Keep that cooler cold: Listeria in deli meats

Listeria monocytogenes (L. monocytogenes) causes the third highest number of foodborne illness deaths annually. L. monocytogenes contamination of sliced deli meats at the retail level is a significant contributing factor to L. monocytogenes illness. The Centers for Disease Control and Prevention’s Environmental Health Specialists Network (EHS-Net) conducted a study to learn more about retail delis’ practices concerning L. monocytogenes growth and cross-contamination prevention.

This article presents data from this study on the frequency with which retail deli refrigerator temperatures exceed 41°F, the Food and Drug Administration (FDA)-recommended maximum temperature for ready-to-eat food requiring time and temperature control for safety (TCS) (such as retail deli meat). This provision was designed to control bacterial growth in TCS foods. This article also presents data on deli and staff characteristics related to the frequency with which retail delis refrigerator temperatures exceed 41°F.

Data from observations of 445 refrigerators in 245 delis showed that in 17.1% of delis, at least one refrigerator was >41°F. We also found that refrigeration temperatures reported in this study were lower than those reported in a related 2007 study. Delis with more than one refrigerator, that lacked refrigerator temperature recording, and had a manager who had never been food safety certified had greater odds of having a refrigerator temperature >41°F.

The data from this study suggest that retail temperature control is improving over time. They also identify a food safety gap: some delis have refrigerator temperatures that exceed 41°F. We also found that two food safety interventions were related to better refrigerated storage practices: kitchen manager certification and recording refrigerated storage temperatures. Regulatory food safety programs and the retail industry may wish to consider encouraging or requiring kitchen manager certification and recording refrigerated storage temperatures.

Food Safety Practices Linked with Proper Refrigerator Temperatures in Retail Delis


Foodborne Pathogens and Disease

Brown Laura G. , Hoover Edward Rickamer , Faw Brenda V. , Hedeen Nicole K. , Nicholas David , Wong Melissa R. , Shepherd Craig , Gallagher Daniel L. , and Kause Janell R.


Australian deli meats a microbiological worry

I look forward to the peer-reviewed paper, because PR before publishing is usually a bad idea. I also like the messaging Publix supermarkets use in the U.S.

A new study by students at Adelaide University, which will be presented this week at a Perth conference, shows hygienic food handling is not practised at many of the city’s supermarket delicatessens.

publix.deli.warningThe study found 134 out of 174 samples of various ready-to-eat deli meats bought at randomly selected supermarkets had bacterial levels that failed to meet food standards guidelines.

“Although no recognised food poisoning pathogens such as Escherichia coli or Salmonella species were found on these meats, the high bacterial count suggests that hygiene has been compromised,” said the university’s Professor Michael Reichel.

“Such out-of-control processes are also susceptible to contamination with serious food poisoning organisms.”

Sliced salami, fritz and roast pork showed the highest proportions of unsatisfactory bacterial counts.

Ham and chicken meats had lower levels of bacteria, but two-thirds of those samples still failed to meet satisfactory standards.

He said 15.5 per cent of samples showed the presence of coliform bacteria, indicating poor hygiene such as people not washing their hands after going to the toilet.

Listeria outbreak leads to warning over hospital sandwiches

Almost a month after an elderly patient died in a Northern Ireland hospital and three others were sickened from Listeria, health trusts have been advised to stop serving sandwiches from a specific food company.

Following the outbreak, the trust carried out a review of food supplier and distribution chains with the Food Standards Agency and Environmental Health.

Health Minister Edwin Poots said preliminary results of tests on sandwiches provided to inpatients indicated low levels of listeria were present although he stressed these were within the legal limits.

In response to an Assembly question on the matter, he said: “As a precautionary measure the Northern Trust decided not to serve sandwiches from a particular supplier until investigations have been completed.

In 2008, three patients died during a listeria outbreak at the Royal Victoria Hospital in Belfast.

Also in 2008, 23 people – primarily elderly – died from Listeria in Maple Leaf deli meats in Canada. Maybe the sandwiches could be heated?

Maple Leaf makes lemon-scented food safety pledge

Maple Leaf Foods, the folks who made deli-meats that killed 23 Canadians in 2008, issued a public food safety pledge yesterday.

Fearless and empathetic leader Michael McCain, speaking on behalf of the 23,500 employees of Maple Leaf Foods, said

“We have spent the last 18 months seeking the advice of the best experts in the world (and in many cases hiring them), examined every one of our previous practices, made significant improvements in all areas of food safety – testing, training and sanitization – and worked with industry and government to raise the bar.”

Maybe. But you’ve retained the worst public relations advisors and it’s going to take a lot of lemons to cleanse the stench on this pledge. Below are all the components of the frat-boy type pledge (thank you sir, may I have another) exactly as it appeared, even though it’s far too wordy, with some editorial comments from me.

*We commit to becoming a global leader in food safety. Our Chief Food Safety Officer will lead the implementation of best practices in sanitation, testing, technologies, product formulations and manufacturing, and has the authority to stop production at any plant where he believes there may be a risk to food safety.”

Awesome. Will those test results be made public?

*We commit to building a strong culture of food safety, with high performance teams, through continuous training, education and communicating results. Our people are encouraged and expected to act on any food safety concern they may have to improve our food safety practices."

Communicating results, like making listeria test results public?

Public availability of food safety testing data underpins efforts to convince a skeptical public that a product is microbiologically safe.

Yes, testing has limitations, just like restaurant inspections, but the goal should be to figure out how best to make that information available – rather than saying people can’t have it or handle it.

On Dec. 31, 2009, Beef Products Inc. took a fairly public hit when the N.Y. Times questioned the efficacy of the company’s use of ammonia as an antimicrobial treatment for ground beef.

BPI founder and chairman Eldon Roth announced in February at the National Meat Association’s annual conference that the company will post on its Web site 100 per cent of its results from the processor’s testing for E. coli O157:H7 and salmonella.

"We’re going to be 100 percent transparent," Roth told Meatingplace in an interview following the announcement. … We’re not promising to be perfect, but I will promise that we will be better.”

That’s how it’s done.

*We commit to following the highest standard of testing and analysis to identify potential risk. Any test that raises food safety concerns will result in immediate quarantine, with no products leaving the plant until the Company (why is this capitalized? Is Maple Leaf its own nation-state? — dp) and government regulatory authorities are confident that the food is safe."

Test and hold. Sorta standard.

*We commit to setting and meeting high standards and measuring our performance against the Global Food Safety Initiative standards through independent audits which will also allow us to continuously improve."

Rather than relying on some auditor waltzing through the plant now and then, why not be able to prove how ab fab Maple Leaf is at this food safety thing. Borrow a page from Cargill (and activists around the world) and install your own video cameras to have data to support food safety pledges.

In April 2009, Cargill Beef announced it had implemented a third-party video-auditing system that would operate 24 hours a day at its U.S. beef plants to enhance the company’s animal welfare protection systems. All of Cargill’s U.S. plants were expected to have the program in place by the end of 2009.

In Feb. 2010, Cargill announced its expanded remote video auditing program will monitor food-safety procedures within its 10 beef-harvest facilities in North America.

Mike Siemens, Cargill leader of animal welfare and husbandry, said,

“The early results with our animal welfare program have been terrific and we’re excited to get all the facilities up-and-running on the program. Cargill has been able to use the RVA technology to help increase an already superior compliance rate at its plants to an even higher level. In addition to the positive results on compliance rates, we have observed healthy competition among plants on performance scores, as well as a general theme of collaboration among plants on how to attack specific operational challenges. The ability to share data and video easily is extremely valuable.”

Angie Siemens, Cargill technical services vice president for food safety and quality, said,

“We’re working to eliminate the opportunity for cross-contamination. We want to have the right steps at the beginning of our process to enhance the efficacy of our intervention technologies later in the process. The major objective of the video auditing application is to design a ground-breaking program that can further reduce the E. coli and Salmonella contamination.”

*We commit to openly sharing our knowledge with industry, government and consumers, so we can learn from them and they can learn from us, in pursuit of better food safety at every step of preparation."

Your knowledge isn’t required. Data would be more meaningful. So would warning labels of some sort, especially for at-risk populations. Florida-based supermarket Publix places all of its deli-cut meats into a plastic bag that says:??

“The Publix Deli is committed to the highest quality fresh cold cuts & cheeses.
Therefore we recommend all cold cuts are best if used within three days of purchase.
And all cheese items are best if used within four days of purchase.”

*We commit to placing public interest and consumers first, by behaving in the most responsible and transparent way possible if there is ever a breach in our food safety system.”

Is that why Maple Leaf and the Canadian Food Inspection Agency set aside epidemiology and waited for confirmatory testing in an unopened package before issuing any public warning, even though local health units had already established a link with Maple Leaf products?

Maple Leaf seems to be suffering from a common affliction that strikes many institutions in decline – they believe their own PR. Actions speak so much louder than words. From the beginning in Aug. 2008, Maple Leaf should have:

• come clean on who knew what when regarding listeria testing;

• made listeria test results public;

• provided warning labels on deli meats for at-risk populations, like pregnant women and all those old people that unnecessarily died; and,

• marketed food safety efforts at retail so consumers can choose.

How long is that deli meat in the window good for? Listeria version

Listeria is a problem. And it’s not going away.

That stood out for me in the 2009 FoodNet data, providing a snapshot of foodborne barf across the U.S.

I told Elizabeth Weise in today’s The USA Today that the 19 per cent annual increase in listeriosis is in part due to the length of time people keep deli meats in refrigerators.

"Sliced deli meat is only good for two to three days." Listeria is particularly dangerous to pregnant women, young children and the elderly. It’s "a huge problem. Thirty percent of the people who get it die.

The U.S. Department of Agriculture is working on a risk assessment of deli meats, says David Goldman of the USDA’s Food Safety Inspection Service.

Those risk assessments have been around since at least 2000.

Several papers published in the latest issue of the Journal of Food Protection show that deli meats sliced – fresh – at the counter are more dangerous than the stuff bought in packages.

Endrikat, et al. note that deli meat was ranked as the highest-risk ready-to-eat food vehicle of Listeria monocytogenes within the 2003 U.S. Food and Drug Administration and U.S. Department of Agriculture, Food Safety and Inspection Service risk assessment (see, those risk assessments have been done).

“A sensitivity analysis, assessing the effect of the model’s consumer storage time and shelf life assumptions, found that even if retail-sliced deli meats were stored for a quarter of the time prepackaged deli meats were stored, retail-sliced product is 1.7 times more likely to result in death from listeriosis.”

The stuff people buy in packages is safer, because of the antimicrobials approved for use in the U.S. and because those slicers are really hard to clean.

I like that the Publix supermarket chain labels their deli meats to inform consumers that the stuff doesn’t last forever.

“The Publix Deli is committed to the highest quality fresh cold cuts & cheeses?. Therefore we recommend all cold cuts are best if used within three days of purchase?. And all cheese items are best if used within four days of purchase.”

The provision of such information did not require Congressional hearings and did not require some hopelessly-flawed consumer education campaign; it required a food safety type to say, this is important, let’s do it.

What’s it worth to barf? Not much in Canada

Chapman and I have thrown around the idea that one of the reasons Canadians seem complacent about foodborne illness – despite several high-profile devastating outbreaks – is the availability of public health care. If someone loses a kidney because of E. coli O157:H7 or a liver because of hepatitis A, the cost is borne by the system. In the U.S. those without health care coverage would be out $100,000 – at a minimum. So Canadian lawsuits are kept to a minimum, media coverage remains stagnant, and everyone goes back to sleep.

As Jim Romahn wrote in Dec. after a $27 million settlement for victims in the Maple Leaf listeria outbreak that killed 20 and sickened hundreds was announced, CEO Michael H. McCain is a wily strategist.

For $27 million, tops, he has bought freedom from a court case that could have proven highly embarrassing to Maple Leaf. The ongoing coverage could well have become the final nail in consumer confidence in Maple Leaf products. The lawyers were sure to ask who knew what and when. They were sure to ask about the degree of plant contamination as the company continued to ship products, failing to first hold them for testing and clearance.

What does that $27 million buy?

• Someone who was ill for up to 48 hours would receive $750

• Up to a week receives $3,000

•Up to two weeks receives $5,500

• Up to a month receives $8,000

• If listeriosis led to a secondary infection that didn’t cause ongoing symptoms, such as meningitis or pneumonia, the settlement is $35,000

• If listeriosis caused sustained or permanent symptoms, the settlement is $75,000 plus $750 for each day of hospitalization

• If secondary complications affected the nervous system and caused “serious and permanent impairment of physical and/or mental function,” payment is $125,000 plus $750 for each day of hospitalization. A family member who was affected psychologically could receive $10,000.

• A death would lead to a $120,000 payment to the victim’s estate. A spouse would be eligible for an additional $35,000, while children could receive $30,000, parents could receive $20,000 and siblings or grandchildren could receive $5,000. Funeral expenses up to $13,500 would also be covered.

• Anyone who “sustained psychological injuries or trauma for up to 60 days” after eating tainted meat, without any injuries, could receive up to $4,000.

• Anyone who was at particular risk, such as pregnant women and the elderly, but did not become ill could receive up to $6,000 for psychological trauma that lasted up to 60 days.

• If psychological symptoms lasted more than 60 days, compensation is set at $13,500.

• Those in the vulnerable group who experienced psychological symptoms for more than 60 days could receive $17,500.

Should deli meats carry warning labels?

Warning labels are a lousy risk management strategy, but the outbreak of listeria in Canada which has killed at least 12 and sickened dozens has had lots of lousy aspects.  So why not?

A story that is running across Canada this morning

With pregnant women and the elderly especially at risk from Listeria, the Canadian Food Inspection Agency needs to step up efforts to alert people to the hazard — perhaps going so far as to put warning labels on deli products — said University of Guelph adjunct professor Doug Powell.

What? Guess that was some stretch at Canadian content. I’m an associate professor of food safety at Kansas State University.  If I’m adjunct at Guelph, I want access to all the money that was provided to deliver news and is instead being used as some sort of room renovation fund by a department chair I never met.

The opinion piece that ran in the Toronto Star this morning was more accurate.

Michael McCain delivered a powerful and compelling apology over the weekend as authorities confirmed Maple Leaf deli meats were the likely source of food-borne illness that has killed at least six and sickened dozens.

Outbreaks of food and water-borne illness are far too common. The World Health Organization estimates that up to 30 per cent of people in so-called developed countries will suffer each and every year. That’s a lot of sick people.

But the current listeria outbreak turns statistics into stories, and challenges a company like Maple Leaf, with world-class aspirations, to do better.

The first case of listeriosis apparently surfaced in late June. Why it took the various health authorities so long to make a link remains to be uncovered.

For now, the Canadian Food Inspection Agency, Health Canada and others are providing little in the way of details regarding who knew what when.

The authorities are, however, proving unjustifiably adept at praising themselves for the speed with which they responded to the outbreak.

Two months after the first case is not an early-warning system. The political barbs that have been tossed around – which provide no insight on managing listeria – are simply embarrassing given the loss of life and illness.

McCain and Maple Leaf are better than this, and can be better:

• Issue pictures of the recalled products:

Telling people to look for products that contain the stamp "Establishment (EST) 97B" puts too much of a burden on people who just wanted to go shopping, not do homework. The U.S. Food and Drug Administration realized this, and last year started including pictures on their recall notices for products deemed to be high health risks.

Pictures aren’t superficial, they are good communication. It’s difficult for even PhD-types to wade through nine pages of recalled products, and pictures can make the connection for those who don’t always know what brands they buy.

• Warn pregnant women and others at risk from listeria in deli meats:

My wife is six months pregnant and she hasn’t had deli meats or smoked salmon or other refrigerated, ready-to-eat foods for six months.

That’s because, as Michael McCain says, the bacterium listeria is fairly much everywhere, difficult to control, and grows in the refrigerator. It also causes stillbirths in pregnant women, who are about 20 times more likely to contract the bug than other adults.

The banter in Canada about government or industry taking the lead on food inspection, whether food should be produced in large or small places, is misguided at best and more likely, political opportunism.

Long before the current outbreak, the advice from the Canadian government about listeria was mushy:

"Although the risk of listeriosis associated with foods from deli counters, such as sliced packaged meat and poultry products, is relatively low, pregnant women and immunosuppressed persons may choose to avoid these foods."

The advice from the U.S. Centers for Disease Control is clear: Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated.

It has been documented that many pregnant women are not aware of the risks associated with consuming refrigerated, ready-to-eat foods like cold cuts.

Don’t expect the bureaucrats in the Canadian government to do anything. If Michael McCain and Maple Leaf are truly concerned with public health, they could at a minimum put warning labels on their products. Maybe near the "(EST) 97B."

• Make your listeria data public:

Maple Leaf Foods spokesperson Linda Smith told CTV Newsnet Friday, officials at the plant are "… constantly looking for it (listeria), constantly swabbing and looking for it."

Smith said the equipment at the plant is sanitized every day and officials take about 3,000 swabs per year. The plant also has a microbiologist on site.

"This plant has an excellent food safety record, excellent inspection record, excellent external auditors. We’ll never know exactly how it got here."

But you do have 3,000 samples per year. If Maple Leaf really wants to restore public confidence, release the listeria data. How many positives does the Toronto plant see in a year? Were there positives leading up to the initial Aug. 17 recall? If there were no positives, why not? What is the protocol when a positive is discovered?

Consumers can handle more, not less information about the food they eat.

Maple Leaf Foods has the unfortunate opportunity to set new standards for consumer confidence.

Douglas Powell of Brantford is an associate professor of food safety at Kansas State University.

Michael McCain of Maple Leaf: Should pregnant women eat deli meats?

There’s been an outbreak of babies amongst the food safety stalwarts in my lab. Katija delivered in June, Ben’s gonna be a daddy next month, and me, trying to keep up with the cool kids, at the end of November.

Michael McCain, the president and CEO of Maple Leaf Foods, seems sincere enough
. He said yesterday that listeria is "pervasive" adding that,

"It (Listeria) is virtually impossible to eradicate in its entirety. It exists in plants, in supermarkets, potentially in your kitchen.”

That’s true. And deli meats and other refrigerated ready-to-eat foods like smoked salmon are particularly good sources of listeria.

Back in May, U.K. environmental health officers from 42 local authorities purchased 1,127 samples of sliced-at-the-counter cooked meats from food retailers including butchers, delicatessens, market stalls and supermarkets.

Laboratory tests found that 15 per cent of the samples were contaminated with low numbers of listeria on the day of purchase, while 7.3 per cent were contaminated with Listeria monocytogenes, the more serious form of listeria.

Although these were within European Food Safety Standards, when the contaminated samples were tested again after storage for 48 hours in a refrigerator, the L. monocytogenes in some of the contaminated samples had multiplied to unsafe levels.

In July, 2008, health types in Ireland warned pregnant women to avoid ready-to-eat, refrigerated and processed foods, such as soft cheeses, cold cuts of meat, pates and smoked fish after an increase in pregnancy-related listeriosis.

A Dec. 2007 review of listeria in pregnancy states,

“One of the most important changes during pregnancy is the down-regulation of the cellular immune system. Because the fetus is genetically different from the mother, the body treats it as a graft. To prevent the maternal immune system from rejecting the fetus, cell-mediated immunity must therefore be suppressed during pregnancy. This is favored by high levels of progesterone. However, reduced cell-mediated immune function leads to increased susceptibility of the woman and her fetus to infections by intracellular pathogens such as Listeria monocytogenes. That is why pregnant women are 20 times more at risk of contracting listeriosis than are other healthy adults. Pregnant women account for 30% of all cases of listeriosis and 60% of cases among persons 10 to 40 years of age.

“Typically, systemic infection occurs most frequently after ingestion of food contaminated with L monocytogenes. The bacteria cross the mucosal barrier of the intestine, probably aided by active endocytosis of organisms by epithelial cells. Once in the bloodstream, bacteria spread to different sites, but they have a particular affinity for the central nervous system or placenta. While circulating, the bacteria are internalized by macrophages and other plasma cells and are thereafter spread cell-to-cell through phagocytosis. As a result, antibodies, complement, and neutrophils become unable to protect the host.”

And that’s why 6-months pregnant Amy hasn’t touched a deli product in over six months. But most women don’t know this. Neither do a lot of doctors or health professionals. During one of our prenatal visits, I asked the aid if there were any foods pregnant Amy should be avoiding.

She said, “no, not really.”

I specifically asked about deli meats.

She said, “Get the deli meat from the counter cause it’s fresher than the pre-packaged stuff.”

She didn’t know about listeria. Most people don’t. Researchers reported in the Australian and New Zealand Journal of Health that in a survey of 586 women attending antenatal clinics in one private and two major public hospitals in New South Wales between April and November 2006, more than half received no information on preventing Listeria.

So, Michael McCain, I know what I’d tell my wife or any other pregnant woman. What would you tell a pregnant woman about deli meats? Would you be willing to put a health advisory on the back of the package?

Deli meats sliced at the deli counter should be consumed within 2 days

The grocery store is my laboratory — or at least part of it.

I often find myself loitering around the deli counter, watching people order pound after pound of sliced roast beef or shaved turkey breast.

At one point a few years ago, I began chatting with one of the customers and politely commented that was a lot of deli meat she was ordering (really, there was a polite context).

She replied it was sandwiches for the kids for the next two weeks.


Yesterday, the Liverpool Daily Post reported U.K. environmental health officers from 42 local authorities purchased 1,127 samples of sliced-at-the-counter cooked meats from food retailers including butchers, delicatessens, market stalls and supermarkets.

Laboratory tests found that 15 per cent of the samples were contaminated with low numbers of listeria on the day of purchase, while 7.3 per cent were contaminated with Listeria monocytogenes, the more serious form of listeria.

Although these were within European Food Safety Standards, when the contaminated samples were tested again after storage for 48 hours in a refrigerator, the L. monocytogenes in some of the contaminated samples had multiplied to unsafe levels.

The tests were carried out at a fridge temperature of six degrees centigrade. However, many domestic fridges are warmer than this, allowing L. monocytogenes to grow faster.

Hugh Lamont, communications manager for the Health Protection Agency North West, said

“We are anxious to ensure that we do not create a scare around freshly sliced cooked meats. We are not saying that people should not buy or eat them, but rather that they should follow ‘use by’ advice where it is given – and consume the products within 48 hours where it is not. We are also reminding food retailers of the advice they should give to customers.”

The U.S. Centers for Disease Control recommendations for persons at high risk from listeria, such as pregnant women and persons with weakened immune systems, includes:

-Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot

-Avoid getting fluid from hot dog packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats

-Do not eat soft cheeses such as feta, Brie, and Camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela, unless they have labels that clearly state they are made from pastuerized milk

-Do not eat refrigerated pâtés or meat spreads. Canned or shelf-stable pâtés and meat spreads may be eaten

-Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.

The USDA risk assessment for listeria is ready-to-eat foods is available at

and one from the World Health Organization is at