection was ultimately linked to people handling loose raw leeks and potatoes in their homes, said the Health Protection Agency (HPA), which has only now acknowledged the outbreak.

The cases began last December and continued until July. In total 250 victims – 100 of them under 16 – were left sick with vomiting and diarrhea. Of those, 74 needed hospital treatment. One unnamed patient, who the HPA said had underlying health problems, died.

In each of the past three years an average of 81 people across the U.K. have been infected with E coli O157 PT8.

"Our study showed a statistically significant association with raw loose leeks and potatoes from sacks, but these vegetables may not be the only source of contamination," said Dr Bob Adak, an HPA gastrointestinal expert who led the multi-agency outbreak control team that investigated it.

Soil on the vegetables is thought to have been the likely source of the E coli bacteria. "In this outbreak, which is now over, the vegetables could have carried traces of contaminated soil. It is possible people caught the infection from cross-contamination in storage, inadequate washing of loose vegetables, insufficient hand washing after handling the vegetables or by failing to thoroughly clean kitchen equipment, utensils or surfaces after preparing the vegetables."

A spokeswoman said the HPA did not alert the public to the ongoing outbreak because they did not know where it had originated and therefore could offer no useful public health advice.

And the sanitized press release nonsense ends here.

Potato and leek soup is a standard in my kitchen, using chicken stock made from the weekly roast chicken.

I’m not sure what else leeks are used for, and they can contribute to some fantabulous gas, but they are a mess to clean: dirt and soil is engrained throughout the white part of the vegetable. I give them a rinse under tap water and then slice for soup. But the risk is with cross-contamination – leeks are grown in soil and whatever microorganisms are within the white bits are going to drip on the counter and elsewhere.

Be the bug, follow the bug.

The folks at the U.K. Food Standards Agency whose idea of science-based verification is to cook meat until it is piping hot, have apparently decided that E. coli O157:H7 – the dangerous kind – found on or in leeks, is the consumers’ responsibility.

"This outbreak is a timely reminder that it is essential to wash all fruits and vegetables, including salad, before you eat them, unless they are labeled ‘ready to eat’, to ensure that they are clean. It is also important to wash hands thoroughly as well as clean chopping boards, knives and other utensils after preparing vegetables to prevent cross contamination,” said Dr Andrew Wadge, chief scientist at FSA.

No questions about what E. coli O157:H7 is doing on so many potatoes and leeks that 250 people get sick.

The Brits are so bad at communicating basic food safety information that FSA put out its own press release stressing the need for home hygiene because of “two recent E.coli outbreaks,” referring to the leeks and the German-based E. coli O104 sprout outbreak earlier this year which killed 53 and sickened over 4,000. People could have washed sprouts all they liked but it wouldn’t have done anything to control E. coli, especially if it was originally in the Egyptian seed, as is widely suspected.

Consumers, you are apparently the critical control point for microorganisms that will rip out your kidneys: FSA says, those leeks and potatoes, “although safe to eat if handled correctly, could have had soil on them containing harmful bacteria.”

Despite decades of food safety communication case studies and research to the contrary, the Brits are intent on forging their own top-10 stupid ways to talk about foodborne illness, with special mention to mad cow disease, salmonella in eggs and proper cooking temperatures.

If U.K. food and health types have a communications policy, it seems to be one of, no positive food, no public statement, no matter how many are dead or dying.

Why not say, as many other jurisdictions do, that an increase in a type of rare but dangerous E. coli has been noted, we’re not sure where it came from, but we’re trying to figure things out, and as soon as we know more, you’ll hear it first from us.

Is there any policy on providing the public with information about foodborne illness in the U.K.?

Stay comfortably numb (there’s a better vid of gilmore and waters earlier this year at http://youtu.be/hUYzQaCCt2o.

Salmonella in grape tomatoes: lotsa drama, not much data, third-party audits still don’t mean much

Canada has to make the simplest things mindnumbingly confusing and bureaucratic. Who has four federal elections in seven years?

On April 29, 2011, Six L’s of Immokalee, Fla. voluntarily recalled a single lot of grape tomatoes, because they had the potential to be contaminated with salmonella. The contamination was detected through a random sample obtained by the U.S. Department of Agriculture at a distributor in New York. The product is from a farm in Estero, Fla. that has since ceased production of that commodity.

The specific lot was packed on April 11 and was comprised of grape tomatoes that can be identified by Cherry Berry lot code DW-H in either in clam shells or 20 lbs. cardboard containers. The product was distributed to North Carolina, South Carolina, Alabama, Florida, New Jersey, New York, Michigan, Pennsylvania, California, Georgia and Canada, and reached consumers through retail stores and restaurant distribution.

No one was sick, USDA tested and found something, at least someone was awake.

But that recall grew. It grew and it grew and it grew until Canada decided it had to do something (apologies to Bob Munsch).

On May 2, 2011, the Canadian Food Inspection Agency took time off from voting in the latest federal election to proclaim that Mastronardi Produce of Kingsville, (that’s near Leamington, in Ontario in Canada) was voluntarily recalling grape tomatoes because they may contain Salmonella anatum.

Mastronardi Produce is taking this action after they were notified by a supplier about one lot of tomatoes that was later determined to be contaminated with Salmonella anatum. The supplier was Six L Packing Company from Immokalee, Florida.

Was Mastronardi, a well-known greenhouse vegetable grower, repacking grape tomatoes from Florida? No, just redistributing.

That’s what Richard Lee, operations manager of the Ontario Greenhouse Vegetable Growers, told me this afternoon. He also said Mastronardi was “helping out” CFIA types, but that people are “poorly educated” about the difference between greenhouse and field grown tomatoes, so OGVG put out its own press release today.

“OGVG would like the public to be aware that this product is NOT of Canadian origin and NOT Greenhouse grown. The original supplier of these tomatoes was Six L Packing Company from Immokalee, Florida.”

(People who write in all caps are yelling; why are you yelling at me?)

“Retailers and consumers can continue to feel confident when purchasing Ontario greenhouse tomatoes,” said OGVG General Manager, George Gilvesy. “All Ontario greenhouse tomato, cucumber and pepper growers are required to pass an annual third party food safety audit as part of OGVG’s licensing regulations. This helps to ensure that all greenhouse vegetable growers are following important food safety standards.”

How often is water quality tested? How about pathogen testing? Are growers and packers notified before the auditor shows up? Are those results public? The program we designed 13 years ago for the greenhouse veggie growers had all those elements, along with round-the-clock food safety assistance and at least decent communications with buyers and consumers. But third-party auditors became the preference of the industry – the folks that enabled salmonella in peanut paste, E. coli in produce, salmonella in eggs, and virtually every other outbreak over the past decade.

At some point, people will realize that proclaiming a third-party audit in the absence of any meaningful data is groveling to the lowest common denominator.

Sorta like the way the Liberals and Bloc were annihilated in the federal election yesterday. Some Canadians woke up.
 

Nosestretcher alert: food safety is not simple, even if a $5 billion corporation says it is

Memo to Michael McCain, CEO, Maple Leaf Foods Inc.:

You or your company, or both, really suck at this communication about food safety risk thing.

In the two years since your killer deli meats actually killed 23 Canadians with listeria and sickened another 50 or so, the best you can do is remind Canadians they should do more?

I understand you probably had some PR-type tell you that Maple Leaf needed third-party experts to validate and endorse your food safety messages, what with killing all those people. Except that third-party validation has been invalidated since the mid-1990s. As a company, you’re better to make public everything you’re doing.

And I understand the web site being promoted by the Canadian Public Health Association was underwritten by the company, and the messages probably came unfiltered from CPHA.

But it’s your name, and your company’s reputation on the web site.

And it doesn’t look good.

After the listeria mess of 2008 in Canada, your company has taken a bunch of baby steps to apparently engage the Canadian public, like targeting bloggers, showing up at food safety meetings and talking about culture.

But if you really want to regain the trust of Canadians, like my parents, who were in Kansas the other day, and my father who said he’d never buy Maple Leaf again, here’s what you can actually do:

* make listeria test results in Maple Leaf plants public;
• add warning labels on deli meats for at-risk populations, like pregnant women and all those old people that unnecessarily died; and,
• market Maple Leaf’s food safety efforts at retail so consumers can actually choose.

Instead, you and your company decide to put your resources into a web site – who doesn’t need another web site – that says,

“Although Canada has one of the best food safety systems in the world, there are still 11 to 13 million cases of foodborne illness across the country each year. That means your ability to stay healthy—whether or not you’re pregnant—depends on what food you eat, how well you store your food at home, and how carefully you prepare it before you eat. …

“As the consumer, once you buy a food product, you are the next link in the chain that keeps your food safe and healthy. This website will give you the information you need to guide you in choosing the right foods, and preparing and storing them safely”

“Eat Safe! is brought to you by the Canadian Public Health Association (CPHA) in partnership with Maple Leaf Foods.

“The contents are for informational purposes only and should never replace the advice and care of a health care professional. Neither CPHA nor Maple Leaf Foods guarantees that the information is accurate, complete, or timely. Neither CPHA nor Maple Leaf Foods will be liable for any direct or indirect loss, damage, or injury caused by the use of this information. CPHA does not endorse and shall not in any way be seen as endorsing any products or services that may be referred in this website. Food Safety For Higher Risk Canadaians is brought to you by the Canadian Public Health Association (CPHA) supported through an unrestricted educational grant from Maple Leaf Foods Inc.”

Wow. Instead of saying, treat deli meats like raw chicken poop, or toxic waste, cause a lot of people can die in a listeria outbreak, CPHA offers up Maple Leaf-funded platitudes that consumers should do more.

I look forward to the evaluation of such nonsense being published in a peer-reviewed journal so the rest of us mortals can better understand the methodology and thinking behind such nonsensical statements.

I do like the multiple language components of the website, but the rest is derogatory, paternalistic, and corporate. It’s like listening to a Journey song and having someone insist it’s real rock and roll.
 

Salmonella in sprouts now sickens 94

The U.S. Centers for Disease Control reports today that:

* from November 1 through December 27, approximately 94 illnesses linked to infection with the outbreak strain of Salmonella I 4,[5],12:i:- were reported from 16 states and the District of Columbia;

* Ppreliminary results of the investigation indicate a link to eating Tiny Greens brand Alfalfa Sprouts at Jimmy John’s restaurant outlets; and,

* consumers should not eat Tiny Greens brand Alfalfa Sprouts or Spicy Sprouts, and restaurant and food service operators should not serve them. Consumers, retailers and others who have Tiny Greens Alfalfa Sprouts or Spicy Sprouts should dispose of them in a closed plastic bag placed in a sealed trash can. This will prevent people or animals from eating them.

Silence from Jimmy John’s and Tiny Greens, other than, hey, our tests were negative.

Epidemiology still works.
 

Baker makes up for cockroach loaf

New Zealand’s biggest baking company is promising compensation to a man who found a cockroach in a loaf of bread.

The firm, Goodman Fielder promised compensation to Rob Hemming, but he heard nothing more until the Herald on Sunday got involved.

Now the company says it will send him a $60 voucher and a ham, but insists the cockroach was not baked into its bread.

Hemming discovered the insect in his bread a month ago.

"The next day I pulled it out of the fridge for breakfast and I spotted a blooming cockroach embedded in the bread."

He took the bread back to the Selwyn Heights Four Square in Rotorua, whose manager offered Hemming a replacement. But he decided to deal with the manufacturer directly.

Hemming called Goodman Fielder. A representative apologised and told him to freeze the loaf and she would post him some packaging to return it.

The first package did not turn up, and it was two weeks before the replacement arrived.

Goodman Fielder spokesman Ian Greenshields said the loaf had been examined at an independent laboratory; "Their tests showed the cockroach was not baked into the product but there was a hole in the bag and the cockroach could easily and most probably crawled into the bag," Greenshields said.

Four Square owner Amish Patel was confident the cockroach had not got into the bread at his shop.

We got ‘street cred’ say UK food safety types, like Pat Boone got rock and roll

There’s no shortage of communication weirdness out of the U.K. Food Standards Authority – home of the ‘piping hot’ food test.

In response to the latest European food survey (which is meaningless but nevertheless found that British respondents were less worried about pesticides, food poisoning, and hormones than their European counterparts, but were most concerned about the welfare of farmed animals and the quality and freshness of food) Andrew Wadge, chief scientist at FSA, said,

“I’m delighted that we Brits keep our stiff upper lip when faced with food scares and have a positive attitude to what we eat. I think we’re right not to worry unnecessarily about food safety threats as there are lots of checks in place to keep food safe. On the other hand it’s important not to be complacent, and there are simple steps people can take to prevent food poisoning such as not eating food past its use by date, not washing poultry – as the bacteria can spread round the kitchen – and always making sure that they cook food thoroughly.”

I’m sure such words were comforting to Sharon Mills as the inquest into her 5-year-old son’s food poisoning death opens today in Newport, Wales. Stiff upper lip, mom.

Then yesterday FSA boasted – gangsta style — it had funded a cooking-challenge TV show with ‘street-cred’ to turn up the heat on food safety.

“In addition to the focus on local ingredients, the show incorporates Agency food safety messages and nutrition advice. … Short 15,10 and 5 second films that subtly convey the Food Standards Agency’s 4Cs messages on chilling, cooking, cleaning and cross-contamination are also shown at the beginning and culinary delights, combining food safety messages with an appetising menu, including local produce.”

During the cook-off, the street market chefs are each given local ingredients for use in their two courses.

I’d want to know how those local ingredients were grown – source food from safe sources is the missing tip.

FSA director of communications, Terrence Collis said,

“Street Market Chefs is not only tremendous entertainment but also pretty informative. Healthy eating and food safety advice is skilfully woven into the program so the viewer never thinks they’re being nagged or got at, while best practice is there for all to see. ‘The chefs prepare carefully balanced meals and make sure they handle, store and cook the food properly. You’ll never get undercooked chicken on Street Market Chefs.”

Will it be piping hot or verified safe with a thermometer? How does comms Terry know the show is informative and skillfully presents advice? Did he ask anyone?

FSA street cred is like saying Pat Boone was doing rock and roll by covering Tutti Frutti.

630 now sick from salmonella in hamburger, calls for improved communication

The salmonella outbreak that has now sickened more than 630 students in Poitiers, France, has led calls for improved communication.

Centre Presse reports a meeting with different concerned parties took place in a closed session at the Prefecture. The FCPE (Federation of Boards of Parents of Students in Public Schools) and the PEEP (Parents of Students in Public Education) were invited.

The teenagers consumed hamburger patties contaminated with salmonella, produced by the Inalca company based in Italy and distributed by the Pomona company into different school cafeterias in France.

Stéphane Jarlégand, the regional Prefecture’s Chief of Staff, said yesterday, “An international investigation is underway,” and that to date, the children have all overcome this misstep and none suffered any “serious effects.”

The French seriously need to improve their communications.

Staff announced that a working group had been set up to “test new technologies able to provide rapid emergency messaging to parents.”

It’s possible that the chosen path will be an automated call broadcasting a clear message that could be sent out via SMS. The system is already in place in Vienne through the Centrale de Civaux (the nuclear plant in Vienne – a.h.) and also for floods.