Pizza worker diagnosed with Hepatitis A potentially exposes thousands to the virus

A North Carolina Papa John's foodservice worker was diagnosed with Hepatitis A, this after he worked for about 2 weeks.  During that time, some 2,400 orders were placed (at 4 people per pie, and each order was at least one pie, that could potentially mean about 10,000 people have been exposed).

There is a long delay from the time someone who is exposed with Hepatitis A until they see symptoms.  And in this case, it took even longer from the time he had symptoms until the time he was diagnosed.

This worker had traveled overseas and probably contracted the disease during that trip.

It is important for those who have been exposed to get vaccinated, especially those who are more susceptible.

A few interesting notes form the CDC website.

• Hepatitis A is a contagious liver disease that results from infection with the Hepatitis A virus. It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. Hepatitis A is usually spread when a person ingests fecal matter — even in microscopic amounts — from contact with objects, food, or drinks contaminated by the feces, or stool, of an infected person.
• If you were recently exposed to Hepatitis A virus and have not been vaccinated against Hepatitis A, you might benefit from an injection of either immune globulin or Hepatitis A vaccine. However, the vaccine or immune globulin must be given within the first 2 weeks after exposure to be effective.
• The Hepatitis A virus is extremely hearty. It is able to survive the body’s highly acidic digestive tract and can live outside the body for months. High temperatures, such as boiling or cooking food or liquids for at least 1 minute at 185°F (85°C), kill the virus, although freezing temperatures do not.
• Some people get Hepatitis A and have no symptoms of the disease. Adults are more likely to have symptoms than children.   If symptoms occur, they usually appear anywhere from 2 to 6 weeks after exposure.  Symptoms usually develop over a period of several days. Symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.
• Almost all people who get Hepatitis A recover completely and do not have any lasting liver damage, although they may feel sick for months. Hepatitis A can sometimes cause liver failure and death, although this is rare and occurs more commonly in persons 50 years of age or older and persons with other liver diseases, such as Hepatitis B or C.
• There are no special treatments for Hepatitis A. Most people with Hepatitis A will feel sick for a few months before they begin to feel better. A few people will need to be hospitalized. During this time, doctors usually recommend rest, adequate nutrition, and fluids.  Alcohol [unfortunately] should be avoided.
• Anyone traveling to or working in countries with high rates of Hepatitis A should talk to a health professional about getting vaccinated. Hepatitis A vaccine is highly effective in preventing Hepatitis A virus infection. Protection begins approximately 2 to 4 weeks after the first injection. A second injection results in long-term protection.

Charlotte Observer
http://www.charlotteobserver.com/2014/04/10/4832499/officials-papa-johns-worker-contracted.html#.U0fpe6PD99A

Officials: Mecklenburg Papa John’s worker contracted hepatitis A
By Karen Garloch The Charlotte Observer
Posted: Thursday, Apr. 10, 2014
Modified: Thursday, Apr. 10, 2014

Mecklenburg County health officials are urging customers who ate food from a Papa John’s restaurant in the northeast part of the county from March 28 to April 7 to get a hepatitis A vaccine.

A worker at the restaurant, at 8016 Cambridge Commons Drive, became ill March 24 but wasn’t diagnosed until April 7 after he was hospitalized. The Health Department learned of his illness Wednesday, according to Health Director Dr. Marcus Plescia.

Whole Genome Sequencing - A Food Safety Game Changer

A new tool is going to have a huge impact on food safety - whole genome sequencing.  Whole genome sequencing is a laboratory process that determines the complete DNA sequence of an organism's genome at a single time.

Using this tool, investigators can tell whether an organism found in a food is the same organism that caused the illness.  In the past, investigators looked a fragmentation patterns on a gel (PFGE) or looked for certain genetic markers.  But with whole genome sequencing (WGS), they can tell, whether an organism is the same, down to a DNA base pair comparison in the whole genome, which for bacteria, is in the range of 4 million base pairs

This tool has already been used in determination that cheese was responsible for a Listeria outbreak.
Twenty years ago, sequencing the whole genome of a living organism was a monumental undertaking, but within the last 10 years, the development and commercialization of the process, has dramatically improved the price and drastically decreased the time needed.  Now, this tool is available for investigators to definitely determine the bacteria involved in outbreaks.  


 Boston.com
http://www.boston.com/lifestyle/health/2014/04/07/experts-decode-germs-dna-fight-food-poisoning/o2wuRAP6LOZmuuCbalGsJM/singlepage.html
Experts decode germ’s DNA to fight food poisoningBy LAURAN NEERGAARD / AP Medical Writer / April 7, 2014


WASHINGTON — Chances are you’ve heard of mapping genes to diagnose rare diseases, predict your risk of cancer and tell your ancestry. But to uncover food poisonings?

The nation’s disease detectives are beginning a program to try to outsmart outbreaks by routinely decoding the DNA of potentially deadly bacteria and viruses.

The initial target is listeria, the third-leading cause of death from food poisoning and bacteria that are especially dangerous to pregnant women. Already, the government credits the technology with helping to solve a listeria outbreak that killed one person in California and sickened seven others in Maryland.

“This really is a new way to find and fight infections,” said Dr Tom Frieden, director of the Centers for Disease Control and Prevention. “One way to think of it is identifying a suspect by a lineup or by a fingerprint?”

Whole genome sequencing, or mapping all of an organism’s DNA, has become a staple of medical research. But in public health, it has been used more selectively, to investigate particularly vexing outbreaks or emerging pathogens, such as a worrisome new strain of bird flu.

Black Peppercorns Recalled Due to Potential Salmonella Contamination

Sprout Farmers Markets and Frontier Organic Spices are recalling containers of black peppercorns after random testing completed by FDA came up positive for Salmonella.  The pepper was reportedly treated (steam pasteurization) and then tested before use by Frontier.  No illnesses have been reported.

 

So what questions could be asked?

• Did the steam pasteurization step perform to the level needed to eliminate Salmonella?  One could at microbial test results for other indicators such as generic E. coli, coliforms, and even APC?  Also, it is important to conduct large sample testing of the peppercorns from this and other lots.
• Was the product potentially contaminated after the processing, perhaps during handling and repackaging?  Are potential sources of contamination also handled within the peppercorn processing environment?  Is environmental testing done, and hopefully if so, did those results indicate any issues?  It will be important for the facility to conduct extensive testing of the processing environment including preoperational and in-process testing looking for Salmonella as well as indicators (coliforms and/or Enterobacteriaceae).
• Did the laboratory complete the verification testing correctly? 

  As we know, Salmonella can survive in dry environments (and products) for long periods of time.

 

FDA Recall Notice

http://www.fda.gov/Safety/Recalls/ucm391996.htm

Frontier Natural Products Co-op Initiates Voluntary Class 1 Recall Due to Possible Health Risk from Organic Black Peppercorns

 

Contact

Consumer:

1-800-669-3275

 Media:

Anne Rierson, anne.rierson@frontiercoop.com

 

FOR IMMEDIATE RELEASE - April 4, 2014 - Frontier Natural Products Co-op is voluntarily recalling several of its products manufactured with organic black peppercorns that were sold under its Frontier and Simply Organic brands, Whole Foods Market 365 Everyday Value, and others due to potential Salmonella contamination. To date, no illnesses have been associated with these products.

 

Chicken Nuggets Recalled Due to the Potential for Contamination by Small Pieces of Plastic

Tyson is recalling 75,000 lbs of chicken nuggets due to the potential to have small pieces of plastic.  It came to light after the company received numerous complaints.  It is believed the plastic pieces were the result of  a scraper inside of a blending machine.

To prevent such issues, it is important to have a good preventive maintenance program and good quality inspection program.

UPI
http://www.upi.com/Health_News/2014/04/06/Tyson-Foods-recalls-chicken-nugget-products-for-possible-plastic-pieces/5571396807813/#ixzz2yCyXRiOw
Tyson Foods recalls chicken nugget products for possible plastic pieces

Small pieces of plastic found in the chicken products resulted in some minor oral injuries.
By Alex Cukan | April 6, 2014 at 3:35 PM


SEDALIA, Mo., April 6 (UPI) -- Tyson Foods Inc. recalled more than 75,000 pounds of chicken nugget products that may be contaminated with small pieces of plastic and other extraneous materials.

The food company said it received consumer complaints that small pieces of plastic were found in the chicken products resulting in minor oral injury. The problem was traced to a product scraper inside a blending machine in the Sedalia, Mo., facility.

The recalled fully cooked chicken nuggets include:

Maintenance of Records Finalized in FSMA Regulation

The Establishment and Maintenance Rule become final for those companies in the U.S. who manufacture, process, pack, transport, distribute, receive, hold, or import food for humans or animals, and foreign persons who transport food in the U.S.  Here is a simplified version of the FDA guidance to help you identify what you need to know about records needed for food operations.

Of course, this should already be in place, much having been required as part of the Bioterrorism Act of 2002.

What are the record availability requirements?

When FDA has a reasonable belief that an article of food, and any other article of food that FDA reasonably believes is likely to be adulterated and presents a threat of serious adverse health consequences or death to humans or animals, or when FDA believes that there is a reasonable probability that the use of or exposure to an article of food, will cause serious adverse health consequences or death to humans or animals, any records or other information accessible to FDA must be made readily available for inspection and photocopying or other means of reproduction. These records must be made available as soon as possible, not to exceed 24 hours from the time of receipt of the official request, from an officer or employee duly designated by the Secretary of Health and Human Services who presents appropriate credentials and a written notice. 
The records may be kept in any format, paper or electronic, provided they contain all the required information.
The records requested may be related to the manufacture, processing, packing, transporting, distribution, receipt, holding, or importation of such an article of food that are maintained by, or on behalf of, an entity subject to the recordkeeping regulation, and at any location.

Food Producers Push Back on FSMA's Feed Rule

A number of food producers, impacted by FSMA Animal Feed Regulation, have commented to FDA about the impositions that the regulation will make.

Many of the waste products generated by food processing plants, including grains generated by distillers, will be subject to the feed regulation because these products are fed to animals.  The concern is that the producers will have to absorb additional costs to implement additional food safety controls over their waste streams.  And in reality, there have been really no issues to support the need for this level of control.

 

For many, it may come to the point where it is more cost effective to dump rather then use these items for feed.  From a sustainability standpoint, this is not the way to go.  The regulation needs to written that makes it easy, yet safe, for producers to continue to use their waste streams, when appropriate, as a source of animal feed.

The Safety of Nutritional Supplements

An article in the New England Journal of Medicine warns about the dangers of nutritional supplements.  There is an increasing market of supplements, and unfortunately, the system for ensuring the safety of those supplements is inadequate.

These supplements are marketed to people looking to loose weight, to be more energetic, or to be less depressed, however, there have been instances where these supplements have been deadly or caused severe damage including liver failure.  Many of us buy into the notion that a pill can fix our issues.

We also overuse many of our normal vitamins and supplements often without the scientific evidence to support such claims.  In some cases, overuse can do more harm than good.

In a related case, there are parents who look to improve the health of their children through 'juicing'.  An article in Medical Daily shows there is a trend for children to take 'detox juice blends".  What works in adults may not be as good for children.


New England Journal of Medicine
http://www.nejm.org/doi/full/10.1056/NEJMp1315559
Perspective
Hazards of Hindsight — Monitoring the Safety of Nutritional Supplements
Pieter A. Cohen, M.D.

N Engl J Med 2014; 370:1277-1280April 3, 2014DOI: 10.1056/NEJMp1315559

Epidemiologists at the Centers for Disease Control and Prevention (CDC) recently confirmed what an astute liver-transplant surgeon in Honolulu already suspected: OxyElite Pro, a popular over-the-counter supplement, was responsible for a cluster of cases of severe hepatitis and liver failure.1 Although patients began to develop severe hepatitis in May 2013, the Food and Drug Administration (FDA), whose job it is to remove dangerous supplements from store shelves, did not learn of the cases until mid-September, 4 months later. By February 2014, the CDC had linked 97 cases, resulting in 47 hospitalizations, three liver transplantations, and one death, to OxyElite Pro. This dietary supplement was recalled, but nothing has been done to prevent another supplement from causing organ failure or death. Nor have any changes been made to improve the FDA's ability to detect dangerous supplements.

The 2007 Peanut Butter Salmonella Outbreak - Criminal Investigation Still Ongoing

The Peter Pan Peanut Butter Salmonella Outbreak is a great case study in how Salmonella can contaminate a low moisture, ready-to-eat food.  In this case, CDC reported indicated over 400 cases  linked to peanut butter that had become contaminated due to "inadvertent moisture got into the production process", or a leaky roof.

Although this case is seven years old, it is not over yet for the parent company, ConAgra.  According to a story in the Atlantic Business Chronicle, the plant underwent an investigation in 2011by the Justice Department for criminal wrongdoing.  The company and the US Attorney's office are still in negotiations regarding the investigation, where it is possible that this "will likely involve a misdemeanor criminal disposition under the Food, Drug & Cosmetics Act."

The Chronicle reports that the company has spent $25 million in connection to the investigation.  This is in addition to the 10's of millions spent on upgrading the plant and the 50 to 60 million for the recall itself.  And of course there is the loss in sales over that time period.


Atlantic Business Chronicle
http://www.bizjournals.com/atlanta/news/2014/04/01/2007-peanut-butter-recall-hanging-over-conagra.html
2007 peanut butter recall hanging over ConAgra

David Allison
Editor- Atlanta Business Chronicle
Apr 1, 2014

Seven years after a recall of peanut butter made at a Georgia plant, federal investigations are still hanging over the head of ConAgra Foods Inc.

British Study Shows Organic Unlikely to Reduce Risk for Cancer

The British Journal of Cancer published an scientific study that indicates women who eat organic foods do not reduce the risk to develop cancer when compared to women who eat a more conventional diet.


British Journal of Cancer
http://www.nature.com/bjc/journal/vaop/ncurrent/abs/bjc2014148a.html
Organic food consumption and the incidence of cancer in a large prospective study of women in the United Kingdom

K E Bradbury1, A Balkwill1, E A Spencer2, A W Roddam3, G K Reeves1, J Green1, T J Key1, V Beral1 and K Pirie1 The Million Women Study Collaborators4

1Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
2Department of Primary Care and Health Sciences, University of Oxford, Oxford OX2 6GG, UK
3Worldwide Epidemiology, GSK, Uxbridge UB11 1BT, UK
Correspondence: Dr KE Bradbury, E-mail: kathryn.bradbury@ceu.ox.ac.uk
4Members of the Million Women Study Collaborators are listed before References.
Received 3 December 2013; Revised 24 February 2014; Accepted 26 February 2014
Advance online publication 27 March 2014Top of page
Abstract

Background:

Organically produced foods are less likely than conventionally produced foods to contain pesticide residues.

Methods:

We examined the hypothesis that eating organic food may reduce the risk of soft tissue sarcoma, breast cancer, non-Hodgkin lymphoma and other common cancers in a large prospective study of 623 080 middle-aged UK women. Women reported their consumption of organic food and were followed for cancer incidence over the next 9.3 years. Cox regression models were used to estimate adjusted relative risks for cancer incidence by the reported frequency of consumption of organic foods.

Results:

At baseline, 30%, 63% and 7% of women reported never, sometimes, or usually/always eating organic food, respectively. Consumption of organic food was not associated with a reduction in the incidence of all cancer (n=53 769 cases in total) (RR for usually/always vs never=1.03, 95% confidence interval (CI): 0.99–1.07), soft tissue sarcoma (RR=1.37, 95% CI: 0.82–2.27), or breast cancer (RR=1.09, 95% CI: 1.02–1.15), but was associated for non-Hodgkin lymphoma (RR=0.79, 95% CI: 0.65–0.96).

Conclusions:

In this large prospective study there was little or no decrease in the incidence of cancer associated with consumption of organic food, except possibly for non-Hodgkin lymphoma.

Keywords:

organic food; cancer; cohort; women