A metal bristle from a grill brush, an example of a metal hazard

As reported by CBS News New York, a man swallowed a metal bristle and caused a severe laceration of his intestine. The bristle, off the grill cleaning brush, had become embedded in the steak and was unknowingly swallowed as the man ate his steak. As it moved through the intestine, it pierced the intestine, leading to a life threatening infection.

When evaluating hazards in food, there is a tendency to minimize the seriousness of metal hazards. This is a great example of how a piece of metal can be missed during chewing as well the type of damage it can cause.

New Jersey Man Recovering After Eating Metallic Bristle From Grill Brushhttp://newyork.cbslocal.com/2012/05/21/new-jersey-man-recovering-after-eating-metallic-bristle-from-grill-brush/#.T7qpLEQFU1c.mailto

RIVER EDGE, N.J. (CBSNewYork) – Think twice before you put the metal to the barbeque this grilling season.

A New Jersey man’s brush with death last week was apparently due to a grilling tool.

Michael DeStafan went to Hackensack University Medical Center thinking he had appendicitis after experiencing excruciating pain in his stomach.

Doctors conducted tests and found a 1 ½-inch-long metallic object had pierced the 54-year-old’s large intestine.  Doctors thought he had swallowed a nail, fish hook or paper.

DeStafan’s wife figured out one of the metal bristles on his grill brush broke off, got stuck to the grill grate and embedded itself in the shell steak her husband had cooked and eaten days before visiting the hospital.
Doctors performed emergency surgery to remove the wire and repair the hole that it made in DeStefan’s large intestine.

“”There was an infection, they just didn’t know how big the infection was, or how much of a hole it had torn inside my intestines, and they didn’t know that until they went in,” DeStafan said. “When I went under he told me I have to do this immediately, because we don’t know what we’re going to find, and there’s a chance that you might not make it.”

DeStafan is hoping his brush with death serves as a warning to others.

“I hope no one will have to go through that,” DeStafan said. “I want people to be aware of the fact that something as simple and innocent as going outside and grilling steaks and hamburgers for your family and friends could potentially be life-threatening.”

The Record reports half a dozen similar cases have been documented in Rhode Island.

DeStafan has since ditched the brush and instead uses a stone to clean the grill.

Update on Salmonella in Ground Tuna

 As of 5/17/12, there are now 316 reported Salmonella infections linked to raw ground tuna product.  The number of states where illnesses have occurred indicate how widespread the contamination must have been within the lots of product produced.  In other words, this was not a one time contamination event for the food processor.

Multistate Outbreak of Salmonella Bareilly and Salmonella Nchanga Infections Associated with a Raw Scraped Ground Tuna ProductCDC News Relase Posted May 17, 2012 2:00 PM EThttp://www.cdc.gov/salmonella/bareilly-04-12/index.html



May 17, 2012Case Count Update

A total of 316 individuals infected with the outbreak strains of Salmonella Bareilly or Salmonella Nchanga have been reported from 26 states and the District of Columbia. The 58 new cases are from Alabama (1), California (2), Colorado (1), Georgia (3), Illinois (4), Indiana (1), Louisiana (1), Maryland (3), Massachusetts (6), New Jersey (1), New York (10), North Carolina (6), Pennsylvania (5), Tennessee (2), Texas (3), Virginia (6), and Wisconsin (3).

Three hundred and four persons infected with the outbreak strain of Salmonella Bareilly have been reported from 26 states and the District of Columbia. The number of ill persons with the outbreak strain of Salmonella Bareilly identified in each state is as follows: Alabama (3), Arkansas (1), California (4), Colorado (1), Connecticut (9), District of Columbia (2), Florida (1), Georgia (13), Illinois (27), Indiana (1), Louisiana (4), Maryland (27), Massachusetts (33), Mississippi (2), Missouri (4), Nebraska (1), New Jersey (26), New York (48), North Carolina (10), Pennsylvania (25), Rhode Island (6), South Carolina (3), Tennessee (4), Texas (7), Virginia (22), Vermont (1), and Wisconsin (19).
Twelve persons infected with the outbreak strain of Salmonella Nchanga have been reported from 5 states. The number of ill persons with the outbreak strain of Salmonella Nchanga identified in each state is as follows: Georgia (2), New Jersey (2), New York (6), Virginia (1), and Wisconsin (1).

Among 316 persons for whom information is available, illness onset dates range from January 28 to May 3, 2012. Ill persons range in age from <1 to 86 years, with a median age of 30. Fifty-nine percent of patients are female. Among 217 persons with available information, 37 (17%) reported being hospitalized. No deaths have been reported.

Illnesses that occurred after April 17, 2012, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

Investigation Update

Laboratory testing conducted by state public health laboratories in Connecticut, Maryland, Massachusetts, Pennsylvania, South Carolina, and Wisconsin has isolated Salmonella from 53 (96%) of 55 samples taken from intact packages of frozen yellow fin tuna scrape from Moon Marine USA Corporation or from sushi prepared with the implicated scrape tuna product. Pulsed-field gel electrophoresis results are available for Salmonella isolates from 41 of the 53 positive samples. Thirty-six samples yielded the outbreak strain of Salmonella Bareilly, and 12 samples yielded the outbreak strain of Salmonella Nchanga. Seven samples yielded the outbreak strains of both Salmonella Bareilly and Salmonella Nchanga.

Underweight meat items results in fine

Kraft recently received some bad publicity for selling packages of food that were deemed underweight by Wisconsin Department of Agriculture. One can be certain that the company was not trying to take advantage of the consumer. Rather, issues happened during processing that impacted pack weight, in this case, the product may have been cooked a little more and thus drove off more moisture.

Each year, a company of two will be caught selling underweight units and then publicly chastised by the press. Each case occurs in roughly the same way. State officials, who regulate retail, pull a dozen or so product units from the store shelf and then weigh the contents of the package to see if those packages meet label weight. In this case, a number of units were below weight.   

In general, the companies try to minimize the give-away (weight above the stated label weight). Weight loss must be factored in (moisture loss through the package, purge, etc). Process variation must be calculated. Taking all this into account, a target weight is determined. Now there will be a few packages that are underweight, but in general, these conditions must be met. For any sample lot (a dozen or so units from a lot), the average weight must exceed label weight, the number of containers at or above weight must be greater than the number of units below weight, and no containers must be more than the MAV (maximum allowable variance).

Those who package food should be aware of Handbook 133 (good document to download and keep on file)
http://dps.sd.gov/licensing/weights_and_measures/images/NISTHandbook133.pdf


Kraft fined for underweight Oscar Mayer packageshttp://www.usatoday.com/money/industries/food/story/2012-05-08/kraft-fined-over-oscar-meyer-packaging-weight/54844906/1

MADISON, Wis. (AP)–Kraft Foods Group has paid a fine of nearly $37,000 to settle allegations of short-weight Oscar Mayer meats found in Wisconsin stores.

State inspectors found 24 packages of Oscar Mayer meats that were below their stated weight. The packages were found in Wisconsin stores between last August and this February.
An official of the Wisconsin Department of Agriculture, Trade and Consumer Protection calls the shortages "very significant."

None were packaged at the Madison factory of Oscar Mayer, which is based in Madison.

A Kraft spokeswoman tells the Wisconsin State Journal some oven heat changes and other manufacturing changes "resulted in unplanned and unwanted variances." She says corrections have been made.

As part of the civil forfeiture agreement, Northfield, Ill.-based Kraft did not admit to violating any Wisconsin laws.

Updates on Salmonella Linked to Tempeh and Pet Food and the Importance of Supplier Control

Here are updates for two ongoing outbreak investigations/recalls. Interestingly, both cases indicate the importance of supplier control – in the case of tempeh, it was an ingredient bought from an on-line supplier, and with the pet food, a co-packer has impacted other retail brands.
Salmonella in Tempeh (original post - http://pennstatefoodsafety.blogspot.com/2012/05/outbreak-of-salmonella-paratyphi-b-in.html)

The number of Salmonella cases associated with contaminated tempeh has increased to 63 according to the NC Department of Ag. In testing, it was found that the starter culture used was responsible for the contamination. The company who sold the starter culture was Tempeh Online, which one can guess is a small, web-based company. (If we think about Supplier Control – it can be difficult for one buying an important component on the web from a unknown entity, where there is limited opportunity to investigate the supplier. Starter culture is an ingredient that needs tight process control in that if the process is contaminated, that contaminate, in this case Salmonella, may grow right along with the designated culture, or can contaminate the culture through cross contamination if handling procedures are not good).

Salmonella-tainted culture shipped from Maryland company
 Test confirms tempeh salmonella source
 http://www.citizen-times.com/article/20120511/NEWS/305110037/Tainted-food-salmonella-outbreak-traced-Md-?odyssey=tab%7Ctopnews%7Ctext%7CFrontpage

Salmonella News Update 5/10/12
 http://buncombecounty.org/news_detail.aspx?newsID=12319
 On Thursday, May 10, Buncombe County Department of Health received final test results from the NC Department of Public Health laboratory confirming that the unopened bag of culture that was added to the tempeh tested positive for the matching strain of Salmonella Paratyphi B linked to the current disease outbreak.
The US Food and Drug Administration is already involved in tracing the origin of the ingredient to identify source of contamination as well as the potential for other Salmonella outbreaks in the US.
As of May 10 at 2 PM, Buncombe County Department of Health reports 58 cases associated with salmonella outbreak. Please keep in mind that this number does not include cases being reported in other counties or states.
NC Department of Public Health reports 63 cases, which includes cases in NC and other states; however there is a slight delay in reporting.
To listen to information, call the HOTLINE: 828.250.5300 (English, Spanish and Russian).
 To report symptoms of Salmonella Paratyphi B, call Communicable Disease Nurses: 828.250.5109.

Pet Food and Salmonella (Original Post - http://pennstatefoodsafety.blogspot.com/2012/05/diamond-pet-foods-linked-to-salmonella.html)

As of 5/11/12,CDC reports there are now 16 related illnesses.
http://www.cdc.gov/salmonella/dog-food-05-12/index.html

A total of 15 individuals infected with the outbreak strain of Salmonella Infantis have been reported from 9 states. Additionally, one ill person has been reported from Canada.

• The number of ill persons identified in each state is as follows: Alabama (1), Connecticut (1), Michigan (1), Missouri (3), North Carolina (3), New Jersey (1), Ohio (2), Pennsylvania (2), and Virginia (1). One new ill person was reported from Pennsylvania.
• Among the 10 patients with available information, 5 (50%) were hospitalized. No deaths have been reported
• Multiple brands of dry dog food produced by Diamond Pet Foods at a single manufacturing facility in South Carolina have been linked to some of the human Salmonella infections.

The FDA news releases state that additional companies are recalling product made by Diamond Pet Food. The pet food has been linked to 14 cases of Salmonella. Companies that use Diamond to co-pack product must now react in the event that their product to may be linked to Diamond. Here again, another supplier control issue. Co-packing is an important part of the food supply chain. Many retailer branded products are produced by co-packers and must rely on these companies food safety systems. If there is an issue with co-packer produced product, and it may be a different brand such as in this case, it may result in a major blow to the retailer’s brand as well. 

From the FDA Recall notice.

http://www.fda.gov/Food/FoodSafety/CORENetwork/ucm302904.htm
 http://www.cdc.gov/salmonella/dog-food-05-12/index.html

May 9, 2012
Diamond Pet Foods has expanded its recall of some brands of dry dog and cat food manufactured in its Gaston, South Carolina facility between December 9, 2011 and April 7, 2012 because it has the potential to be contaminated with Salmonella.

The FDA, CDC and state and local officials are collaborating to investigate cases of human illness linked to some brands of dry pet food produced by Diamond Pet Foods at the South Carolina facility.
Consumers should check the company’s website, Diamond Pet Foods Recall Information6 , for information on how to read lot codes and “best by” dates involved in the recall, as well as specific states where the following products were distributed:

· Chicken Soup for the Pet Lover’s Soul
· Country Value
· Diamond
· Diamond Naturals
· Premium Edge
· Professional
· 4Health
· Taste of the Wild
· Apex (distributed only in the state of South Carolina)
· Kirkland Signature (Costco)
· Kirkland Signature Nature’s Domain (Costco)
· Canidae
Several other companies with products manufactured at the Gaston, S.C. facility have issued voluntary recalls, since some of their products were produced at the Gaston facility during the time frame of the recalls and have the potential to be contaminated with Salmonella. Those companies include:
Dick Van Patten's Natural Balance7
Apex Pet Foods8
Canidae9, Wellpet LLC10
Solid Gold Health Products for Pets11

Diamond Pet Foods continues to work directly with distributors and retailers where the recalled products are carried to remove them as quickly as possible from the marketplace. FDA will provide updates on the recall and the investigation as new information becomes available. Complete information on the recalled products, including photos, lot numbers, and distribution information on each is located at Diamond Pet Foods Recall Information.

Reusable grocery bag responsible for transferring norovirus in Oregan outbreak

A reusable grocery bag was found to be the carrier of norovirus that was responsible for girls on an Oregon soccer team getting ill. Investigators conducted tests on the bag and found norovirus on the sides of the bag, below the handle.

Reusable grocery bags have increased in usage as people look try to become more ‘green’. It is important however, that these bags be recognized as a potential source of contamination. Much concern with reusable grocery bags is usually directed to the potential contamination from raw meats (purge from raw meats dripping onto the bags, carrying potential pathogens such as Salmonella or STEC E. coli along with it). Thus it is important to wash afterward. In this case however, a sick individual transferred norovirus to the bag and then the norovirus was transferred from the bag to other individuals who became ill. 

Norovirus has a low infectious dose (it does not take a lot of viral particles to make one ill) and is relatively resistant to normal environmental conditions (it has been shown to survive for weeks on carpets, so it probably would be the same with grocery bags). Typical symptoms of norvirus infections are vomiting (acute onset) diarrhea and stomach cramps.  Symptoms can occur within 18 to 48 hours of exposure.



Oregon norovirus traced to reusable grocery bagUSA Today 5/10/12
http://www.usatoday.com/news/health/story/2012-05-10/Oregon-norovirus-grocery-bags/54874814/1?csp=34news

PORTLAND, Ore. (AP)–Oregon investigators have traced an outbreak of norovirus to a reusable grocery bag that members of a Beaverton girls' soccer team passed around when they shared cookies.

The soccer team of 13- and 14-year-olds traveled to Seattle for a weekend tournament in October 2010.

Diamond Pet Foods Linked to Salmonella Outbreak

For Update (http://pennstatefoodsafety.blogspot.com/2012/05/updates-on-salmonella-linked-to-tempeh.html)

CDC reports that there are 14 cases of Salmonella linked to dry dog food produced by Diamond Pet Foods. People become ill from handling the pet food itself and from interaction with the pet who ate the food (yes, and there are probably a few people who may take a little bite themselves).

From the CDC information, it appears that cases could have been seen as early as late 2011, but cases have been coming in sporadically over a 5 or 6 month period. FDA released the first recall notice by Diamond on April 6, (http://www.fda.gov/Safety/Recalls/ucm299606.htm) but indicated no illnesses were reported. Diamond expanded the recall again on April 26th (http://www.fda.gov/Safety/Recalls/ucm302137.htm) and again on April 30th (http://www.fda.gov/Safety/Recalls/ucm302514.htm) to include puppy formula, but in both recall notices did not indicate whether people were affected. Much of this delay is probably related to the low level of cases that occurred over the last 5 months in that connecting illnesses to a product becomes difficult. Couple that with the slow movement of pet food from manufacture to store shelf to purchase to use and to illness. The company started the recall when they got test results back from Michigan Department of Ag , but that expanded the recall as Ohio Dept of Health found Salmonella in product during an illness investigation.  It appears then that CDC had sufficient information to link illnesses with product.

From past incidents with Salmonella in dry dog food such as the Mars Pet Foods in 2008, Salmonella can establish itself in pet food plants and be very difficult to eliminate. This Mars facility that was linked to the Salmonella outbreak was eventually shuttered. If one had to determine how this occurs, Salmonella comes in on the raw materials, and ross contaminates (through air movement via dust particles, personnel movement, etc) the post process side or finished product side of the operation (after the heating step known as extrusion). Once there, Salmonella can make its way into the nooks and crannies and slowly be released into the final product. This can be seen in the Diamond Pet Foods case because there is not just one product implicated, but rather a number of products.

If consumers have Diamond Pet Foods, they should cease use and return to store or dispose.  

Multistate Outbreak of Human Salmonella Infantis Infections Linked to Dry Dog Food
CDC News Release Posted May 3, 2012 5:15 PM ET
http://www.cdc.gov/salmonella/dog-food-05-12/index.html

· A total of 14 individuals infected with the outbreak strain of Salmonella Infantis have been reported from 9 states.

· The number of ill persons identified in each state is as follows: Alabama (1), Connecticut (1), Michigan (1), Missouri (3), North Carolina (3), New Jersey (1), Ohio (2), Pennsylvania (1), and Virginia (1).
· Among the 9 patients with available information, 5 (56%) were hospitalized. No deaths have been reported.
· Multiple brands of dry pet food produced by Diamond Pet Foods at a single manufacturing facility in South Carolina have been linked to some of the human Salmonella infections.
· Consumers should check their homes for recalled dog food products and discard them promptly. People who think they might have become ill after contact with dry pet food or with an animal that has eaten dry pet food should consult their health care providers.

Has Artisanal Become the New Natural for Food Products?

In an article by Jillian Eugenios, she asks the question, “Does ‘artisanal’ even mean anything anymore?”. (http://bites.today.msnbc.msn.com/_news/2012/05/02/11503731-does-artisanal-even-mean-anything-anymore). It is in reference to a lawsuit filed against Dunkin Donuts and their new ‘artisan’ line of bagels. The lawsuit claims that this term should be limited to “products produced by hand, using traditional methods in small quantities”. My guess is that each Dunkin Donuts shop is not hand making bagels in the back of the store.

However, if I indeed want bagels made by hand in small batches, I will go to a family owned bakery. The term ‘artisinal’ in of itself, will not drive my purchase. My other guess is that the DD ‘artisanal’ bagels are probably pretty good. And if they were called by another name, say ‘really good bagels’ , they would still be pretty good bagels, regardless of the name.

And who is to decide what is ‘artisinal’? If a chain of family owned bagel shops makes bagels in the back of each store, can they call that artisanal? What if they centralize production to reduce costs and improve quality by making these same bagels in one location and then distributing them to the other shops…is this still ‘artisinal’? We have the same issue with term ‘organic’, and there are actually federal rules on what is considered, ‘organic’.

At this point, ‘artisanal’ is destined to become the new ‘natural’, or the new ‘gourmet’. We probably should spend more time on finding that quality product we like, or establishments we choose to buy from, rather than on what we call it.

Outbreak of Salmonella paratyphi B linked to Organic Tempeh

For Update (http://pennstatefoodsafety.blogspot.com/2012/05/updates-on-salmonella-linked-to-tempeh.html)

A North Carolina company, Smiling Hara Tempeh, is recalling unpasteurized Tempeh (fermented bean product) which has tested positive for Salmonella and linked to at least 34 cases of salmonellosis. The company has taken complete responsibility for this outbreak, and is recalling the product.  The product was produced in a shared commerical kitchen of a food incubator.

I think this case shows that no matter the size of the company, or the image they have (see website excerpt below), there is the potential for foodborne illness if all necessary preventive measures are not enacted. Too often, companies that are local, or that claim organic status, or that process foods in a traditional way consider themselves as being inherently safer than larger or conventional companies. Many consumers believe this as well. Salmonella does not read the internet, nor does it care about where those food products are made. If there is an opening, whether it is a processing error, less than hygienic personnel pracitces, or contaminated raw materials, Salmonella will simply take advantage of it.

The strain responsible for this illness was Salmonella paratyphi B which causes an illness similar to Typhoid Fever. It is a very serious infection with symptoms that include a high, sustained fever, headache, diarrhea, abdominal pain, and enlarged liver or spleen. Symptoms can last up to a week or longer, and patients are usually treated with antibiotics. There is also a longer incubation period (time of consumption to the time symptoms are seen) of 7 to 14 days or longer. (Because of this, there may be additional cases.)

Some people eat tempeh raw, but it is normally cooked, often through frying cubes cut from the block.   One would expect the cause to be either cross contamination (raw product contaminating clean surface or other food item) or through undercooking of the product.

Excerpt from Smiling Hara Tempeh website:
http://www.smilingharatempeh.com/
Smiling Hara(meaning “happy belly”) was created in 2009 and spawned from a passion to provide Western North Carolina with an organic, GMO-free, UNpasteurized, local source of Tempeh. We are committed to providing the most nutritious and fresh Tempeh possible, giving our customers the healthiest option and at the same time providing a market for local, organic farmers. We have developed a unique line of Tempehs, including not only the traditional soy Tempeh, but also a variety of legumes such as Black Bean and Black-Eyed Peas! We produce our Tempeh fresh every week right here in Asheville, NC.
Whether you are vegan, vegetarian, pescatarian, or omnivorous, do your body a favor and incorporate local, unpasteurized Tempeh into your regular diet.
 A Intro to Tempeh From Wikipedia

Tempeh (English pronunciation: /ˈtɛmpeɪ/; Javanese: témpé, IPA: [tempe]), is a traditional soy product originally from Indonesia. It is made by a natural culturing and controlled fermentation process that binds soybeans into a cake form, similar to a very firm vegetarian burger patty.

Tempeh begins with whole soybeans, which are softened by soaking and dehulled, then partly cooked. Specialty tempehs may be made from other types of beans, wheat, or may include a mixture of beans and whole grains.

A mild acidulent, usually vinegar, may be added in order to lower the pH and create a selective environment that favors the growth of the tempeh mold over competitors. A fermentation starter containing the spores of fungus Rhizopus oligosporus is mixed in. The beans are spread into a thin layer and are allowed to ferment for 24 to 36 hours at a temperature around 30 °C (86 °F). In good tempeh, the beans are knitted together by a mat of white mycelia.
 Salmonella traced to Asheville tempeh
Tests confirm bacteria in Smiling Hara product as outbreak worsenshttp://www.citizen-times.com/article/20120501/NEWS/305010037/Salmonella-traced-area-tempeh?odyssey=tab%7Ctopnews%7Ctext%7CFrontpage
10:08 PM, Apr. 30, 2012
Joel Burgess Citizen-Times.com

ASHEVILLE — A local maker of fermented bean product confirmed Monday evening that its product tested positive for salmonella. as an outbreak caused by the bacteria worsens.

Smiling Hara Tempeh, which makes a soy, black bean and black-eyed pea version of the product, according to its website, had pulled the food from shelves earlier Monday.

Tests by the N.C. Department of Agriculture confirmed the bacteria was present in a sample collected from a routine inspection by the Food and Drug Protection Division, according to a statement from Smiling Hara Tempeh. Further testing is being done, it added.

FSIS issues verification testing for Non O157 STECs

FSIS has just issued the Verification Testing for Non-O157 STEC for Beef Trimmings. While this new wrinkle in the E. coli-Beef trim issue has caused a lot of concern, the anticipated outcome may not come anywhere close to the hype.  

Domestic product http://www.fsis.usda.gov/OPPDE/rdad/FSISNotices/29-12.pdf
Imported http://www.fsis.usda.gov/OPPDE/rdad/FSISNotices/30-12.pdf

Background - On June 4th, FSIS will begin testing for six non-0157 serogroups (O26, O45, O103, O111, O121, and O145) in addition to O157:H7. Like E. coli O157:H7, these E. coli serogroups are viewed as adulterants in non-intact raw beef products and product components (raw ground beef and beef trim).

A few interesting notes:
1) FSIS does not expect establishments to reassess their HACCP plans because of this testing implementation. (Facilities should address non-O157 STEC in their Hazard Analysis.)

2) FSIS will not schedule a for-cause FSA in response to a non-O157 positive sample result. Outside of that, FSIS will follow Directive 10,010.3 Rev 3 including resampling. (And corrective action for positive product, which will include holding and dispositioning of positive product). http://www.fsis.usda.gov/OPPDE/rdad/FSISDirectives/10010.1Rev3.pdf

3) “FSIS recognizes that establishments will begin taking steps to address non-O157 STECs in their HACCP systems and performing activities to gather data to validate that their food safety systems are adequately designed to control non-O157 STECs. Establishments are to document and identify in their initial validation activity plans the time frame in which they will have accumulated sufficient data to conclude that their food safety systems are demonstrated to be adequate to control for the relevant non-O157 STECs”.

4) FSIS will not require establishments to adjust their existing testing programs for non-O157 STEC.

5) A confirmed positive is an isolate that has stx and eae genes and one or more of the target serogroup genes (O45, O26, O113, etc.). A positive is not just a positive for the genes, but the bacterium must be isolated and biochemically confirmed, so establishments should be prepared to deal with false positives.