CDC Report - Hepatitis A Cases Among Food Handlers as All Those Infected with Hepatitis A

In a CDC report, investigators looked at the uptick of Hepatitis A in many states across the country.  Those regarded as high risk is where "infections are spreading primarily through close contact among persons who use drugs and persons experiencing homelessness, as well as among men who have sex with men (MSM)"  Of interest in the report was the percentage of food handlers, and overall, the percentage of cases associated with food handlers was low (3.8%).  Looking at food handlers, a high percentage of them were people in the high risk - people use drugs, have unstable housing or are homeless, are active in MSM, or had been incarcerated.

From the report, "Among 22,825 hepatitis A outbreak cases reported from these 26 states during July 1, 2016–September 13, 2019, 871 (3.8%) were among food handlers; 587 (67.4%) hepatitis A–infected food handlers reported one or more risk factors (i.e., drug use, unstable housing or homelessness, MSM, or incarceration) during the 15–50 days before symptom onset. "

https://www.cdc.gov/mmwr/volumes/69/wr/mm6920a4.htm
Notes from the Field: Assessing the Role of Food Handlers in Hepatitis A Virus Transmission — Multiple States, 2016–2019
Weekly / May 22, 2020 / 69(20);636–637
Megan G. Hofmeister, MD1; Monique A. Foster, MD1; Martha P. Montgomery, MD1; Neil Gupta, MD1 (View author affiliations)

COVID Times - News Shorts for Week Ending May 23, 2020

CDC Changes Wording on COVID-19 Guidelines Regarding Surfaces - "[CDC] appears to have recently changed its guidelines from early March that initially said it “may be possible” to spread the virus from contaminated surfaces. The CDC now includes "surfaces or objects" under a section that details ways in which the coronavirus does not readily transmit"

Individuals Who Recovered from SARS-CoV-2 Virus Likely to Have Immunity - In a study published in Cell, researchers found that individuals who had been exposed to the virus had a significant immune response, which bodes well for developing a vaccine to the virus.

Nearly Two Hundred FSIS Inspectors Have Tested Positive for COVID-19

Temporary reduction in daily global CO2 emissions during the COVID-19 forced confinement
"The estimated decrease in daily fossil CO2 emissions from the severe and forced confinement of world populations of –17% (–11 to –25%) at its peak are extreme and probably unseen before. Still, these only correspond to the level of emissions in 2006."

FDA Issues Guidance for Using Refer Trailers That Once Held Human Remains

FDA issued a guidance document - Returning Refrigerated Transport Vehicles and Refrigerated Storage Units to Food Uses After Using Them to Preserve Human Remains During the COVID-19 Pandemic - that allows those refrigerated trailers that once held the remains of those who passed from COVID-19 to be used for food transport, provided proper sanitation.

According to the guidance, "Refrigerated food transport vehicles and refrigerated food storage units used for the temporary preservation of human remains during the COVID-19 pandemic subsequently can be safely used for food transport and food storage under certain circumstances.  It is important that food is protected during transport and storage to ensure food is safe for humans and animals and that conditions do not exist that may adulterate the food.  Before returning to service to transport or store human or animal food, refrigerated food transport vehicles and refrigerated food storage units used to hold human remains during the COVID-19 pandemic should be thoroughly cleaned and disinfected."

I just have a problem with this.  You?

USDA Issues Report on 2017-2018 Listeria Outbreak Associated with Country-Cured Ham

USDA-FSIS issued an After Action Review Report on a 2018 Listeria Outbreak associated with country-cured hams.  The case involved product sold by Johnston County Hams of Smithfield, N.C. and in this outbreak, 4 people become infected with one death.  The company recalled close to 90,000 pounds of product.

In the report, the issues involving the product are discussed.  The product supposedly received a cook-in-bag process to eliminate listeria.

• One issue was the product was exposed to the environment  - "The implicated product was considered [by the facility] to have not been exposed to the processing environment after undergoing an initial cook-in-bag lethality step to inactivate vegetative pathogens, including L. monocytogenes. However, the investigation revealed that the product was, in fact, exposed to the processing environment after cooking, which may have allowed the product to become contaminated with L. monocytogenes.:
• "After an initial cooking step in a sealed bag, the ham was removed from the bag, drained of its juices, and placed into a second bag; during this process, the ham may have been cross-contaminated from the processing environment."
• "After being placed in the second bag, the ham and bag were placed into metal molds, the top of which was pressed down to form the ham, then re-cooked. In some instances, this process led to tears in the bag, which allowed the cooked ham to be exposed to the processing environment again."
• The other issue is that the heat treatment used for the product may not have been sufficient considering the product had a low Aw - "Before being cooked multiple times, the ham was salt-cured and dried, thus lowering its water activity. Additionally, the draining of juices may have resulted in drier conditions during cooking. The establishment used FSIS cooking guidance (“Appendix A”) as scientific support that the cooking process achieved lethality of pathogens, including L. monocytogenes. However, Appendix A guidance was not intended for lower water activity products cooked under dry conditions or for products cooked multiple times. L. monocytogenes may survive cooking under these conditions. Hence, the process may not have been lethal to L. monocytogenes."

https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/foodborne-outbreak-investigation/outbreak-lm-ham-2018
Listeria monocytogenes Illness Outbreak Associated with Ready-to-Eat, Country-Cured Ham, 2017–2018
After-Action Review Report 2018-16
May 13, 2020

This Week in Mislabeled Products for Week Ending May 16, 2020

Variety Pack Package Misses Allergen - Evans Food Group Ltd., an Arlington, Texas establishment, is recalling approximately 3,796 pounds of ready-to-eat (RTE) pork skin products due to the product containing soy which is not declared on the product label.  The issue, discovered during a record review, found that one product contains soy – the red hot fried pork skins – is packaged in a variety pack that does not declare soy on the outside package display panel; however, soy is declared on the individual 1-oz. product label and is listed in the individual product’s list of ingredients.

Chicken Wing Packaging Misses Allergens - Zilk’s Plus Resources, LLC of Austin, TX announces a voluntary recall for select 12 oz bottles of Pluckers World Famous Wing Sauces because they may contain undeclared allergens. The recall was initiated after it was discovered that these products were distributed in packaging that did not adequately reveal the presence of soy-, wheat- or milk- containing ingredients in the affected products.

Bread Put in the Wrong Bag - The Essential Baking Company of Seattle, Washington is recalling 84 loaves of 32 oz. Sliced Columbia Bread, expiration date May 6.20, due to undeclared egg. The actual product in the bags may be 16 oz. Challah Bread which was mis-labeled as Sliced Columbia Bread and the label does not declare egg.

Ice Cream with Added Spinach Recalled After Listeria Positive Test

Ramar Foods of Pittsburg, CA, is recalling its 14 ounce packages of Peekaboo branded Mint Chocolate Chip with Hidden Spinach Ice Cream product because of the potential contamination of Listeria monocytogenes, The potential for contamination was discovered after internal routine testing by Ramar Foods revealed the presence of Listeria monocytogenes in some packages of the ice cream.

First, it seems that "hiding" vegetables in ice cream is just wrong.

In the hazard analysis, one would need to recognize that cooked or blanched vegetables would have a Listeria monocytogenes risk. The report does not indicate whether the spinach was cooked/blanched at the establishment or by the supplier. As a post-process addition, the vegetables would need sufficient controls to prevent contamination by Listeria.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/ramar-foods-recalls-mint-chocolate-chip-hidden-spinach-ice-cream-because-possible-health-risk
Ramar Foods Recalls Mint Chocolate Chip With Hidden Spinach Ice Cream Because of Possible Health Risk
Summary
Company Announcement Date: May 14, 2020
FDA Publish Date: May 14, 2020
Product Type: Food & Beverages Ice Cream/Frozen Dairy
Reason for Announcement:  Potential to be contaminated with Listeria monocytogenes
Company Name:  Ramar Foods
Brand Name:  Peekaboo
Product Description:  Mint Chocolate Chip with Hidden Spinach Ice Cream

USDA Issues Alert for Ravioli from PA Establishment for E. coli

USDA FSIS issued "a public health alert because approximately 70 pounds of raw beef ravioli products, produced by P&S Ravioli Company, a Philadelphia, Pa. establishment, may be contaminated with E. coli O157:H7. A recall was not requested because the affected product is no longer available for purchase."  According to the report, "The problem was discovered when P&S Ravioli Company was notified by their third-party laboratory that a sample was positive for E. coli O157:H7, but the products associated with the sample had already been shipped into commerce. The establishment notified FSIS of the sampling results and subsequently controlled all product remaining for sale."

https://www.fsis.usda.gov/wps/portal/fsis/newsroom/news-releases-statements-and-transcripts/news-release-archives-by-year/archive/2020/pha-05122020-01
FSIS Issues Public Health Alert for Raw Beef Ravioli Products Due to Possible E. Coli O157:H7 Contamination
5/12/20

COVID Times - News Shorts for May 14, 2020

FDA Issues Alert on Accuracy of Allergen Test - FDA issued an alert that they have data that suggests potential inaccurate results from using the Abbott ID NOW point-of-care test to diagnose COVID-19. Specifically, the test may return false negative results. FDA has received 15 adverse event reports about the Abbott ID NOW device that suggest some users are receiving inaccurate negative results.  Of course, false negatives are worse than false positives in that someone has the infection but is told they don't.

CDC Report on High Infection Rate Following a Choir Practice - Following a 2.5-hour choir practice attended by 61 persons, including a symptomatic index patient, 32 confirmed and 20 probable secondary COVID-19 cases occurred (attack rate = 53.3% to 86.7%); three patients were hospitalized, and two died. Transmission was likely facilitated by close proximity (within 6 feet) during practice and augmented by the act of singing.

Why Bats Can Carry Bad Viruses and Not Get Sick - Super Immunity - “Instead of killing bat cells as the virus does with human cells, the MERS coronavirus enters a long-term relationship with the host, maintained by the bat’s unique ‘super’ immune system,” 

The Virus Can Also Infect Cats, Minks, and Ferrets - This article discusses the virus's protein pike structure, but states that "Cats, ferrets and minks are also susceptible: In order to infect a cell, features of the spike protein must bind with a receptor on the host cell’s surface, and cats have a receptor binding site that closely matches that of humans."

COVID Virus's Cellular Targets Are In More Than Just Respiratory System - The COVID-19 "virus's  “spike” protein binds to a receptor on human cells known as angiotensin-converting enzyme 2 (ACE2). Another human protein, an enzyme called TMPRSS2, helps to activate the coronavirus spike protein, to allow for cell entry."  Epithelium cells that line the airway have these receptors, and so this is the primary means of infection.  But these cell types are found in other parts of the body including the intestines.  This is the reason we see a wide variety of symptoms, including that "approximately one third of COVID-19 patients experience gastrointestinal symptoms such as diarrhea, and the fact that the virus often can be detected in stool samples ."  

Unfortunately for men, they have a higher concentration of ACE2 in their blood.

How Does COVID-19 Become Deadly - A lot of news articles have detailed the "cytokine storm”. that occurs after an infection starts.  "This storm is an over-activation of white blood cells, which release too-great amounts of cytokines – inflammation-stimulating molecules – into the blood."  "The rapidly increased cytokines attract an excess of immune cells such as lymphocytes and neutrophils, resulting in an infiltration of these cells into lung tissue and thus cause lung injury".

Hot Dog Sales are Up - "American households continue to turn to hot dogs as a convenient and kid-friendly solution with many more at-home meal occasions. The week ending May 3 marked the ninth week of multi-digit year-over-year sales gains for hot dogs vs. a nearly flat performance in 2019." 

Farmers' Markets Are Busy, But They Endure Higher Operating Costs  - Farmers' Markets have done an excellent job at providing a safe shopping experience during the COVID-19 pandemic, but their higher costs of operations have severely cut into profitability.

Basil Imported from Columbia Recalled Due to Cyclospora

United Natural Foods, Inc. (UNFI) is recalling their  Wild Harvest® Organic Basil because of the potential to be contaminated by Cyclospora cayetanensi.  The product was distributed out of their  MN distribution center.  The recall comes after routine sampling found the pathogen.  The product is out of Columbia.

Cyclospora cayetanensis is a parasite that causes intestinal illness when consumed.  There have been a number of outbreaks associated with fresh RTE greens such as basil and cilantro.  It gets on these items from the irrigation water used for growing the product.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/unfi-voluntarily-recalls-wild-harvestr-organic-basil-due-possible-health-risk
UNFI Voluntarily Recalls Wild Harvest® Organic Basil Due to Possible Health Risk
Summary
Company Announcement Date:  May 11, 2020
FDA Publish Date:  May 11, 2020
Product Type:  Food & Beverages  Vegetable Products
Reason for Announcement:  Contaminated by Cyclospora cayetanensis
Company Name:  United Natural Foods, Inc.
Brand Name:  Wild Harvest
Product Description:  Organic Fresh Basil

Updated Handout for Food Handlers and COVID-10

Penn State Extension updated it's handout for food employees regarding COVID-19.  This is available as a PDF handout and will be available in a one page poster.

Food Handlers and COVID-19
https://extension.psu.edu/food-handlers-and-covid-19
PDF available

The novel coronavirus responsible for the current pandemic is a specific strain from a large family of viruses that includes those that cause the common cold. This strain, SARS-CoV-2, causes a respiratory illness designated COVID-19, and symptoms include high fever, intense headache, and difficulty breathing, among others. These symptoms can be more severe in populations considered to be high risk, such as the elderly or people with underlying health conditions, where pneumonia and even death can result.
According to the Centers for Disease Control and Prevention, coronaviruses are generally thought to be spread from person to person through respiratory droplets. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly eyes, but this is not thought to be the main way the virus spreads.
Currently, there is no evidence to support that transmission of COVID-19 is associated with food. However, before preparing or handling foods, food handlers should follow these practices.

When sick, stay home from work.
Symptoms specific to COVID-19 include:

Preparing Food Service Establishments to Reopen During the COVID-19 Pandemic

This Penn State Extension fact sheet is intended to help food service establishments prepare to reopen and remain safely operational; tips for employees are also provided.

https://extension.psu.edu/preparing-food-service-establishments-to-reopen-during-the-covid-19-pandemic  (a PDF is provided as well).
Preparing Food Service Establishments to Reopen During the COVID-19 Pandemic

As local and state municipalities allow restaurants to resume dine-in services, these establishments need to think about how they can open while still providing a healthy environment that incorporates social distancing and other disease preventive controls. Based on the recently published COVID-19 Reopening Guidance: A Guide for the Restaurant Industry by the National Restaurant Association, Penn State Extension has developed this fact sheet for small and local operations in Pennsylvania. It is important to note that these establishments

Before Reopening:

• Deep clean the entire facility. Remember to use approved sanitizers on food-contact surfaces. Disinfectants can be used on non-food-contact surfaces. Deep cleaning should not only be completed before opening but also on a set schedule for regular detailed cleaning (weekly or more depending on use).

CDC Issues 2019 FoodNet Report

CDC issued their FoodNet Report for 2019 which looks at data from 10 sites in the US over time.
"The report summarizes preliminary 2019 data and describes changes in incidence compared with that during 2016–2018. The incidence of enteric infections caused by these eight pathogens reported by FoodNet sites in 2019 continued to increase or remained unchanged, indicating progress in controlling major foodborne pathogens in the United States has stalled. "
 But they also state, "Recent increases in foodborne illness might be due, in part, to increased testing and improved technologies. Quick and easy culture-independent diagnostic tests continue to reveal infections that might not have been diagnosed in the past because of limited testing. At the same time, whole genome sequencing and other new laboratory technologies have enhanced our ability to identify outbreaks, emerging strains, and sources of infection."

So comparing year to year may not be valid because more tests are being completed and the tests are more accurate.    Table 1 from that document gives number of infections which shows Campylobacter and Salmonella as the two most prevalent types of foodborne pathogens.

FDA Issues Warning Letters to Companies Selling COVID-19 Remedies - The New Era of Snake Oil Salespeople

FDA has been issuing a number of Warning Letters to companies which are marketing and selling products with claims that it can prevent or treat the novel Coronavirus.  Here is a few of the Warning Letters which were issued over the past few days.

• Dr. Dhole's Sushanti Homeopathy Clinic -  claims homeopathy medicine which is selected as Genus Epidemicus is given to healthy people to prevent Coronavirus
• Honey Colony LLC - sell a chealated silver product with claims as a prevention from coronavirus.
• Antroids.com and Foxroids.com - offers lopinavir + ritonavir, marketed as “Lopimune 200mg/50mg,” under the heading “Coronavirus Treatment.” While there are FDA-approved versions of lopinavir + ritonavir on the market in the U.S., there are no approved drug applications offered by either company  In addition, no drug has yet been approved by the FDA for use in the prevention, diagnosis, treatment, mitigation, or cure of COVID-19
• Hopewell Essential Oils - Claims that using essential oils to make breathing easier with Coronavirus related pneumonia.
• Santiste Labs LLC - Created a transdermal patch with that claims to boost your immune system and provide antiviral support all day,
• Prefense LLC - marketing and online sales for hand sanitizers with claims that it works against COVID-19 and that the sanitizer lasts all day.

Claims and FDA Issues for Each with Links

Probiotic Fiber Product Recalled For Potential of Plastic Pieces from Bottle Cap

GSK Consumer Healthcare is voluntarily recalling five lots (listed below) of Benefiber Healthy Shape Prebiotic Fiber Supplement powder and Benefiber Prebiotic Fiber Supplement powder due to the potential for green plastic pieces or shavings from bottle caps to be present in the product.  As of the date of the recall announcement, GSK Consumer Healthcare has received one consumer complaint of a green particle observed inside a bottle of product.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/gsk-consumer-healthcare-recalls-benefiber-healthy-shape-prebiotic-fiber-supplement-and-benefiber
GSK Consumer Healthcare Recalls Benefiber Healthy Shape Prebiotic Fiber Supplement and Benefiber Prebiotic Fiber Supplement Due to Possible Plastic Contamination from the Bottle Cap
Summary
Company Announcement Date:  April 28, 2020
FDA Publish Date:  April 28, 2020
Product Type:  Food & Beverages
Reason for Announcement:  Potential for plastic pieces or shavings
Company Name:  GSK Consumer Healthcare
Brand Name:  Benefiber
Product Description:  Prebiotic Fiber Supplement

This Week in Mislabeled Product for Week Ending May 2, 2020

Traces of Milk Detected by Customer - Medifast, Inc. of Baltimore, Md., is recalling 24,923 boxes of OPTAVIA Essential Old Fashioned Maple & Brown Sugar Oatmeal because the product may contain undeclared traces of milk.  The recall was initiated after discovering that certain lots of OPTAVIA Essential Old Fashioned Maple & Brown Sugar Oatmeal packets inadvertently contain undeclared traces of milk. The issue was discovered when the company was contacted by a customer. 

Wrong Outer Case - Peanut Crackers In Cheese Boxes - Mondelēz Global LLC announced today a voluntary recall of a limited quantity of RITZ Cheese Cracker Sandwiches Family Size (21.6 oz. carton) product in the United States. This recall is being conducted because the outer packaging indicates that the product is Cheese variety, while the individually-wrapped product contained in the package is Peanut Butter variety. The outer carton does, however, provide an allergen advisory statement indicating that the product “May contain peanuts.” In addition, the inner package contains 16, 1.35oz. individually-wrapped six-cracker sandwiches that are properly labeled as RITZ Peanut Butter Cracker Sandwiches and declare peanut as an ingredient. The recall was initiated after it was discovered that the product containing peanut was distributed in outer packaging that did not list “peanut butter” in the ingredient statement. Corrective actions are being taken to help ensure that this issue does not recur.

Wrong Chicken Ingredient Contains Soy - Condies Foods of Kearns, UT is recalling 165 units of roll chicken salad on croissant single item# 43237 “USE THRU” 03/6/2020 - 05/6/2020, and sndw chicken sandwich on white single item.  After an inhouse audit of our ingredients by our Quality Assurance Manager it was discovered that the wrong ingredient had been purchased and used, it was decided to initiate a voluntary recall to ensure that our public would not get further exposure to an erroneous product.