CDC research shows outbreaks linked to imported foods increasing

The US currently imports about 16% of food consumed. For seafood, that figure is about 85%. Currently about 1% of imported food is checked by the FDA at the port of entry. Over a 5 year period (2005 to 2010), there have been 39 outbreaks and close to 2400 illnesses linked to imported foods.

While we get a glimpse of the risk associated with imported foods through outbreak reports, it is hard to really know the true extent. FDA has limited capabilities, especially with import analysis, although the Food Safety Modernization Act includes measures which will help support FDA.

Much of it comes down to making sure those who import those food products. Are they doing what they need to do to ensure their foreign suppliers have capable food safety systems in place? Are they conducting verification testing?

As consumers, we try to by local where we can, but there is still demand to have an assortment of fruits, vegetables and seafood year round. And do we do ourselves a disservice by forgoing these items just because it is from another county in that we are giving up important components of a healthy diet?

CDC research shows outbreaks linked to imported foods increasing
Fish and spices the most common sources
March 14, 2012

 http://www.cdc.gov/media/releases/2012/p0314_foodborne.html

 Foodborne disease outbreaks caused by imported food appeared to rise in 2009 and 2010, and nearly half of the outbreaks implicated foods imported from areas which previously had not been associated with outbreaks, according to research from the Centers for Disease Control and Prevention, presented today at the International Conference on Emerging Infectious Diseases in Atlanta.

Lean Finely Textured Beef ( AKA Pink Slime) is safe

It is hard to miss the hysteria around so called ‘pink slime’, or to be technically correct , lean finely texturized beef, or LFTB. LFTB is basically meat protein that is recovered from fat trimmings that would have otherwise been lost. In the process of butchering a cow, fat is trimmed away. In trimming, it is hard to get only fat with no meat protein attached. The LFTB process was developed to separate that meat protein from the fat. Ammonium hydroxide is used as a processing aid to keep microbial levels in control.

The meat protein that is generated is finely ground, so it appears more as a paste than what we would call meat. Is it safe? Like any meat product, as long as it is cooked correctly, it is safe. The ammonium hydroxide is a GRAS (generally recognized as safe) chemical and when used at these very low levels, poses no health risk.

The issue is primarily related to the appearance, and once it was dubbed pink slime, it became difficult for consumers to accept. Because of this, many fast food chains discontinued its use (it was added in a small percentage to give more burger for the dollar.) Meat provided for school systems also buy beef with LFTB as a way to keep the cost of food down. Granted, it is not very appealing to look at. But neither are many other food ingredients when seen being used in food production. And, it is a process that recovers value from the byproducts, instead of wasting it.

Dr. Mills of Penn State Animal Science provides some nice comments regarding LFTB.

http://live.psu.edu/story/58528

Here is a link that reviews the safety of ammonium hydroxide.

http://www.foodinsight.org/Resources/Detail.aspx?topic=Questions_and_Answers_about_Ammonium_Hydroxide_Use_in_Food_Production

Cola, BPA, and Our Aversion to Risk

Recently, Campbell Soup made the decision to move away from cans that contain BPA the lining. Was it justified? FDA initially concluded that BPA was not a risk, but after public pressure, they are reevaluating its safety.

 Another controversy brewing is the caramel color that gives cola soft drinks their brown color. The chemical, 4-methylimidazole (4-MI), is formed when the caramel color is manufactured. According the FDA, the levels found in soda are well below any concern. The FDA spokesman, Doug Karas stated "A consumer would have to consume well over a thousand cans of soda a day to reach the doses administered in the studies that have shown links to cancer in rodents”. However, the consumer watchdog group, Center for Science in the Public Interest (CSPI), doesn’t agree. They have petitioned FDA to have 4-MI banned.

 How do the risks associated with certain chemicals in our food stack up against non-food related risks? For the consumer, this question is difficult to answer. In evaluating the risk associated with a chemical, numerous studies are completed. The scientists issue reports and from these reports, numerous interpretations are made, including ones by industry associations, consumer advocacy groups, and government agencies. Then some of these interpretations make their way to the consumer, either through the mass media (TV, newsprint) or through social media (websites, blogs). 

The studies that are conducted to determine risk are rarely perfect. Animal models, where large quantities are injected into small animals such as rats, are often used for toxicity determinations. With these, there is always a question of how realistic it is when compared to humans and their normal living conditions. When large scale human surveys are used to determine risk, it is often difficult to control all of the variables including what people eat, their daily habits, and their genetic makeup. In the end, we hope that conclusions that are drawn are done are unbiased and done in the best interest of the public.

 Public opinion polls have been done that show that that is an increasing concern in the consumers’ perception of food hazards. The apparent lack of trust on these technical risk assessments and this can be linked to a number of factors. One is the stories that are reported in the news media and how they are reported. In addition to television and print news, many people now use the internet for their information. On the internet, we see the whole gamut of information, from the scientific studies themselves to the totally unscientific opinion pieces. 

One of the primary fears that people have is cancer. Certainly past tragedies provide an underpinning for the public’s concern. Asbestos and tobacco are two examples of cancer related items that have received a high level of media coverage and have led to people being skeptical. So when a linkage is made between a chemical in food and cancer in the news or the media, it will get attention. The question of the level of risk, however, is often more difficult to discern. 

How should one respond? First, consumers should inform themselves as best they can by using valid sources of information. It is also important to understand the bias of those providing the information, and try to obtain a balance in what is read. Remember that the information out there is rarely clear cut, so it is important for consumers to make a determination where they feel comfortable.

Links

http://healthland.time.com/2012/03/06/soda-wars-can-the-color-in-your-cola-give-your-cancer/?iid=hl-main-lede?xid=gonewsedit#ixzz1oRRVsFCH
http://www.forbes.com/sites/amywestervelt/2012/03/05/under-pressure-from-parents-advocacy-groups-campbells-goes-bpa-free/
http://www.forbes.com/sites/henrymiller/2011/10/25/bpa-is-still-ok/

Social Media Taking Over for Mom

The Progressive Grocer discusses a study" Clicks & Cravings: The Impact of Social Technology on Food Culture, which finds social/digital media is replacing Mom as the go-to culinary source of knowledge for many people."  These surveys are great references - we sense that more people are using social media as a tool for deciding what to eat, how to prepare it, and then chatting about it with others, but here is a study to support those notions.  

http://www.progressivegrocer.com/top-stories/headlines/consumer-insights/id34891/social-media-redefining-our-relationship-with-food/

"The study was jointly developed and conducted by consumer research firm The Hartman Group and Publicis Consultants USA, a food and nutrition marketing agency. Study results show almost half of consumers learn about food via social networking sites, such as Twitter and Facebook, and 40 percent learn about food via websites, apps or blogs."

Impact on food safety - the internet is the wild west of information, where anyone can write anything.  It is alway important for people to use trusted sites, and to review information provided in that recipe against validated information (foodsafety.gov for example).  If a recipe suggests that you undercook an item, for example to cook chicken to 150F instead of 165F, you should consider not using that recipe.

Avoiding High Risk Foods

Consumers who want to reduce the risk of foodborne illness should consider avoiding these foods.
 
Avoid high-risk foods, food-safety expert recommends
Friday, February 24, 2012
http://live.psu.edu/story/58000

UNIVERSITY PARK, Pa. -- It seems that hardly a week goes by without another reported case of some food being blamed for causing people to get sick. Most recently, a national restaurant chain's clover sprouts were linked to a Midwestern outbreak of pathogenic E. coli, and dozens of cases of Campylobacter in four states have been linked to the consumption of raw milk from a Pennsylvania dairy.

As consumers, we start to ask whether any foods are safe to eat.

While it is unlikely that we can completely eliminate the risk of foodborne illness, we can certainly identify a few food items that pose a higher risk of making us ill and avoid them, advises a food-safety expert with Penn State's College of Agricultural Sciences.

"One just needs to look through U.S. Centers for Disease Control reports to see that there are certain foods that show up time and again," said Martin Bucknavage, extension food-safety specialist. "In my opinion, these are foods we certainly should consider removing from our diet if we are interested in reducing our chances of contracting foodborne disease."

Following are a few foods Bucknavage suggests avoiding:

-- Raw sprouts. In the last 15 years, there have been at least 30 reported cases of foodborne illness linked to raw sprouts.

"Pathogenic bacteria come in on the seeds or beans, and during the sprouting process, the conditions are right for these bacteria to multiply," he explained. "Processors will sanitize seeds to remove bacteria, but that measure has not been foolproof."

-- Raw milk. People have consumed raw milk for ages, but from time to time, pathogenic bacteria make their way into the milk, Bucknavage noted.

"In the recent outbreak of foodborne illness related to raw milk sold in southern Pennsylvania, 77 people became infected by Campylobacter, which will cause severe diarrheal conditions for as long as a week or more."

Bucknavage conceded that there are avid proponents of drinking raw milk, who point to the fresh taste and the perceived health benefits.

"However, these health benefits have not been scientifically proven, and the working part of the cow, the udders, are close to the ground and can become contaminated with pathogenic organisms such as Salmonella, Campylobacter, Listeria and E. coli," he said.

"While most of those who sell raw milk keep the dairy environment as clean as they can and regularly test the health of the cows, a long history of outbreaks shows that there is a real risk of dangerous bacteria making their way into milk. This is why pasteurization became a standard practice in the late 1800s."

-- Raw oysters. These are another food that has a loyal following, Bucknavage pointed out. But he explained that oysters are filter feeders and can capture pathogenic bacteria and viruses if they are harvested in contaminated waters.

"A process such as depuration -- allowing oysters to live in cleaned water for a period of time -- can help, but use of this practice is limited," he said.

-- Undercooked ground beef. While some people undercook hamburgers intentionally, the majority do it because they do not use the correct endpoint for cooking, according to Bucknavage. They should measure the recommended internal temperature of 160 F using a meat thermometer.

"It would be fair to say that most people measure whether something is cooked by visual evaluation -- the lack of pink color," he said. "But this is an unreliable method.

"Some people will point out that they eat steak with pink in the middle. But this is different than hamburger. In the process of making hamburger, the meat is ground, and the exterior parts where the bacteria reside are mixed throughout the meat. Because of this, we need to achieve a higher cooking temperature in the center of the meat."

Chicken is another example of a food that often is undercooked, whether on purpose or by accident, Bucknavage lamented. Poultry has been shown to have a high prevalence, or contamination rate, of Campylobacter, he noted.

"To properly cook poultry, an internal temperature of 165 degrees Fahrenheit or higher is required," he said. "Otherwise, organisms such as Campylobacter can survive."

Along with avoiding high-risk foods, it is also important to practice effective cleaning and sanitizing of food-preparation surfaces and cooking utensils, Bucknavage said, as well as storing food under proper conditions. "Doing this, we can go a long way in protecting ourselves and our families from contracting foodborne illness."

Norovirus Outbreaks 2012

The leading cause of foodborne disease is making its mark this winter. Just this February, Norovirus caused more than 200 attendees at a cheerleader camp in Washington State to become ill. In St. Maarten, a cruise ship returned to port as 31 became ill. In Virginia, an elementary school was closed because so many students were ill. And in New Jersey, more than 400 college students become ill at three universities located in the same county.

There are some important reasons that lead to so many people becoming ill from Norovirus. One is the virus’s low infectious dose. It is estimated that it may take only 10 viral particles to make someone ill. Then, there is the ability of the virus to survive for up to two weeks on dry surfaces and in water for months. The virus can be spread through a number of ways including through contaminated food or water, from contaminated surfaces, directly from a sick person, or from the intake of aerosolized droplets of vomitus.

The main symptom of Norovirus infection is another factor for its spread – acute-onset vomiting. This prevents people from becoming sick in a secure location. Rather, rapid onset can occur at a dinner table, on a carpet, or on the bus. People usually become ill within 24 hours of exposure, although longer incubation periods do occur. Once someone is sick, they can experience symptoms for 24 to 72 hours, and can remain contagious for up to 3 days.  

Because of this short incubation time, low infectious dose, and ease of spread, one can see why it spreads through a school or a cruise ship so quickly. While rarely fatal, people who become ill need to watch so that they do not become dehydrated.

The most important key in preventing infection is frequent, but correct hand washing – scrubbing hands with soap and warm water. Additionally, it is important for people to stay home when ill, especially when they may have been exposed to someone who has had the illness. They should also stay home for at least 48 hours after systems have subsided. Contaminated surfaces must be cleaned using a strong chlorine bleach solution, 1 cup of bleach o one gallon of water.  Cooking will destroy the organism.

CDC link for additional information
http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus.htm

Outbreak cases
http://www.inquisitr.com/193064/norovirus-outbreak-2012-washington-state-cheerleading-competition/
http://www.huffingtonpost.com/2012/02/13/crown-princess-departs-af_0_n_1272706.html
http://www.nbc12.com/story/16958672/norovirus-outbreak-causes-school-to-close
http://www.nj.com/mercer/index.ssf/2012/02/mercer_county_colleges_report.html

E. coli O26 infections linked to Clover Sprouts

Raw sprouts are responsible for another outbreak of foodborne illness and at least the fourth outbreak linked to the same restaurant chain, Jimmy Johns. In this latest case, there are 12 people infected with STEC O26 (CDC and AP link below). 

After the last outbreak linked to the restaurant chain in late 2010 where close to 120 people became ill with Salmonella, the chain switched from alfalfa sprouts to clover sprouts. But sprouts are sprouts – they are a higher risk food item in that it can be difficult to remove organisms such as Salmonella and E.coli from the seeds, and the process that allows the seed to sprout also may allow the organism to grow. Now, it appears the chain will drop sprouts from its menu (http://www.kirksvilledailyexpress.com/news/x1793836666/Jimmy-Johns-permanently-pulls-sprouts-from-menu). 

Tainted sprouts again linked to Jimmy John’s, outbreak is fourth linked to restaurantBy Associated Press, Published: February 15
http://www.washingtonpost.com/business/tainted-sprouts-again-linked-to-jimmy-johns-outbreak-is-fourth-linked-to-restaurant/2012/02/15/gIQAGxFVGR_story.html

WASHINGTON — Raw sprouts from the sandwich chain Jimmy John’s have been linked to an outbreak of foodborne illness — again.

The federal Centers for Disease Control and Prevention said Wednesday that 12 cases of E. coli poisoning in five states are linked to raw clover sprouts eaten at Jimmy John’s restaurants. The outbreak comes a year after raw alfalfa sprouts from one of the chain’s suppliers were linked to 140 salmonella illnesses. Sprouts from the chain’s suppliers were also linked to a 2009 salmonella outbreak in several Midwestern states and were suspected in an E. coli outbreak in Boulder, Colo. in 2008.

Raw Milk Testing Requirements - Outbeak of Campylobacter in Family Cow Raw Milk

In a recent report (below), there are now 77 cases of campylobacterosis from the consumption of raw milk associated with Family Cow.  What standards are in place for a dairy to sell raw milk?  Attached is the section on testing schedule from Pennsylvania's guidenance for those selling raw milk.  Note that there is no requirement for continuous testing.  In general, APC, coliform, and somatic cell counts are required twice per month and these parameters serve as indicators of sanitary quality,  However, actual pathogen testing is only required once every six months.  Now, dairies selling raw milk may be testing  more frequently.  Probably a good question for the producer of your raw milk.

Raw Milk Testing Standards
Guideance -
PERMITS ALLOWING THE SALE OF
RAW MILK FOR HUMAN CONSUMPTION
http://www.portal.state.pa.us/portal/server.pt/gateway/PTARGS_0_2_24476_10297_0_43/AgWebsite/Files/Publications/Draft_-_Revision_of_Raw_Milk_Guidance_Doc_Final.pdf
9. Regular Testing of Raw Milk.
a.  Responsibility. A raw milk permit holder is responsible to arrange for the regular sampling and testing required with respect to the raw milk permit, and to pay for this testing.

9b. 
Pennsylvania Approved Dairy Laboratories. All raw milk samples submitted for testing must be analyzed at an official laboratory (a laboratory which is under the direct supervision of the Department) or a  Pennsylvania approved dairy laboratory (a laboratory authorized or designated
by the Department as allowed to perform specific milk testing).
c.  Testing Schedule. A raw milk permit holder must coordinate raw milk testing on the following
schedule, and the raw milk samples must meet the following standards: 

Another illness case linked to The Family Cow's raw milk

http://www.publicopiniononline.com/localnews/ci_19984720

CHAMBERSBURG - The number of cases of sickness linked to The Family Cow raw milk stands at 77 in four states.

Expanding the list of bad [foodborne disease causing] bacteria?

There is currently a push to put a zero tolerance on four strains of drug-resistant salmonella in uncooked meat (link below). This comes after the 2011 outbreak of Salmonella linked to ground beef where 20 people were reported to become ill. (http://www.cdc.gov/salmonella/typhimurium-groundbeef/020112/index.html). The responsible organism was a multi-drug resistant strain of Salmonella Typhimurium.

Another recent expansion was the addition of 6 strains of E. coli non-O157 STEC. Although the testing program was to go into effect in March of 2012, it was pushed pack to June of 2012. The reason relates to the lack of validated test methods to detect the specific pathogenic strains (link below).

Looking for a given bacterial species is difficult enough, but when we have to look for strains of bacteria containing specific genes, reliable testing is not always easy. Throw in the fact that the product being tested is raw, and that the prevalence of bacteria is very low, and it makes one question to what degree can we track and eliminate the sources. (For example, FSIS reports the prevalence of Salmonella in ground beef is about 2% (http://www.fsis.usda.gov/PDF/Progress_Report_Salmonella_Testing.pdf), and in a 2009 study by ARS, the level for MDR Salmonella was only 0.6% (http://www.ncbi.nlm.nih.gov/pubmed/19201965)).  

Will consumers benefit? Will public health be better served? Will regulatory requirements for zero tolerance be enforceable or achievable?

Interesting note, a consumer group recently requested that FDA put a zero tolerance of Vibrio vulnificus on oysters (http://cspinet.org/new/201202091.html) to help protect those who choose to consume raw oysters. Vibrio vulnificus is a natural contaminate in waters where oysters are harvested, especially in the warmer months. In most all cases, the organism affects those who have underlying medical condition, primarily past or present alcohol abuse. Are oyster fisherman going to start testing oysters before delivering to the local shuck house? Why not just make it illegal to consumer raw oysters?

Salmonella Outbreak Spurs Call to Expand List of Banned Bacteria
February 08, 2012, 1:59 PM EST
Bloomberg Businessweek
http://www.businessweek.com/news/2012-02-08/salmonella-outbreak-spurs-call-to-expand-list-of-banned-bacteria.html
By Stephanie Armour