Norovirus outbreak on cruise ship, Over 600 people ill

A Royal Caribbean cruise ship returned to port early as an outbreak of norovirus caused 577 of the passengers (out of 3050 on board) and 49 of the crew to become ill.

Symptoms of norovirus infection include vomiting and diarrhea as well as nausea, stomach pains, headache, fever, and body pain.  The symptoms can last from one to several days.  The vomiting can often be described as acute onset vomiting, which means that as soon as you feel like you have to vomit, you vomit...and that can be anywhere you are standing or sitting, including the dinner table.  This is one reason it can be spread so easily within a captive group of people, such as on a cruise ship.  The virus can be aerosolized on the vomitus particles as it leaves the person's mouth

Another reason is that the virus is stable on surfaces unless that surface is effectively sanitized.  So it can get onto people's hands, onto food, onto dinner tables, and unless properly cleaned and sanitized, it will remain there until it is transferred to another's hands or to a food item.

People can continue to shed the virus even after the symptoms have subsided.  So hand washing continues to be a must.

The cruise ship industry has gone to great measures to prevent such outbreaks.  Constant cleaning and quarantining sick people are standard practices.  However once the illness gets to a critical mass, it can be next to impossible to control, and that is what appears to have happened here.

This cruise ship will need to undergo extensive cleaning and sanitizing before returning to service.  Residual virus-containing vomit not cleaned can serve as the source for the next outbreak.   And with that many people reported as being ill, you can imagine the amount of yuck laying around the place.


Cruise ship heads home after illness outbreakMary Beth Marklein @mbmarklein, USA TODAY 11:35 a.m. EST January 27, 2014

http://www.usatoday.com/story/news/nation/2014/01/27/illness-outbreak-on-cruise-ship/4936777/

More 600 passengers and crew have experienced gastrointestinal symptoms.

 A Royal Caribbean cruise ship is headed back to New Jersey two days early after an outbreak of gastrointestinal illness spiked over the weekend, the cruise line says.

A report posted online by the Centers for Disease Control and Prevention says 577 of the ship's 3,050 passengers, or 18.9%, and 49 of 1,165 crew, or 4.2%, reported symptoms such as vomiting and diarrhea during the voyage.

In Japan, man arrested in frozen food conatamination case; over 2800 ill

In Japan, a man was arrested for contaminating frozen food products with the pesticide malathion. The deliberate contamination resulted in over 2800 becoming ill, many of them children. The company was forced to recall over 6 million units of frozen food including frozen pizza and lasagna. It is suspected that the perpetrator added the contaminate immediately before the packaging process. 9 products are reported as having been contaminated.

It is interesting in that, according the news reports, that the company had restrictions on bringing personal items into the production area....so much so, that one person, according the news reports, was astonished that someone was able to get the chemical out on the floor. He also worked as part of a team when on the production floor - there were 4 people assigned to the crust area including the accused.

Another interesting note is that the President of the company as well as the President of the subsidiary will resign in March due to this incident. Salaries of these and other top officials will be cut for a period of time.

The accused is reported as being a contract worker, although he worked at the same facility for 8 years.

This case shows the amount of damage one person can cause through deliberately contaminating food, especially considering it occurred in what appears to be a facility with decent controls.



Arrest made over tainted frozen food
http://the-japan-news.com/news/article/0000973903
Japan NewsMonday, January 27, 2014

The Yomiuri Shimbun

A man in his late 40s was arrested on Saturday on suspicion of obstructing business by lacing frozen foods with a pesticide at a major food maker’s subsidiary plant in the town of Oizumi, Gunma Prefecture.

The man, Toshiki Abe, 49, is a contract employee working at the plant of AQLI Foods Corp., a subsidiary of Maruha Nichiro Holdings Inc., police said.

Investigators detected malathion on clothes he wore at the plant. He had been missing since Jan. 14, but was discovered in Saitama Prefecture on Friday.

Colorado's New Food Safety Challange - POT!

With the passing of the law to make marijuana legal , Colorado must now address issues associated with legalization including regulations impacting food safety. Food safety comes into play because THC, the psychoactive component, can be added to a number of different products including pastries, cookies, and candies. So what hazards are associated with the plant and within the process of making these products? How does one control dosage of THC? How should products be labeled?

Looking down the road, the potential exists for other states to pass legal status to marijuana. To what degree does this give Colorado companies a head start in the development, manufacture and distribution of pot and THC? By the time other states get into the game, the Colorado industry will be well developed, giving those existing companies a competitive advantage. Along with that, many of the legal food standards that are set will be established in Colorado.

Some have suggested that marijuana get the Federal okay for use, since it is considered GRAS...oops it is grass, not GRAS (generally recognized as safe).

 There was an outbreak of Salmonella associated with Marijuana in 1982 (below)

Colorado Imposes Food Safety Rules On Marijuana Industry
By Luke Runyon
http://kvnf.org/post/colorado-imposes-food-safety-rules-marijuana-industry
Fri January 24, 2014
kvnf.com

Colorado made history when it opened up licensed marijuana retail shops this year. Aside from just legalizing the purchase of smoke-able marijuana, it also means pot brownies have the potential to be big business.

Food products infused with marijuana’s psychoactive ingredient, THC, are available in stores across the state.

Marijuana, though, is still considered illegal by the federal government. The existing food safety system, which relies heavily on support from federal agencies, can’t ensure that marijuana-infused foods are safe.

Salmonella forms biofilm that increases resistance to disinfectants

A research study has shown that Salmonella forming biofilms increases the organisms ability to withstand disinfectants, especially as the biofilm ages. This study showed that 168 hour old biofilm increased the probability of survival against disinfectants compared to 48 hour old biofilms. They suggest that these biofilms can help Salmonella survive in facilities for long periods of time

Salmonella can be very difficult to remove from an establishment once it has become established. One study showed that a Salmonella strain survived for 10 years in a facility despite intensive cleaning and decommissioning of contaminated equipment. Two recent outbreaks in the US ultimately resulted in the shuttering of operations after those facilities were not able to eliminate Salmonella from the environment.

Biofilms may only be part of the answer. Aged bacterial cells may have increased resistance. We know that Salmonella has survived in products like peanut butter for months. We know that in dry products, Salmonella has increased heat resistance. For example, almonds roasted in oil require a process of 1.6 minutes at a temperature of 260ºF to achieve a 4 log kill.
Food processors beware: Salmonella biofilms incredibly resistant to powerful disinfectants

Phys.org.com 1/15/14
http://phys.org/news/2014-01-food-processors-beware-salmonella-biofilms.html#jCp

Once Salmonella bacteria get into a food processing facility and have an opportunity to form a biofilm on surfaces, it is likely to be extraordinarily difficult, if not impossible, to kill it, according to research published ahead of print in the journal Applied and Environmental Microbiology.

Researchers from National University of Ireland, Galway conducted a study in which they attempted to kill Salmonella biofilms on a variety of hard surfaces, using three types of disinfectant.

"We found that it was not possible to kill the Salmonella cells using any of the three disinfectants, if the biofilm was allowed to grow for seven days before the disinfectant was applied," says Mary Corcoran, a researcher on the study. Even soaking the biofilms in disinfectant for an hour and a half failed to kill them

Tyson recalls mechanically seperated chicken meat due to the potential for Salmonella

Tyson Foods is recalling 33.840 pounds of mechanically separated chicken products due to the potential for contamination by Salmonella Heidelberg. This is institutional use product – 10 lb. chubs / 40 lb. cases.

The issue was discovered after seven inmates in a Tennessee correctional facility become ill with two requiring hospitalization.

Mechanically separated meat (MSM) is meat that is recovered from the bone through the use of a machine that presses the carcass against a screen or sieve, allowing the meat to be separated from the bone. The recovered meat has the appearance of a paste. This product can be reformed to make items such as chicken nuggets, or added to make chicken sausage or hot dog products.

Being a raw meat product, it has the potential to carry pathogens that are inherently present on the poultry including Salmonella and Campylobacter. USDA testing indicates that the level of Salmonella and Campylobacter tend to be high in this product type, mostly due to increased handling.

It is a low cost protein product…think sustainability or increased utilization.  It is easy to see why this cheaper source of meat product is utilized by the correctional facilities, but now will there need to be consideration for pre-cooking or irradiating this product?


USDA News Release
Missouri Firm Recalls Mechanically Separated Chicken Products Due To Possible Salmonella Heidelberg Contamination
Class I Recall 001-2014
Health Risk: High Jan 10, 2014

Congressional and Public Affairs
Felicia Thompson
(202) 720-9113
http://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2014/recall-001-2014-release


WASHINGTON, Jan. 10, 2014 – Tyson Foods, Inc. a Sedalia, Mo., establishment, is recalling approximately 33,840 pounds of mechanically separated chicken products that may be contaminated with a Salmonella Heidelberg strain, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The mechanically separated chicken products were produced on Oct. 11, 2013. The following products are subject to recall:

40-lb. cases, containing four, 10-lb. chubs of “TYSON MECHANICALLY SEPARATED CHICKEN.” 

The products subject to recall bear the establishment number “P-13556” inside the USDA mark of inspection with case code 2843SDL1412 – 18. These products were shipped for institutional use only, nationwide. The product is not available for consumer purchase in retail stores.

FSIS was notified of a Salmonella Heidelberg cluster of illnesses on Dec. 12, 2013. Working in conjunction with the Tennessee Department of Health (TDH), FSIS determined that there is a link between the mechanically separated chicken products from Tyson Foods and the illness cluster in a Tennessee correctional facility. Based on epidemiological and traceback investigations, seven case-patients at the facility have been identified with illnesses, with two resulting in hospitalization. Illness onset dates range from Nov. 29, 2013 to Dec. 5, 2013. FSIS continues to work with TDH on this investigation and will provide updated information as it becomes available.    

Consumption of food contaminated with Salmonella can cause salmonellosis, one of the most common bacterial foodborne illnesses. The most common symptoms of salmonellosis are diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating the contaminated product. The illness usually lasts 4 to 7 days. Most people recover without treatment. In some persons, however, the diarrhea may be so severe that the patient needs to be hospitalized. Older adults, infants, and persons with weakened immune systems are more likely to develop a severe illness. Individuals concerned about an illness should contact their health care provider.

FSIS advises all consumers to safely prepare their raw meat products, including fresh and frozen, and only consume poultry products that has been cooked to a temperature of 165 °F. The only way to confirm that poultry products are cooked to a temperature high enough to kill harmful bacteria is to use a food thermometer that measures internal temperature, http://1.usa.gov/1cDxcDQ.

Consumers with questions about the recall should contact Tyson Foods’ consumer relations department at 866-886-8456. Media with questions should contact Worth Sparkman, Tyson Foods’ public relations manager, at 479-290-6358.

Consumers with food safety questions can "Ask Karen," the FSIS virtual representative available 24 hours a day at AskKaren.gov or via smartphone at m.askkaren.gov. The toll-free USDA Meat and Poultry Hotline 1-888-MPHotline (1-888-674-6854) is available in English and Spanish and can be reached from l0 a.m. to 4 p.m. (Eastern Time) Monday through Friday. Recorded food safety messages are available 24 hours a day. The online Electronic Consumer Complaint Monitoring System can be accessed 24 hours a day at: http://www.fsis.usda.gov/reportproblem.

Chineese Fox Meat Scandal

In China, Wal-Mart has recalled donkey meat after it was found to be adulterated…with among other meats, fox meat. While donkey meat is consumed by some in the northern parts of China, fox is not. Fox is reported as tasting rank, but is cheap due to the fact that farmers who raise fox for the fur trade will have a carcass to dispose. And then what to do with the carcass….in this case, grind it into some donkey.

Retailers and foodservice companies rely on suppliers, so managing the supply chain is critical. In China, were food safety systems have been more lax in the past, one cannot assume that downstream suppliers have the necessary systems in place to guarantee safety and quality. Even in the US, there have been a number of food safety issues occurring at retail that were caused by poor practices by downstream suppliers. Those who have succeeded in China have been companies that put great effort into managing their supply chain.



Wal-Mart recalls donkey product in China after fox meat scandal
By Adam Jourdan
Reuters
SHANGHAI Thu Jan 2, 2014 5:11am EST
http://www.reuters.com/article/2014/01/02/us-walmart-china-idUSBREA0103O20140102

(Reuters) - Wal-Mart Stores Inc, the world's largest retailer, has recalled donkey meat sold at some outlets in China after tests showed the product contained the DNA of other animals, the U.S. company said.

MMWR on 2010 Salmonella Outbreak from Pulled Portk at Church Fesitval

This week in MMWR, there is a report on the 2010 Salmonella outbreak from consumption of pulled pork with coleslaw from a church festival in Ohio. 64 people became ill….most reporting diarrhea, cramps, fever and headache. The median duration of illness was 5 days. 

While they could not identify how the food became contaminated, the producer of the pulled pork did prepare it in a private home. The pork was said to be cooked to a temperature of 180F.

So if you had to guess….did cross contamination occur in the home kitchen as larger amounts of food were being moved about in a small space? Or was the temperature of 180F actually reached? Was the temperature even checked?



Morbidity and Mortality Weekly Report (MMWR)
Weekly
January 3, 2014 / 62(51);1045-1047
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6251a2.htm?s_cid=mm6251a2_e


Outbreak of Salmonellosis Associated with Consumption of Pulled Pork at a Church Festival — Hamilton County, Ohio, 2010


On June 18, 2010, Hamilton County Public Health (HCPH), a local health department in Ohio, began receiving reports of gastrointestinal illness from persons who attended a church festival held during June 11–13 in a suburban community of Hamilton County. HCPH investigated and confirmed the existence of a foodborne outbreak associated with consumption of pulled pork prepared in a private home and sold at the church festival. Sixty-four attendees with gastroenteritis were identified. Salmonella enterica serotype Typhimurium (Salmonella Typhimurium) was found in stool specimens from three patients; no other pathogen was found. Because the outbreak was identified after the church festival had concluded, the environmental investigation was limited to interviews of food handlers. The primary public health interventions consisted of 1) active surveillance for additional cases of salmonellosis associated with the festival, 2) consultation with the festival organizers and food vendors to ensure the pork product was not resold or consumed elsewhere, 3) education of the festival organizers and food vendors about relevant public health regulations and food safety practices, 4) traceback of the implicated product to the retailer in Indiana, and 5) notification of the Indiana State Department of Health. The results of the investigation call attention to the public health implications of unregulated food service at events such as church festivals, which generally are exempt from public health inspection and licensure in Ohio. Food sold in such environments might place populations at risk for foodborne illness.

FDA's Proposed Rule on Prevention of Intentional Contamination (Food Defense)

On December 20, 2013, FDA rolled out the proposed rule on food defense – Proposed Rule for Protecting Food against Intentional Adulteration. In this rule, facilities will need to develop and implement a food defense plan. In doing this, they will identify any actionable process steps and implement mitigation strategies that will protect food from intentional contamination.

 

Of the FSMA sections proposed thus far, this is one that should receive sufficient debate. Requiring facilities to have a written food defense plan is one thing, but the sticking points will be on enacting mitigation strategies for actionable steps is where there can be some controversy. Adulteration is a low risk event, so how much resources should a facility commit to putting in control measures. And there can be significant difference of opinions on which steps truly represent a risk, and then which control measures should be used for those steps.

 

For example, a facility may have a bulk mixing tank. People who work in the facility may not see any significant risk due to the fact that it is out in the open and only employees have access. But from the CARVER analysis, this process step was deemed the highest risk area within the facility. The facility management may not think that further mitigation is needed, outside of limiting visitors in the facility. But an inspector may want more control, like a cover (which would making cleaning difficulty), a gate to limit access (not practical if the batch operator has to constantly access the batch area), or hire an extra employee for two batch operators. Maybe all would be suggested.

 

In doing a Food Defense Plan, there are a number of factors that come into play in preventing adulteration in a facility. But a motivated assailant can pose a risk to even the most secure facilities. So in the case of the mix tank, what if a subversive terrorist was hired, what if they paid an employee millions of dollars, what if…..

 

So it is important that facility management and regulatory inspectors understand the true risks associated with intentional adulteration and that resources be judiciously applied. Otherwise, the ‘what ifs’ that can be posed the security of any operation or any process can get way out of hand and pose a significant financial burden to the facility, or create a bigger food safety risk.

 

 

Focused Mitigation Strategies to Protect Food Against Intentional Adulteration

 

Link to the proposed regulation.

http://www.regulations.gov/#!documentDetail;D=FDA-2013-N-1425-0002

 

 The Link to the proposed rule website.

http://www.fda.gov/Food/GuidanceRegulation/FSMA/ucm378628.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery#summary

 

Here are a few sections from that summary page:

 

Summary

 

FDA’s proposed rule on food defense would require domestic and foreign facilities to address vulnerable processes in their operations to prevent acts on the food supply intended to cause large-scale public harm. The proposed rule, which is required by the FDA Food Safety Modernization Act, would require the largest food businesses to have a written food defense plan that addresses significant vulnerabilities in a food operation.

 

The FDA is proposing that the requirements be effective 60 days after the final rule is published in the Federal Register. Recognizing that small and very small businesses may need more time to comply with the requirements, the FDA is proposing tiered compliance dates based on facility size. The proposed rule was published on December 24, 2013, and comments are due by March 31, 2014. The FDA will hold a public meeting on February 20, 2014, to explain the proposal and provide additional opportunity for input.

 

MMWR case study- Staph enterotoxin outbreak from food served at office party

In the Dec 20th edition of MMWR, a case study of a 2012 incident of staphylococcal enterotoxin poisoning is presented. The outbreak occurred at a military base where 13 individuals were admitted to the hospital after eating contaminated perlo (a chicken, sausage rice dish). According to the report, the 22 individuals became ill 2 to 3 hours after eating at a work lunch party. Symptoms included nausea, vomiting and diarrhea. While there were a number of dishes served, the investigation determined the perlo was the culprit. This item had been prepared the previous day, kept warm in an unheated oven overnight (8 hrs), and then reheated the next day.

Staphylococcus is commonly found on people and can contaminate food when properly handled. However, the key factor in this case was the temperature abuse, in this case, holding the food overnight in the unheated oven. During this time at the elevated temperature, the organism grows and produces the heat stable enterotoxin that is not destroyed during reheating. When the contaminated food is eaten, symptoms are usually seen within a few hours. If the perlo had been properly cooled, the organism would not have grown and would not have formed the toxin.

Keep this story in mind as you attend the various holiday parties this holiday season. It will make you wonder about who cooked each of the dishes and how good their food safety practices are.


 Outbreak of Staphylococcal Food Poisoning from a Military Unit Lunch Party — United States, July 2012
Weeklyhttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm6250a2.htm?s_cid=mm6250a2_e
December 20, 2013 / 62(50);1026-1028


On July 30, 2012, the emergency department at a military hospital was visited by 13 persons seeking care for gastrointestinal illness with onset 2–3 hours after a work lunch party. The hospital responded by opening up temporary evaluation and treatment capacity in primary-care clinics and a progressive-care unit and by diverting one patient to a local civilian hospital. An immediate outbreak investigation was conducted by local military public health personnel with assistance from CDC. Initial epidemiologic analysis implicated "perlo" (a chicken, sausage, and rice dish) and bacterial intoxication as the outbreak mechanism. This enabled public health personnel to 1) recommend no further consumption of perlo and 2) reassure appropriate authorities that no additional ill persons likely would be seeking care and advise that nothing more than supportive care of ill persons likely would be required. After interviewing party attendees, investigators found nine additional persons who met their case definition. Subsequent CDC laboratory analysis of a sample of perlo detected staphylococcal enterotoxin A, supporting the epidemiologic findings. Improper food handling and preparation measures were identified and addressed by the appropriate authorities, who provided additional detailed education on food preparation safety for the persons who prepared the meal.

Epidemiologic and Environmental Investigation