Les Nessman explains how to talk about continuing leafy green outbreaks

A romaine lettuce task force was organized by the industry in December to help prevent future outbreaks, said Jennifer McEntire, vice president of food safety and technology for the United Fresh Produce Association.

The task force has representation from all types of growing operations from different growing regions, she said.

One primary focus of the task force is preventing outbreaks by looking at root cause analysis, she said.

A table of leafy green-related outbreaks – at least 80 since 1995 – is available here.

But Les Nessman gets to the heart of this political process — in 1978:

Risk communication sucks, everyone needs innovative food safety stories

Consumers in most developed countries have greater access to safer food than ever before, yet the issue of consumer perception on the safety of the food supply, the control infrastructure and existing and new process technologies is often not positive.

A series of high profile food incidents, which have been ineffectively managed by both the regulators and the industry, and where there has been a failure to be open and transparent, have sensitised a proportion of consumers to scary stories about the food supply. There has been concomitant damage to consumer confidence in (i) the safety of food, (ii) the food industry’s commitment to producing safe food and (iii) the authorities’ ability to oversee the food chain.

Threats to consumers’ health and their genuine concerns have to be addressed with effective risk management and the protection of public health has to be paramount.

Dealing with incorrect fears and misperceptions of risk has also to be addressed but achieving this is very difficult. The competencies of social scientists are needed to assist in gaining insights into consumer perceptions of risk, consumer behaviour and the determinants of trust.

Conventional risk communication will not succeed on its own and more innovative and creative communication strategies are needed to engage with consumers using all available media channels in an open and transparent way. The digital media affords the opportunity to revolutionise engagement with consumers on food safety and nutrition-related issues.

Moving from risk communication to food information communication and consumer engagement

Wall, P. G., & Chen, J. (2018). Moving from risk communication to food information communication and consumer engagement. Npj Science of Food, 2(1). doi:10.1038/s41538-018-0031-7

https://www.researchgate.net/publication/329324755_Moving_from_risk_communication_to_food_information_communication_and_consumer_engagement

It’s explained by shit in irrigation water: Santa Barbara farm first fingered with outbreak strain of E coli O157 in Romaine lettuce that sickened 59 in US, 28 in Canada: Tumble those dice

Welcome to Washington, D.C., Frank, and government PR.

On Nov. 20, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention warned the American public of a multi-state outbreak of E. coli O157:H7 linked to romaine lettuce and advised against eating any romaine lettuce on the market at that time.

According to FDA Commissioner Scott Gottlieb, M.D. and FDA Deputy Commissioner Frank Yiannas, we  have new results to report from this investigation tracing the source of the contamination to at least one specific farm. Based on these and other new findings, we’re updating our recommendations for the romaine lettuce industry and consumers.
Today, we’re announcing that we’ve identified a positive sample result for the outbreak strain in the sediment of a local irrigation reservoir used by a single farm owned and operated by Adam Bros. Farms in Santa Barbara County.

The FDA will be sending investigators back to this farm for further sampling. It’s important to note that although this is an important piece of information, the finding on this farm doesn’t explain all illnesses and our traceback investigation will continue as we narrow down what commonalities this farm may have with other farms that are part of our investigation. While the analysis of the strain found in the people who got ill and the sediment in one of this farm’s water sources is a genetic match, our traceback work suggests that additional romaine lettuce shipped from other farms could also likely be implicated in the outbreak. Therefore, the water from the reservoir on this single farm doesn’t fully explain what the common source of the contamination. We are continuing to investigate what commonalities there could be from multiple farms in the region that could explain this finding in the water, and potentially the ultimate source of the outbreak.

As of Dec. 13, our investigation yielded records from five restaurants in four different states that have identified 11 different distributors, nine different growers, and eight different farms as potential sources of contaminated romaine lettuce. Currently, no single establishment is in common across the investigated supply chains. This indicates that although we have identified a positive sample from one farm to date, the outbreak may not be explained by a single farm, grower, harvester, or distributor.

At the same time, the U.S. Centers for Disease Control updated its warning to advise U.S. consumers to not eat and retailers and restaurants not serve or sell any romaine lettuce harvested from certain counties in the Central Coastal growing regions of northern and central California. If you do not know where the romaine is from, do not eat it.

  • Some romaine lettuce products are now labeled with a harvest location by region. Consumers, restaurants, and retailers should check bags or boxes of romaine lettuce for a label indicating where the lettuce was harvested.
      • Do not buy, serve, sell, or eat romaine lettuce from the following California counties: Monterey, San Benito, and Santa Barbara.
      • If the romaine lettuce is not labeled with a harvest growing region and county, do not buy, serve, sell, or eat it.
      • The Public Health Agency of Canada has identified ill people infected with the same DNA fingerprint of E. coliO157:H7 bacteria in Canada.

‘Something is going on’ Salmonella Typhimurium infections in France jump from 50 to 2500 per year in a decade

(As usual, something may be lost in translation)

Salmonella contamination, found in cold cuts, mainly pork, exploded in 10 years in France, because of the progression of a new strain, called “monophasic typhimurium variant”.

(I particularly like the graphic, right, of the pregnant woman, with five bottles of wine in the fridge and a couple of beers).

On October 30th, lots of dry sausages contaminated with this salmonella were removed from supermarket shelves. Withdrawals and recalls have already taken place in the spring, on sausages that had sickened a dozen young children in the south of France. Dry sausages were also concerned.

Dr. François-Xavier Weill, director of the national center of reference for Salmonella, at the Institut Pasteur, at the origin of this discovery with his teams . It is here, in Paris, that the bacteria are identified, after analysis of the samples sent by the analysis laboratories. This is how the rise in food infections has been spotted.

“While it was detected that about 50 in 2007, we are at 2500 per year now,” says François-Xavier Weill. As a result, this bacterium, which causes gastroenteritis and fever, which can reach sepsis in the most fragile, has risen to the third position of salmonella, which gives the most poisoning. “We sounded the alarm, we said we’re paying attention, something is happening”. 

“Manufacturers must continue their work to limit the risks of the farm to the fork, explains Nathalie Jourdan-da Silva, doctor epidemiologist at Public Health France, agency that gave the alert in 2012 in one of its publications. But there is no risk zero, especially since this salmonella, identified in the swine industry, has since expanded to the beef sector. 

And the father of Amy’s French family was in Paris the other day, and he looked up and saw Charlie Watts, the drummer for the Rolling Stones, so this song is in honor of the time the Stones moved to southern France as tax exiles from the UK and recorded Exile on Main Street.

Surveys still suck: How likely would you go back to a restaurant involved in a foodborne illness outbreak

This study reports an investigation of the determinants of the likelihood consumers will revisit a restaurant that has had a foodborne illness outbreak, including the moderating effects of restaurant type and consumer dining frequency.

A scenario-based survey was distributed via Amazon’s Mechanical Turk to collect data from 1,034 respondents; the tally of valid responses was 1,025. Partial least squares-based structural equation modeling (PLS-SEM) showed perceived vulnerability and perceived severity to be statistically significant; both also negatively affected customer intentions to patronize restaurants cited for serving foods that caused foodborne illness outbreaks.

Results suggest that type of restaurant is a significant moderator between perceived severity and customer intentions. The type of diner, however, based on frequency, does not moderate the relationships between perceived severity and perceived vulnerability and customer intentions to patronize restaurants that served food causing a foodborne illness outbreak (FBI).

Using protection motivation theory (PMT) (Rogers, 1975), this study’s findings contribute to understanding determinants and moderators of customer intentions to revisit restaurants after a foodborne illness outbreak.

Consumers’ return intentions towards a restaurant with foodborne illness outbreaks: Differences across restaurant type and consumers’ dining frequency

Food Control

Faizan Ali, Kimberly J. Harris, Kisang Ryu

DOI : 10.1016/j.foodcont.2018.12.001

http://m.x-mol.com/paper/921130

Food Safety Confessional: Sheila says she is horrible

Sheila is a former MSc student with me at Kansas State University and a tough military chick. We hardly ever saw each other, because phones and the Internet sometimes work (despite administratium claims to the contrary), but she has kept up the food safety conversation. I was privileged to work with her and a whole bunch of other military food safety folks over the years.

Sheila writes:

I am a horrible food safety professional.  

Not at work. At work I’m a straight-laced, all business, don’t-you-dare-break-the-rules-or-I’ll-kick-you-in-the-nuts kinda girl.  My problem is outside of work.  When I’m off the clock I turn into Andrew Zimmern’s sister by another mister.  I like to eat weird stuff.  

I spent 15 years with the U.S. Army as a Food Safety Specialist and got to travel all over the world.  While others in the group were sticking to main stream chow hall fare and MREs, which has its own dangers, I was happy to find some random vendor selling mystery meat on a stick by the side of the road.  It might have been dog, or monkey, or bat, or rat.  I really have no idea, but it sure tasted good.  Boiled chicken heads?  Roasted sparrows?  Camel on a spit?  Beaver tater tot hotdish?  A whole sheep buried in the desert sand for 2 days?  Hell yeah, bring it on!  From Africa, Australia, Central America, the South Pacific, the Arctic, the Middle East and the Far East, it didn’t matter where I was I had to try the odd local fare.  Still do when I travel.  Real haggis is amazing.

Back at home, cooking for myself or eating out, I am also bad.  When cooking for others all safety precautions are followed, thermometers, separate cutting boards and utensils for different food types, obsessive hand washing, but I make all kinds of exceptions when food is just for me.  E. coli and Salmonella be damned.  My eggs need to be over medium. Scrambled eggs are gross.  I eat raw, homemade cookie dough.  I love homemade eggnog.  Don’t give me that store bought boxed crap that tastes like nutmeg infused cardboard.  Now if I could find pasteurized eggs in the shell, I’d use them, but out in the Minnesota tundra they just aren’t available.  I like my steak on the rare side of medium rare, even if it is needle tenderized.  Hamburgers done medium.  Sushi is a favorite food and I go for raw and roe.  Raw oysters are a heavenly treat.   

But here’s the deal.  I know the potential consequences of eating all of these risky foods.  I am generally healthy, aside from the arthritis and anger issues the Army so generously gave me.  I realize healthy people still get food poisoning, but I am willing to occasionally take that risk to enjoy certain foods.  I would never force anyone else to do what I do and I often tell people not to do it and why. 

Do as I say, not as I do. 

And even I have limits.  Chicken must be cooked to 165F.  I don’t drink raw milk.  I rant about the raw pet food trend.  And I avoid potlucks like the plague.  I’m sure it all tastes great, but I just can’t do it.  I don’t trust what most people do in their kitchens unless I’m there to see it.  If invited to a party that’s potluck and I can’t get out of it, I bring potato chips and eat before I get there.  Weird right?  

Oh, and I have 12 beautiful pet snakes of varying sizes and species, but that’s another story.  

Our church is the arena, our religion is hockey, so we don’t educate, we inform

Consumers in most developed countries have greater access to safer food than ever before, yet the issue of consumer perception on the safety of the food supply, the control infrastructure and existing and new process technologies is often not positive.

A series of high profile food incidents, which have been ineffectively managed by both the regulators and the industry, and where there has been a failure to be open and transparent, have sensitised a proportion of consumers to scary stories about the food supply. There has been concomitant damage to consumer confidence in (i) the safety of food, (ii) the food industry’s commitment to producing safe food and (iii) the authorities’ ability to oversee the food chain.

Threats to consumers’ health and their genuine concerns have to be addressed with effective risk management and the protection of public health has to be paramount. Dealing with incorrect fears and misperceptions of risk has also to be addressed but achieving this is very difficult. The competencies of social scientists are needed to assist in gaining insights into consumer perceptions of risk, consumer behaviour and the determinants of trust.

Conventional risk communication will not succeed on its own and more innovative and creative communication strategies are needed to engage with consumers using all available media channels in an open and transparent way. The digital media affords the opportunity to revolutionise engagement with consumers on food safety and nutrition-related issues.

Moving from risk communication to food information communication and consumer engagement

Npj Science of Food 2

Patrick Wall and Junshi Chen

https://www.nature.com/articles/s41538-018-0031-7

Puking Veronica: The real indicators of a Norovirus outbreak in a university residence

Been there, done that.

Chapman wrote this back in 2009

Brae Surgeoner, Doug and I had a paper published in the September 2009 Journal of Environmental Health about some research we conducted in the Winter of 2006. The study came about because a whole bunch of kids in the University of Guelph’s residence system started puking from an apparent norovirus outbreak. There were lots of handwashing signs up and we wanted to know whether they changed hygiene behavior (especially if kids were using the tools available when entering the cafeteria). Turns out that the kids weren’t doing as good of a job at hand hygiene as they reported to us.

NC State’s press release is below (the Kansas State release is here):

As public health experts warn of potential widespread outbreaks of H1N1 flu this school year, a new study from North Carolina State University shows that students do not comply with basic preventative measures as much as they think do. In other words, the kids aren’t washing their hands.

“Hand washing is a significant preventative measure for many communicable diseases, from respiratory diseases like H1N1 to foodborne illness agents, such as norovirus,” says Dr. Ben Chapman, assistant professor of family and consumer sciences and food safety extension specialist at NC State. The new study, which examined student compliance with hand hygiene recommendations during an outbreak of norovirus at a university in Ontario, finds that only 17 percent of students followed  posted hand hygiene recommendations – but that 83 percent of students reported that they had been in compliance. Norovirus causes gastrointestinal problems, including vomiting and diarrhea. Every year there are 30 to 40 outbreaks of norovirus on university campuses, affecting thousands of students.

Chapman, who co-authored the research, says this is the first study to observe student hygiene behavior in the midst of an outbreak. Previous studies examined self-reporting data after an outbreak – and the new research shows that the self-reporting data may be inaccurate.

“Typically, health officials put up posters and signs and rely on self-reporting to determine whether these methods are effective,” Chapman says. “And people say they are washing their hands more. But, as it turns out, that’s not true.

“The study shows that while health authorities may give people the tools we think they need to limit the spread of an outbreak, the information we’re giving them is not compelling enough to change their behavior. Basically, it doesn’t work. But we do it again with every outbreak, and we’re doing it now with H1N1.”

Chapman says the study shows that health officials need to target specific audiences, such as students in a particular dorm or who eat at a particular cafeteria, and tailor their information to those audiences. For example, telling them where the nearest washrooms are, or pointing out where hand sanitizer units are located. “The more specific the information is for an audience, the better off you are,” Chapman says.

Chapman adds that health authorities also need to use language appropriate to their target audience. “For example, don’t refer to something as a ‘gastrointestinal illness,’” he says, “instead, tell them ‘this could make you puke’ or ‘dude, wash your hands.’ The idea is to craft compelling messages that create discussion in that audience. Make them talk about it.”

Chapman also says that health officials should take advantage of social media, such as text messaging and Facebook, to raise awareness. “If your audience consists of students,” he explains, “you should use media that students use.

“Campuses need to expect outbreaks will happen and plan accordingly. Have the response tools in hand.”

The study, “University Students’ Hand Hygiene Practice During a Gastrointestinal Outbreak in Residence: What They Say They Do and What They Actually Do,” was co-authored by Chapman, Dr. Douglas Powell of Kansas State University and Brae Surgeoner, a former graduate student at the University of Guelph. The study was published in the September issue of the Journal of Environmental Health.

Lacey Burkholder, Katherine Allensworth, Haley Schaffter

https://ideaexchange.uakron.edu/cgi/viewcontent.cgi?article=1815&context=honors_research_projects

Illness contributes to a decrease in student class attendance which can lead to increased academic stress. Decreasing the spread of illness among those living in residence halls is essential to academic success. The purpose of this systematic review was to identify interventions implemented in residence halls on college campuses to reduce the spread of illness. The PICO question directing the research for this study asks, “How do interventions affect the spread of illness in university residence hall populations?”. The research conducted was completed by means of a systematic review of literature including 20 peer reviewed articles published between 1999-2017 from the databases CINAHL Plus, PsychInfo, and PubMed. Findings from this review revealed a focus on three interventions used to decrease illness among college students living in residence halls: (1) hand washing, (2) lifestyle initiatives, and (3) education. Of the three, hand washing and educational measures were found to decrease the spread of illness, while lifestyle initiatives were found to have no direct correlation to the spread of illness.

Can you hear me know? The new holiday tradition: Searching for recalls and outbreak information

Longtime friend of the barfblog.com, Michéle Samarya-Timm, health educator at the Somerset County Department of Health (that’s in New Jersey, represent) writes:

Baking pumpkin pies with Aunt Kay’s secret recipe.  Watching Miracle on 34th Street.  Preparing the dining room with the good china.  Diffusing political conversations at the dinner table. 

Some traditions give a sense of warmth, connection, and continuity, and regularly define a family’s holiday. Unfortunately, there is now a need to add an additional tradition to the season – actively checking for foodborne outbreaks and recalls to prevent folks from getting sick.

 Last week, on Tuesday, November 20th at 2pm, (two days before Thanksgiving), the CDC posted a media statement with advice to consumers, restaurants, and retailers: 

 “CDC is advising that U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until we learn more about the outbreak.”

 The need to release such a notice, right before a major holiday is an unpropitious scenario.  It was also very concerning in its specificity to consumers, retailers and restaurants:

“Wash and sanitize drawers or shelves in refrigerators where romaine was stored.”

Such an alert is most effective if it reaches the intended audiences.   Folks at my holiday table did not hear about the outbreak.  Neither did many local health departments.

Issuing media releases is one way for public health agencies to reach large groups of people. However, distracted by holiday preparations, travel, shopping, family, football and bad weather this advisory was only partially disseminated to the public. A person had to be following news outlets or social media to receive timely notice. I heard about the recall from the woman next to me while I was getting a haircut – not from the CDC or FDA, or any other federal or state agency.   

 It’s disturbing. The CDC could have sent this info directly to local health departments, or notify them that a news release was issued. This was not the first time as a local public health official that I received delayed – or no – official communication about a national foodborne issue.

Local public health professionals rely on communications systems established by federal and state oversight agencies. Most commonly, if a verified or suspect foodborne contamination or outbreak has occurred, the Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture, or the U.S. Food and Drug Administration (FDA) will ascertain the appropriateness of information release. If this information is deemed credible, notification is forwarded individually or en masse to state departments of health. The states, in turn, push this information down to local regulators. Each step in the process contains elements that may delay the rapid dissemination of outbreak information. The ability and willingness of all stakeholders to quickly and readily share incident particulars with fellow responding agencies can enhance effectiveness and amplify response efforts.

Electronically sending this advisory directly to the nearly 3,000 local health departments in the US would provide the opportunity for hundreds of health inspectors, health educators, epidemiologists and other to reach the hospitals, food banks, schools, mom and pop establishments and local residents who may not have otherwise received the alert. This was a missed opportunity, and hopefully one that didn’t cause additional cases of illness.

As I’ve written before, coordinated communication strategies within and between public health agencies is less robust than it should be. As a result, state and local public health officials may hear about foodborne disease issues first from other sources, such as the media, word of mouth, public complaints, or the food industry.   

 We need to learn how to communicate better with each other.  Local public health shouldn’t have to keep an eye on the news media, Twitter or Facebook for information pertinent to protecting the people in our jurisdictions.  A multitude of electronic portals exist for purposes of interagency  communication, CDC, FDA, and the public health system should collectively define how pertinent information – such as this romaine advisory – rapidly and routinely gets to the grass roots public health workforce. Continuously improving interagency coordination and communication is a goal that is fundamental to increasing the effectiveness of this nation’s food safety systems. I’m putting this out there, because I’m willing to help with the solution. That way, in future years, I can spend my holidays perfecting Aunt Kay’s pie recipe.

This holiday, I’m thankful for public health influencers and amplifiers – like barfblog.com – that act as outbreak aggregators, and push out info to local public health types like me.   

Some background information and recommendations on this topic can be found in:  Getting the message across: an analysis of foodborne outbreak communications between federal, state, and local health agencies   https://calhoun.nps.edu/handle/10945/49379

We’ve got a match and 164 are sick: Happy Thanksgiving Jennie-O turkey store sales, LLC recalls raw ground turkey products due to possible Salmonella Reading contamination

FSIS and our public health partners, including the Centers for Disease Control and Prevention (CDC) and state public health officials, are investigating a Salmonella Reading outbreak. Please note that FSIS is continuing to investigate illnesses associated with this widespread outbreak, and additional product from other companies may also be recalled. Salmonella is prevalent and can be present in raw poultry and meat – no raw poultry or meat is sterile. In addition to discarding the product associated with this recall, consumers can protect themselves now and in the future by always cooking their turkey, and other poultry products thoroughly, to a safe internal temperature of 165 degrees, as measured using a food thermometer. The cooking process kills the Salmonella. No one should be eating partially cooked or raw turkey. Additionally, it is essential that people wash their hands after handling raw poultry, meat, and pet food to avoid cross contamination.

Jennie-O Turkey Store Sales, LLC, a Barron, Wis. establishment, is recalling approximately 91,388 pounds of raw ground turkey products that may be associated with an illness outbreak of Salmonella Reading, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The raw ground turkey products items were produced on September 11, 2018. The following products are subject to recall: [View Labels (PDF only)]

1-lb. packages of “Jennie-O ground turkey 93% lean | 7% fat” with “Use by” dates of 10/01/2018 and 10/02/2018.

1-lb. packages of “Jennie-O Taco Seasoned Ground Turkey” with a “Use by” date of 10/02/2018.

1-lb. packages of “Jennie-O Ground Turkey 85% Lean | 15% Fat” with a “Use by” date of 10/02/2018.

1-lb. packages of “Jennie-O Italian Seasoned Ground Turkey” with a “Use by” date of 10/02/2018.

The products subject to recall bear establishment number “P-190” inside the USDA mark of inspection. These items were shipped to retail locations nationwide.                                

FSIS, and its public health partners, including the Centers for Disease Control and Prevention (CDC) and the Arizona Department of Health Services, have been conducting traceback activities for a sample of Jennie-O brand ground turkey in an intact, unopened package from a case-patient’s home. The patient tested positive for Salmonella Reading and the sample from the ground turkey matches the outbreak strain.  

FSIS, the CDC, and state public health and agriculture partners, have been working together on an illness cluster involving 164 case-patients in 35 states. Patients have reported eating different types and brands of turkey products purchased from many different stores, handling raw turkey pet food and/or raw turkey, or working with live turkeys or living with someone who handled live turkeys. FSIS continues to work with the CDC and state health departments on this investigation and will provide updated information as it becomes available. Based on the continuing investigation, additional product from other companies may also be recalled.