Update - Salmonella linked to tuna used in sushi

Update 5/3/12
CDC reports that there is now close to 260 people infected with two different strains of Salmonella.

CDC Release 5/2/12
http://www.cdc.gov/salmonella/bareilly-04-12/index.html

Based on an epidemiologic link and results of laboratory testing, CDC has combined this Salmonella Bareilly investigation with an ongoing multistate outbreak investigation of Salmonella serotype Nchanga infections. The two associated PFGE patterns have been grouped together as the "outbreak strains."

A total of 258 persons infected with the outbreak strains of Salmonella Bareilly (247 persons) or Salmonella Nchanga (11 persons) have been reported from 24 states and the District of Columbia.

• 32 ill persons have been hospitalized, and no deaths have been reported.

4/17/12
According to the CDC, the Salmonella Bareilly that caused close to 150 illnesses has been linked to tuna used in sushi. The raw tuna served was frozen, but of course, was not cooked. While freezing will eliminate parasites, it will not eliminate Salmonella. The majority of tuna linked to this outbreak was from India. The US importer, Moon Marine, has begun recalling close to 59,000 lbs of tuna.

When producing a ready-to-eat food such as sushi grade tuna, the highest degree of sanitation and operating cleanliness must be maintained. This requires that the producer maintain tight production controls and procedures each and every day. This tuna meat, or tuna scrape, is a lower grade product and is essentially meat that was scrapped from the backbone of the tuna and had the look of a ground product.

A lawsuit has already been filed against the importer.  As an importer, they have the responsibility for ensuring the processing plants they purchase from have adequate quality and safety systems in place.

Multistate Outbreak of Salmonella Bareilly Infections Associated with a Raw Scraped Ground Tuna Product
http://www.cdc.gov/salmonella/bareilly-04-12/index.html
CDC Release  4/17/2012

A total of 141 persons infected with the outbreak strain of Salmonella Bareilly have been reported from 20 states and the District of Columbia.
The number of ill persons identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (6), District of Columbia (2), Florida (1), Georgia (6), Illinois (13), Louisiana (3), Maryland (14), Massachusetts (9), Mississippi (2), Missouri (4), New Jersey (8), New York (28), North Carolina (2), Pennsylvania (6), Rhode Island (5), South Carolina (3), Texas (4), Virginia (8), and Wisconsin (14).  21 ill persons have been hospitalized, and no deaths have been reported.

Collaborative investigation efforts of state, local, and federal public health agencies indicate that a frozen raw yellowfin tuna product, known as Nakaochi Scrape, from Moon Marine USA Corporation is the likely source of this outbreak of Salmonella Bareilly infections. Nakaochi Scrape is tuna backmeat that is scraped from the bones of tuna and may be used in sushi, sashimi, ceviche, and similar dishes. The product looks like raw ground tuna. 

Consumers should not eat the recalled product, and retailers should not serve the recalled raw Nakaochi Scrape tuna product from Moon Marine USA Corporation.
This investigation is ongoing. CDC and state and local public health partners are continuing surveillance to identify new cases.

U.S. NEWS  WSJ
Updated April 16, 2012, 6:48 p.m. ET
Tuna Blamed in Salmonella Outbreak Is Recalled
By BILL TOMSON WSJ 4/15/12
http://online.wsj.com/article/SB10001424052702304299304577348030392954406.html?mod=googlenews_wsj

The Food and Drug Administration said Monday a California supplier of raw tuna used in sushi was behind a salmonella outbreak that has sickened more than 100 people in 20 states.
Moon Marine USA Corp. in Cupertino, Calif., has begun recalling 58,828 pounds of raw yellowfin tuna because it may be contaminated, the FDA said. Many of the people who became ill reported eating an item known as spicy tuna, the agency said, and most of the illnesses occurred in New York.

NY Times reports E. coli on Chicken...oh noooooo

What would we do without the occasional ‘shocking’ story about raw meat containing bacteria, in this case, a study that E. coli was found on chicken? Yes, raw meat, including chicken, can and will have E. coli associated with it, as well as some pathogens such as Salmonella and Campylobacter. This will occur whether it is conventionally processed, organic, or even farm raised. Those processing chicken put in steps to help reduce the level of bacteria, but it is nearly impossible to eliminate all bacteria on a raw product (one that you would still want to buy). I don’t want a farmer or processor treating my chicken to a point that eliminates all of the bacteria, and neither should you. It would not be a chicken that you would want to buy.  

Have we become such germaphobes that we cannot longer tolerate the thought that E. coli might be on a raw chicken or raw beef. What, you don’t think that soon after you put on your underwear that you have a few E.coli on them? Or on our hands after we use the restroom? And what do we do, we wash them. And for raw meat and poultry products…..we cook them (and keep our kitchen counter clean as well).

A few problems with this study, one pointed out by our own Dr. Cutter in the NY Times article below. (You can link to the published report http://www.pcrm.org/health/reports/fecal-contamination-in-retail-chicken-products.)

They constantly refer to the E. coli contamination as feces. Although linked, these are two different images. Yes, there may be a few E.coli in your underwear, or even on your hands after you use the restroom, but would you call it feces? Have you ever seen feces on a raw chicken breast? Does your chicken breast smell like poop? E. coli is of fecal origin, and it can cross contaminate onto food and surfaces such as your hands, but to what degree are feces particles present…microscopic at best. And if that thought still concerns you, then you better live in a bubble with your colon direct linked to the sewer pipe.

Another issue is that the study does not look at actual levels of E. coli per bird, just the absence or presence. Therefore, it is possible that there may only be an extremely low level of E.coli there…and based upon real scientific studies, we know that this is the case. So we start with a bird where there are billioins and billions of E. coli present in the intestine, the bird is eviscerated, cleaned, and packaged. Now, there only has be a few organisms present for the test to show a positive. I am surprised the number isn’t even higher….but that would be no more concerning.

Is it surprising that the person who conducted the study is a vegan? So what is the agenda? I have no problems with those people who choose not to eat meat. But please don’t push that agenda onto others through the use of ill designed studies.

The real take away…cook your food….and use a thermometer to verify.

48% of Chicken in Small Sample Has E. Coli
By STEPHANIE STROM
NY Times Published: April 11, 2012

A recent test of packaged raw chicken products bought at grocery stores across the country found that roughly half of them were contaminated with the bacteria E. coli.

E. coli, which the study said was an indicator of fecal contamination, was found in 48 percent of 120 chicken products bought in 10 major cities by the Physicians Committee for Responsible Medicine, a nonprofit group that advocates a vegetarian diet among other things. The study results were released Wednesday.

“Most consumers do not realize that feces are in the chicken products they purchase,” said Dr. Neal D. Barnard, president of the group. “Food labels discuss contamination as if it is simply the presence of bacteria, but people need to know that it means much more than that.”

Food safety specialists said the findings were a tempest in a chicken coop, particularly because the test was so small and the E. coli found was not a kind that threatened public health. 

100 ill from Salmonella Bareilly

CDC reports that more than 100 people in 19 states are ill from Salmonella Bareilly. CDC states that, this time, at there is no confirmed link to any product. But various news reports state that sushi (spicy tuna rolls) are being looked at closely.

Multistate Outbreak of Salmonella Bareilly InfectionsCDC, Apr 6
 http://www.cdc.gov/salmonella/bareilly-04-12/index.html

Highlights
· A total of 100 persons infected with the outbreak strain of Salmonella Bareilly have been reported from 19 states and the District of Columbia.
· The number of ill persons identified in each state is as follows: Alabama (2), Arkansas (1), Connecticut (5), District of Columbia (2), Georgia (4), Illinois (9), Louisiana (2), Maryland (10), Massachusetts (4), Mississippi (1), Missouri (1), New Jersey (7), New York (23), North Carolina (2), Pennsylvania (3), Rhode Island (4), South Carolina (3), Texas (3), Virginia (5), and Wisconsin (9).
· 10 ill persons have been hospitalized, and no deaths have been reported.
· The investigation has not conclusively identified a food source.
 · The investigation is ongoing into individual food items and their sources.
CDC and FDA are working together on the investigation and will provide updates as soon as they are available.
· If a specific food source is identified for this outbreak, public health officials will alert the public and take further steps to prevent additional illnesses.


More salmonella cases reported in outbreak
http://www.chicagotribune.com/news/local/breaking/chi-more-salmonella-cases-reported-in-outbreak-20120406,0,4200695.story

By Ryan Haggerty Tribune reporter
Chicago Tribune
 1:35 p.m. CDT, April 6, 2012

Seven more people have been confirmed as victims of a nationwide salmonella outbreak, including one more person in Chicago, state and federal health officials announced today.

In all, 100 people across the country and nine in Illinois have been made ill in the outbreak, whose source has still not been determined, officials with the Centers for Disease Control said.

The outbreak, which was first confirmed Wednesday, involves salmonella bareilly, an unusual strain of the salmonella bacterium, CDC officials said.

It has been connected to reported illnesses that have occurred between Jan. 28 and March 25 in 19 states, plus the District of Columbia. Those affected said they had eaten sushi, sashimi or similar foods in the week before their symptoms began, according to the CDC.

FDA releases 2nd edition of Bad Bug Book

FDA has recently released the second edition of the Bad Bug Book.
http://www.fda.gov/downloads/Food/FoodSafety/FoodborneIllness/FodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/UCM297627.pdf

This is a great online reference for foodborne pathogens and toxins (bacteria, viruses, parasites, and natural toxins). There are 5 new chapters in this book – below is a quick summaries of each (as well as grayanotoxin). Each chapter also has an insert – For Consumers: A Snapshot – that provides an overview of each pathogen.

Cronobacter - Causes illness, including bacteremia and meningitis, primarily in infants and immocompromised adults. Can survive in low moisture foods, and has been an issue in powdered infant formulas. “The illness it causes is rare, but when it occurs, infants younger than 2 months old are at highest risk. The death rate is high, from 10 percent to 80 percent… It can then multiply after liquid is added to the formula, especially if the formula is stored at an incorrect temperature, and cause illness in babies who drink it..” To avoid illness in infants, it is important to follow food safety instructions when preparing infant formula.

Enterococcus, “Anyone can become infected with the Enterococcus bacterium, but the people most likely to suffer serious problems are those who already have other serious illnesses. In otherwise healthy people, it may cause diarrhea, cramps, nausea, vomiting, fever, and chills, starting 2 to 36 hours after they eat contaminated food. Enterococcus can be passed to people in different ways, and not much is yet known about how often it’s transmitted by food. But it is known that meat and milk that aren’t processed or cooked properly or that are handled in unsanitary ways are among the foods that can transmit it. A major concern about Enterococcus is that it has become resistant to some antibiotics that were used to treat it – that is, those antibiotics no longer kill it. You can help protect yourself from getting foodborne illness from this and other bacteria or viruses by following basic food-safety tips; for example, by not using unpasteurized (“raw”) milk or certain cheeses and other food made from it, by thoroughly cooking meat or food that contains meat, and by washing your hands, kitchen equipment, and other surfaces before and after you handle food.”

Francisella tularensis, “The bacterium Francisella tularensis causes a disease called tularemia (nicknamed “rabbit fever”). Tularemia can take different forms, depending on how the bacterium enters the body. If it enters through the mouth when a person eats or drinks contaminated food or water, it can cause tularemia that affects the throat or intestines, although this is an uncommon form of the disease. Symptoms of this type range from mild to severe in otherwise healthy people, and it rarely causes death. In the more serious cases, untreated throat infection may spread to vital organs (such as the lungs, brain, or liver), and may cause extensive bowel damage, with bleeding and infection of the bloodstream, especially in people with weak immune systems. People can develop tularemia of the throat or intestines by eating undercooked meat from an infected animal (particularly rabbits) or drinking contaminated water. Eating food or drinking water contaminated by animal waste, such as rodent droppings, also can cause this form of tularemia and many other diseases. Cooking food well is one of the safety tips that can help protect you from getting this form of tularemia, especially if you eat the kind of wild animals known to be carriers, such as rabbits.”

Phytohaemagglutinin, “Eating undercooked bean can cause you to have extreme nausea, severe vomiting, and diarrhea. They contain a protein that’s found naturally in many plants (and animals, including humans), where it performs important functions. But when it reaches high levels in some plants, particularly kidney beans, the protein can act as a toxin. Cooking the beans properly destroys the toxin. Don’t use slow cookers (the kinds of pots that you plug in and that cook food at low temperatures for several hours) to cook these beans or dishes that contain them. Slow cookers don’t get hot enough to destroy the toxin in kidney beans. Studies done by British scientists suggest that beans should be soaked in water for at least 5 hours, the water poured away, and the beans boiled in fresh water for at least 30 minutes.”

Venomous fish, “lionfish (Pterois volitans), a known venomous species from the Pacific Ocean, recently has become invasive and over-abundant along the U.S. south Atlantic coast and in the waters surrounding several Caribbean island countries, presenting new opportunities for human consumption.”

Grayanotoxins – “If bees make their honey from the pollen and nectar of flowers from some types of rhododendron, the honey may contain grayanotoxin, a substance poisonous to humans. Other plants from the same family that may contain it, in the Eastern part of the U.S., include mountain laurel and sheep laurel. Sickness that results from eating honey that contains grayanotoxin is sometimes called “mad honey” poisoning. It has occurred in the past in the U.S., but now appears to be very rare here. Nausea and vomiting are common symptoms of grayanotoxin poisoning. A rarer symptom is burning, tingling, and numbness around the mouth. The toxin affects nerve cells, including not only the nerves that affect the brain, but also those that affect the heart and other muscles. For this reason, grayanotoxin poisoning causes not only problems like dizziness, weakness, confusion, vision disturbances, and heavy sweating and saliva flow, but also irregular or very slow heartbeat, low blood pressure, and fainting. These poisonings are rarely fatal.”

60 Minutes segment "Is Sugar Toxic?"

In case you missed it, here is the 60 Minutes segment on sugar, ‘Is Sugar Toxic?’.

http://www.youtube.com/watch?v=B56Gpf1f5_A

Too much sugar is bad, that is hard to deny. But with consumers having made it such a big component of their diet, will they be willing to change their diet? Hopefully segments like this will get people to think about their diet with the goal of reducing sugar….significantly.

FDA will not ban BPA at this time

The controversy will continue as FDA has decided not to ban BPA from food packaging materials at this time (due to inconclusive evidence). A ban would have had a huge impact on the food supply, as companies rushed to find suitable replacements. Continued study will occur.

U.S. Denies Request to Ban Chemical in Food PackagingBloomberg
By Jack Kaskey - Mar 30, 2012 6:07 PM ETFri Mar 30 22:07:58 GMT 2012

http://www.bloomberg.com/news/2012-03-30/u-s-denies-request-to-ban-chemical-in-food-and-drink-packaging.html

The U.S. Food and Drug Administration rejected a request to ban a contested chemical from cans and other packaging because opponents didn’t provide enough data to support a rule change. 

Continued study of bisphenol A, known as BPA, including completion of federal studies currently in progress, is the most appropriate course of action, the agency said in an e-mail today. The chemical has been used in epoxy linings since the 1960s to extend the shelf life of canned foods and beverages. 

Manufacturers of baby bottles and cups have stopped using polycarbonate containing BPA in response to consumer concerns it may affect children. Campbell Soup Co. (CPB) is among food makers phasing out the use of BPA, while beverage companies such asCoca-Cola Co. (KO) have kept the chemical, saying it’s safe. 

“The information provided in your petition was not sufficient to persuade FDA, at this time, to initiate rulemaking to prohibit the use of BPA in human food and food packaging,”David H. Horsey, an acting associate FDA commissioner, said today in a letter to the Natural Resources Defense Council. 

NRDC, a New York-based environmental advocacy group, petitioned the FDA in 2008 to ban its use in food and drinks packaging. BPA, produced by combining phenol and acetone, mimics the female hormone estrogen and may affect the brain and prostate gland in fetuses and young children, according to theNational Institutes of Health. 

Quickly Processed 

A ban would hurt profits at can-maker Silgan Holdings Inc. (SLGN)and others in the $60 billion industry, Ghansham Panjabi, an analyst at Robert W. Baird & Co., said before the FDA announcement. The biggest U.S. producer of BPA is Saudi Basic Industries Corp. (SABIC), followed by Bayer AG (BAYN) and Dow Chemical Co. (DOW) 

About 4.7 million metric tons of BPA valued at about $8 billion will be produced this year, according to a report by GlobalData, a London-based publisher of business intelligence. Three times as much BPA goes into polycarbonate plastics, used in items ranging from plastic bottles to DVDs, as is used in epoxy resins.

The FDA plans to complete an updated safety review of BPA this year and will make any changes to the chemical’s status based on the science, Douglas Karas, an agency spokesman, said in an e-mail. People of all ages metabolize and rid their bodies of BPA faster than rodents used in studies, he said.

Federally funded research confirms that the human body quickly processes and eliminates BPA, making it “very unlikely” that the chemical causes harm, the American Chemistry Council, a Washington-based industry group, said in a statement today. 

‘Dangerously Off Course’

Sarah Janssen, a senior scientist at the NRDC, said the FDA’s denial of a ban shows “a major overhaul” of chemical regulation is needed. The Environmental Working Group, a Washington-based advocacy group, said consumers can no longer trust the FDA to protect the health of their families. 

“The agency has veered dangerously off course,” Jane Houlihan, the group’s senior vice president for research, said today in a statement. “Pregnant women and new parents should no longer think FDA has their backs.” 

The North American Metal Packaging Alliance, a Washington-based industry group, praised the FDA’s decision. 

“A ban without conclusive scientific evidence of risk would compromise the safety of canned foods and beverages,” John Rost, the alliance’s chairman, said in an e-mailed statement. 

To contact the reporter on this story: Jack Kaskey in Houston at jkaskey@bloomberg.net

2 cases of botulism linked to tofu

Tofu, sold in NY City, has been linked to 2 cases of botulism. The tofu was purchased by a couple in a NY City store. The tofu was displayed in a non-refrigerated, water filled bin. This is the first cases of botulism in NYC in more than 15 years.

‘Tofu is made by coagulating soy milk and pressing the resulting curds. The process begins by soaking, grinding, boiling and straining dried or fresh soybeans. Coagulation of the protein and oil (emulsion) suspended in the boiled soy milk is the most important step in the production of tofu. This process is accomplished with the aid of coagulants. Two types of coagulants (salts and acids) are used commercially. The third type of coagulant, enzymes, is not yet used commercially but shows potential for producing both firm and "silken" tofu’. (adapted from Wikeapedia).

Clostridium botulinum spores would survive the boiling and then be able to grow in the non-refrigerated product (in the absence of a secondary inhibitor. Tofu products vary greatly, even in terms of inclusion of antimicrobial parameters.) The spores will germinate and grow in the protein rich, non-refrigerated product. The product sitting in water would ensure a sufficient water activity as well as help support an anaerobic environment, both essential for C. botulinum. As C. botulinum grows, it produces a neurotoxin. If ingested, the neurotoxin enters the bloodstream and shuts down muscle function, potentially leading to death through the inability of the victim to breath.

Tofu is a considered a potentially hazardous food (TCS food) and thus requires refrigeration during distribution, at retail, and by the consumer.

 Tofu suspected of giving botulism to two people in QueensBotulism is a rare but potentially fatal foodborne illness

By Kerry Wills / NEW YORK DAILY NEWS 

Saturday, March 31, 2012, 2:18 AM
Read more: http://www.nydailynews.com/new-york/queens/tofu-suspected-giving-botulism-people-queens-article-1.1053799#ixzz1qtIZYyHM

Two people got botulism - a rare but potentially fatal foodborne illness - after buying tofu at a store in Flushing.

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