Public health protects public health; if people got sick we wouldn’t be doing our job

Posted on January 25, 2012 by Douglas Powell

RiverStone Health in Montana was criticized last month when it raised concerns about a man who wanted to make Christmas dinner in his family’s kitchen and deliver the meals to shut-ins.

Health officials say they were only doing their job.

“Let’s imagine the unimaginable,” said RiverStone Health CEO John Felton. “Suppose 35 people got salmonella. What would the question of RiverStone Health have been at that point? We would not have been the Grinch who stole Christmas. We would have been the folks who allowed 35 people to get sick because we didn’t execute our responsibility.”

RiverStone objected to Cody Walter, owner of Delivery 2u, using private kitchens to prepare and distribute food. RiverStone provided Walter with information on food safety. They also identified a number of commercial kitchens so the holiday meals could be prepared in a facility equipped to safely store and prepare the food and milk donations he was receiving.

Walter said he was “shut down” and suggested the Grinch had stolen Christmas.
Public sentiment overwhelmingly sided with Walter.

“What needs to be clear is that we don’t have any interest whatsoever in preventing churches, nonprofit organizations and others from doing the good they do in the community,” Felton said. “Our compelling interest is to protect the safety and health of the public. What we don’t want is to have a bunch of people get sick because we didn’t provide the information they need.”

RiverStone Health employs nine registered sanitarians, six of whom are involved in food inspections. In fiscal year 2011, they conducted 1,750 unannounced inspections in 1,000 licensed establishments. The number of inspections does not include temporary events such as Christmas Stroll, Saturday Live and the Strawberry Festival.

“Cody Walter was doing a good thing,” Felton said. “If we would have had advanced notice we could have worked closely with him. We don’t want to discourage people from doing those types of things. He seems like a good-hearted guy, but there is a huge difference between cooking for five people and cooking for 50 and then delivering it.”

Walter said he understands now that RiverStone Health was only trying to protect him as well as those to whom he would deliver meals. “There are no hard feelings. They were only doing what they should be doing,” he said. “They are there for a reason.”

Poopy nuts update; public health hopeless at straight talk

Posted on April 8, 2011 by Douglas Powell

I generally buy walnuts in a plastic bag, already shelled. Once home, they go into a glass container where I’ll grab a few while puttering in the kitchen, or toss some on a salad, or into Amy’s oatmeal cookies or fiber-brownies (right, displayed this morning by daughter Sorenne).

When the E. coli O157:H7 outbreak in walnuts was first announced, early on April 4, 2011, the Canadian Food Inspection Agency said people were sick but wouldn’t say how many while fingering walnuts imported from California and imported by Amira Enterprises of St. Laurent, Quebec as the suspected source.

Later on April 4, 2011, the Public Health Agency of Canada issued its own statement, saying 13 were sick and that “consumers who have raw shelled walnuts in their home can reduce the risk of E. coli infection by roasting the walnuts prior to eating them. Consumers should place the nuts on a cooking sheet and bake at 350°F for 10 minutes, turning the nuts over once after five minutes.”

Sorenne won’t be doing that.

At the time I noted this advice does not account for the risk of cross-contamination with a virulent pathogen and that my microbiology friends look forward to testing it out.

On April 7, 2011, Quebec health types confirmed the death of one person linked to the walnuts and a spokesthingy said, "The Canadian Food Inspection Agency has serious doubts as to whether the infections are related to walnuts, but it’s the most probable source.”

(Are you getting a sense of how well single-food inspection agencies work?)

Late last night, PHAC issued another statement, saying there were 14 people sick in Quebec, Ontario and New Brunswick, including 10 hospitalizations, 3 cases of hemolytic uremic syndrome, and one death.

The PHAC statement emphatically states:

“If you have these products in your home, don’t consume them.”

But then goes on to less emphatically state,

“Until further notice, consumers who have raw shelled walnuts in their home can reduce the risk of E. coli infection by roasting the walnuts prior to eating them. Consumers should place the nuts on a cooking sheet and bake at 350°F for 10 minutes, turning the nuts over once after five minutes. Wash your hands and cooking utensils thoroughly after handling the walnuts.”

So PHAC added a washing recommendation in recognition of cross-contamination risks.

This is sorta hopeless. Throw any suspect walnuts out and don’t underestimate the risk of cross-contamination.

PHAC then ritually stated how people should cook meat to the proper internal temperature, wash fresh fruits and vegetables before eating them, clean counters and cutting boards and wash your hands regularly.

Sorenne wonders what this has to do with walnuts.

Public Health Agency of Canada, with all your salaries and collaborating bureaucrats, why are you so terrible at talking about food safety (see anything related to PHAC and listeria, 2008).

Consumers are not the critical control point (CCP) for walnuts sitting in a jar at home.

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

Posted on January 21, 2011 by Douglas Powell

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.

Woman’s arm, hand become stuck in mixer at pretzel shop

Posted on November 23, 2010 by Douglas Powell

This is unfortunate, and gross, and it’s often the job of public health types to clean up the mess.

mycentraljersey.com is reporting that a 35-year-old borough woman was airlifted to a local hospital after her hand became stuck in a dough twister at Jim’s Pretzels on S. Main Street.

Police Chief Mark Peltack said the incident happened at 10:53 a.m. Monday when local resident Loretta Jones, an employee at the establishment, had been attempting to make pretzels. Peltack said it took rescue-squad workers a short amount of time to release her hand from the machine.

Jones was then airlifted via state police helicopter to Robert Wood Johnson University Hospital in New Brunswick. Jones was listed in fair condition at the hospital late Tuesday afternoon.

At the shop, there are various sizes and types of pretzels, an assortment of dips and pretzels wrapped around sausages and hot dogs. The shop also is known for its catered events, in which the store makes platters of pretzels nuggets and five dips, such as spicy or hot mustard; cheddar or nacho cheese; and sweet cream cheese.

Florida not inspecting food at hospitals, nursing homes

Posted on July 31, 2010 by Douglas Powell

In a few weeks we’ll be leaving for a month of seaside (Gulf-side) writing in Florida.

As food safety dude and axman Roy Costa has pointed out, I sure hope I don’t end up in a Florida hospital, because no one is doing food inspections.

The Department of Health told Associated Press yesterday it’s working with other agencies to figure out who will handle inspections at the state’s 286 hospitals and 671 nursing homes. Meanwhile, the Department of Children & Families is temporarily taking over the inspection of day-care centers, which were also part of the cuts.

The health department had been inspecting facilities four times a year until Gov. Charlie Crist signed a bill (HB 5311) stopping them. Experts say people at these facilities are the most vulnerable for foodborne illnesses.

DCF Secretary George Sheldon said his agency decided to fill the gap at day cares and will temporarily oversee inspections because “it was the right thing to do.”

DCF employees already inspect day-care facilities for safety issues. Sheldon said the Legislature was trying to consolidate inspections to prevent multiple state agencies from visiting the same facilities to inspect different standards.

The health department inspected more than 15,000 day-care centers last year, finding nearly 12,000 violations, including food from unsafe sources, poor hygiene and contaminated equipment.

I don’t really care who inspects as long as there is accountability in the system through — at a minimum — public availability of results and mandatory training for anyone who handles and prepares food.

Cause of Florida woman’s near-fatal food illness a mystery; exposes failures in system

Posted on June 24, 2010 by Douglas Powell

The Palm Beach Post reports this morning that Amber Dycus, 38, of Loxahatchee, Florida, went to the hospital after four days of illness. The doctors told her she was in acute kidney failure, hours from death. She endured six days of intensive care, multiple blood transfusions and, so far, 196 bags of plasma.

There are more treatments to come, and no signs yet that her kidney function is approaching normal. She feels lucky to be alive, but also very afraid – afraid of eating out, afraid of catching germs, afraid of never getting better.

Dycus desperately wants to know what did this to her. Her lawyer, Craig Goldenfarb, thinks the public ought to feel the same way.

A health department inquiry has resulted in the brief closure of a Royal Palm Beach restaurant where Dycus often ate. Inspectors found roaches, improper food temperatures, slime in the freezer and a dishwasher with almost no sanitizer in it. After a thorough cleaning and a tuneup on the dishwasher, the restaurant, Hilary & Sons, has reopened.

But was it really the source of her illness? A series of missed opportunities, miscommunications, delays, and no small measure of scientific uncertainty means there may never be a conclusive answer.

At Palms West last month, Dycus was diagnosed with hemolytic-uremic syndrome. It’s an often fatal condition that happens when toxins cause red blood cells to shear apart and clog capillaries, shutting down the kidneys and leading to a buildup of waste in the blood.

It’s associated with outbreaks of dangerous E.coli O157 food poisoning.

Normally, when E.coli O157 is suspected, the health department is notified immediately, so that a public health investigation can be launched.

Dycus said her doctors told her she must have eaten contaminated beef. She’s grateful to them, and the nurses at Palms West, whom she says saved her life. But one thing they did not do was notify health authorities. A spokeswoman for Palms West said she could not comment.

It wasn’t until Dycus contacted a lawyer, and her lawyer called the media, that a health inquiry began. By then, a month had passed, the foods Dycus had eaten had long since disappeared, and the ability to tell exactly what sickened her had become nearly impossible to discern.

Courtesy Nailsea Court

Food inspection vs. investigation

Posted on February 18, 2010 by Douglas Powell

Allen Mozek, M.P.H., Supervising Food Inspector, New York State Department of Agriculture & Markets, writes in this contribution to barfblog.com that,

I find that food inspectors in all regulatory agencies have a tendency to confuse their inspection techniques with their investigative techniques. This results in lost evidence (primarily food samples) to prove the cause of a foodborne illness.

A little background…

The spirit of public health and food inspection is education and prevention. Food inspectors are allowed access without a warrant because they are looking for compliance, whereas police officers are denied access without a warrant because they are looking for evidence. This difference in emphasis on compliance versus evidence gathering reflects a difference in approaches. Evidence is gathered during routine inspection, but a food inspector’s initial expectations are compliance (or so says public health law).

Unfortunately, the daily emphasis on education and prevention creeps into investigations of foodborne disease. I say "creep" because I suggest that the habit of educating prevents inspectors from finding the evidence necessary to solve cases.

Once a case is reported, an inspector should be gathering evidence and
no longer educating at the expense of "showing your hand" or otherwise
reveal too much information. I think it’s about changing gears from an
inspection mentality to an investigation mentality — the two are very
different.

5 sick, 1 dead in new listeria outbreak in Canada

Posted on September 22, 2009 by Douglas Powell

Canadian health types can’t seem to decide whether to go public with bad health news or whether to do it just enough to cover their asses afterwards.

A press release showed up on the Public Health Agency of Canada web site dated 21.sep.09 but it didn’t show up in any of the other notification systems like e-mail or RSS feeds. No media has picked it up. Phyllis Entis of e-food alert noticed it, so good.

The Public Health Agency of Canada (PHAC) is working with provincial and local health authorities, Health Canada and the Canadian Food Inspection Agency (CFIA) to investigate cases of Listeria monocytogenes in Canada.

Currently, there are six cases under investigation. The six cases were caused by the same strain of Listeria monocytogenes. This strain is relatively common and it is unknown whether or not these cases are connected to the same source.

Investigation is ongoing to determine the possible cause of illness in each individual case, and to determine if there is a common source for the infections.

One of the cases has died, and listeriosis contributed to this death. … However, most healthy people exposed to Listeria are at very low risk of being affected by the bacteria.

Why do bureaucrats insist on saying listeria is low risk? I’m sure it doesn’t feel low-risk to the sick people and dead person. Just report what is being done.

Underground restaurants in St. Louis: how bored are Americans?

Posted on May 4, 2009 by Douglas Powell

Food pornography is nothing new. Neither are so-called underground restaurants. That the St. Louis Post-Dispatch thinks both may be new and newsworthy may help explain the decline of American newspapers (and look at that cool arm decal in this pic from the Post, right, below).

Although underground restaurants have been popping up around the country for several years, this incarnation, launched last summer, appears to be the first of its kind in St. Louis.

Diners learn about an upcoming monthly dinner only through word of mouth. They sign up on a website using a pass code. On the day of the dinner, they get an e-mail telling them where to go. Sometimes it’s a private house; other times, it’s a rented space. …

Health department officials in the St. Louis area say underground restaurants violate health codes because they lack the proper inspections and permits.

"Even if a church sets up a buffet for a charity event, they need a permit," said Craig LeFebvre, a spokesman for the St. Louis County Health Department.

If someone invites friends to a private dining event in St. Louis County, they’re not violating any laws. But if they put up any signs — including a website — and the event is open to a paying public, they need a permit, explained Gerrin Cheek Butler of the county’s health department.

The chef, who asked not to be identified, said,

"The whole thing is an experience. It’s not just this consumer thing, where you show up, order, and get pushed out the door an hour later."

Correct. It’s a way to charge a premium for porn.

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