Shigella Outbreak in American Samoa, 2014 - CDC MMWR

Shigella is one of the reportable illnesses according to the US Food Code.  In this CDC MMWR Report, it can be seen why when you consider so many children became infected in such a short period of time.

In this outbreak, some 280 cases of severe diarrhea (and in some cases bloody diarrhea), primarily among young children, were seen on this US Territorial Island.  Investigators felt that most of the cases were due to person-to-person contact [although it can be transferred via ready-to-eat foods when the foods are handled by an infected handler.]

 

    

CDC - Morbidity and Mortality Weekly Report (MMWR)

 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6401a8.htm?s_cid=mm6401a8_e

Notes from the Field: Outbreak of Diarrheal Illness Caused by Shigella flexneri — American Samoa, May–June 2014

  

Weekly

 

January 16, 2015 / 64(01);30-30

  

Julia E. Painter, PhD1,2, Allison Taylor Walker, PhD1,2, Jarratt Pytell2, Motusa Tuileama Nua3, Siitia Soliai-Lemusu3, Eric Mintz, MD2, Ibne Ali, PhD2, Michele Parsons, MS2, Haley Martin2, Michael Beach, PhD2, Anna Bowen, MD2, Jennifer Cope, MD2 (Author affiliations at end of text)

 

On May 9, 2014, a physician at hospital A in American Samoa noticed an abnormally high number of children presenting to the emergency department with bloody diarrhea. Based on preliminary testing of stool specimens, Entamoeba histolytica infection was suspected as a possible cause. Shigella was also suspected in a subset of samples. On May 22, the American Samoa Department of Health requested assistance from CDC with the outbreak investigation. The goals of the investigation were to establish the presence of an outbreak, characterize its epidemiology and etiology, and recommend control measures. The CDC field team reviewed the emergency department log book for cases of diarrheal illness during April 15–June 13, 2014. During this period, 280 cases of diarrheal illness were recorded, with a peak occurring on May 10. Twice as many cases occurred during this period in 2014 compared with the same period in 2011, the most recent year for which comparable surveillance data were available. Cases were widely distributed across the island. The highest number of cases occurred in children aged 0–9 years. Across age groups, cases were similarly distributed among males and females. These patterns are not consistent with the epidemiology of disease caused by E. histolytica, which tends to cause more cases in males of all ages.

Trichinellosis Surveillance in the United States, 2008 - 2012 - Summary of CDC Report

CDC issued a surveillance report on cases of Trichinellosis.  This is a quick summary.

 

Trichinellosis is a parasitic disease caused by Trichinella, a nematode. It had been traditionally associated with undercooked pork, but more recently it is more associated with wild game.  [Prior to improvements in pig husbandry in 1940's and 1950's, it was estimated that over 15% of people in the US had been infected by Trichinella.]

 

From the report:

"Trichinella infection in human hosts can be divided into an intestinal (enteral) phase and a muscular (parenteral) phase, with clinical manifestations ranging from asymptomatic infection to fatal disease, depending on the number of larvae ingested. After ingestion, larvae are released into the intestinal mucosa and subsequently migrate to the blood vessels, from which they spread throughout the body before reaching the skeletal muscles."

 During the initial phase, within the first few days of infection, symptoms can range from asymptomatic to severe gastrointestinal distress.  As the parasite migrates to the muscle and embeds itself, the person can have fever, muscle pain, and swelling.  Death can occur in cases where this is inflammation of the heart, brain, or lung tissue as well as due to respiratory failure from a high level of infection of encysted worms in the diaphragm muscle [it gets so many encysted worms that the muscle can't work...tell me that isn't a miserable way to buy the farm].

 

During the reporting period, 2008-2012, there were 84 confirmed cases.

• 22 cases were linked with pork products, including 10 with commercial pork products, 6 with wild boar, and 1 with home-raised swine, and 5 unspecified.
• 41 cases were linked to bear meat
• 2 cases with deer meat
• 2 with ground meat
• 17 cases unknown
• From 51 cases that were further investigated, 24 reported eating raw or undercooked meat [for the other cases, as we know, people hate to admit being stupid...who wants to admit eating bear tartare, or drinking the fresh blood of their hunted bear prey...yeah, you know that guy].

So the number of cases has continued to decline thanks to commercial pork practices and better cooking practices by the consumer, but vigilance is still needed, especially with wild game.  Consumers of pork and game must follow proper cooking or freezing methods to destroy the parasite.

Soft Cheese Recalled in WA After Being Linked to 3 Listeria Cases

A Washington state company is recalling soft cheese products after being linked to 3 cases of Listeria monocytogenes infection. One of those cases was a death.

There have been a number of Listeria issues related to soft cheeses, especially in smaller companies who have entered into the cheese market. In this case, the company was started in the year 2000 (translated Website) and appears to have grown over time. With increasing popularity of Farmers' Markets, food entrepreneurs have found a entry channel to sell products, including soft cheeses. However, as with this case, careful attention to risk control must be made.



FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm430730.htm
Queseria Bendita LLC Recalls Fresh Cheeses and Sour Cream Because of Possible Health Risk

Contact: Consumer:  Sandra Aquilar 509-961-8949

FOR IMMEDIATE RELEASE — January 16, 2015 — Queseria Bendita LLC of Yakima, Washington is recalling all lots of Panela, Queso Fresco, Requeson, Cotija fresh soft cheese products and Sour Cream to include those with best by dates up to 4/16/2015 because of a potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, listeria infection can cause miscarriages and stillbirths among pregnant women.

Panela, Queso Fresco, Requeson, Cotija fresh soft cheese products and Sour Cream were distributed to Hispanic grocery stores in Washington and Oregon and the firm also sold products from its on-site store in Yakima, Washington.

Vegetable Smoothie Blends and Listeria - Recall and Controlling Risk

A Smoothie Blend is being recalled after Listeria was detected in the spinach and/or kale ingredients used in the blend. There have been no  illnesses and the organism has not been detected in the finished product.

The risk associated with vegetable smoothies is that some of the vegetable ingredients may be sources of Listeria.  Listeria can contaminate vegetables, such as kale or spinach, at the field level or during storage.  The latter can be more of an issue because vegetable storage areas are cool and often damp, which fits the growth conditions conducive to Listeria.  With longer storage times, in some cases from one packing season to the next (in order for the processors to make product throughout the year), there may be increased opportunity for Listeria contamination.

Many of these vegetables have been traditionally cooked, and so, long term storage had not been a big issue.  But with smoothies, there is no cooling step to eliminate an organism like Listeria.  These vegetables are blended in the raw state and then consumed.  Additionally, once blended, storage of vegetable matrix could serve to enhance the numbers because the matrix would likely support growth, albeit slowly if stored at refrigeration temperatures.

Blenders may also use frozen vegetables.  These vegetables are oaten produced with the intention that they will be cooked (thus they have cooking instructions), but blenders will use them without cooking.

For companies blending smoothies, supplier control is critical.  Other control steps in include having a washing/sanitizing step in place prior to blending as well as a strict refrigeration and a tight shelf-life.  For consumers who blend raw vegetables - use sound vegetables, wash produce well, and then consume immediately upon blending.

Of course Listeria is not the only pathogen that can be associated with produce.  Produce contain bacteria pathogens, such as Salmonella or STEC E.coli, viruses, and parasites.  Generally, however, the risk would be considered very low, especially when farmers follow GAP principles.

 

 

This product, pictured here, is sold frozen.  Freezing would prevent growth of Listeria, but once thawed, Listeria would be able to grow.

 FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm430735.htm
Inventure Foods, Inc. Issues Voluntary Recall Of Its Rader Farms® Fresh Start Smoothie Blend, Sunrise Refresh Fusion, And Daily Power Fusion Due To Possible Health Risk

Contact 
Consumer:  Inventure Foods Customer Service   866-890-1004
Media:  Matt Jackson   Lambert, Edwards & Associates mjackson@lambert-edwards.com
616-233-0500

FOR IMMEDIATE RELEASE – January 18, 2015 – Inventure Foods, Inc. of Phoenix, Arizona, has issued a precautionary recall of its RADER FARMS® Fresh Start Smoothie Blend, Fresh Start Sunrise Refresh Fusion, and Fresh Start Daily Power Fusion because of a potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.

Listeria Strains in Caramel Apple Outbreak Found in Apple Packing Shed

 FDA announced that the two strains of Listeria responsible for the caramel apple outbreak were found in the apple packing facility. 

Like the Listeria outbreak in cantaloupes,  this brings increased attention to apple control in the fruit packing area.

FDA Notice
http://www.fda.gov/Safety/Recalls/ucm429689.htm

Bidart Bros. Works with Federal and State Officials to Determine Source of Listeriosis-Associated Outbreak

Contact:
Consumer:
(661) 399-0978

FOR IMMEDIATE RELEASE — January 9, 2015 — Bakersfield, Calif. — Today, the United States Food and Drug Administration (FDA) announced the results of findings from additional tests performed on samples collected from Bidart Bros. apple processing plant. Test results confirm two strains of Listeria monocytogenes were found at the apple processing facility and are believed to be the same strains associated with the outbreak. Those same strains were also found in Bidart Bros. apples collected from a retailer by the FDA. Today, the CDC confirmed that the majority of the persons made ill reported consuming caramel-coated apples.

“The results are devastating to the Bidart family,” says Leonard Bidart, President Bidart Bros. “As a family-owned grower operating in California since the 1930s, we place safety at the forefront of everything we do. Our hearts go out to all who have been impacted by the apple-related listeriosis outbreak.

Rule Delayed Requiring Labeling of Mechanically Tenderized Meat

A rule requiring the mandatory labeling of mechanically tenderized meat was delayed due to slow government action.

The rule was proposed because of the higher food safety risk associated when meat is tenderized using blades or needles.  The blades or needles can force bacteria deeper into the meat, and so this meat then needs to be cooked a little more in order to destroy those backer and thus ensure safety.  That is, you don't want to serve mechanically tenderized meat rare or medium rare....it needs to be cooked to 155F internal versus 145 F as is done for intact meat (straight cuts of steak).    Of course, many people do not know this, and cook those mechanically tenderized steaks like they would intact steaks..  Labeling would indicate to people that these steaks need to be cooked to 155F internal temperature.


Food Safety Magazine
http://www.foodsafetymagazine.com/news/mandatory-labeling-for-mechanically-tenderized-meat-delayed-until-at-least-2018/
Mandatory Labeling for Mechanically Tenderized Meat Delayed Until At Least 2018
News | January 5, 2015
 By Staff

According to a final rule by the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS), mechanically tenderized beef products will not require special safety labels for at least another three years. The tenderization process softens the meat with tools and devices that are known to cultivate pathogens that can lead to foodborne illness.

Lack of Allergen Control by Spice Supplier's Supplier Results in Recalls

Updated 1/12/14

A PA firm is recalling a wide range of spices because the Cumin ingredient they used may contain peanuts, an issue that originated with their supplier.

There have been two assoicated recalls by food companies because the supplier of the spice had allergen issues.  In this case, a cumin spice may have been contaminated with peanut.  Because it is peanut, it is a Class I recall.

This is not the first time we have seen spice supplier have allergen issues that resulted in downstream recalls.  There was a similar recall in November.  Smaller companies are often challenged because of limited resources to properly vet their suppliers regarding allergen control.  And even with a thorough audit that reveals a decent program, mistakes cans still occur.  



FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm429688.htm
Con Yeager Spice Company Issues a Voluntary Recall for Ground Cumin and Seasoning Blends (containing Ground Cumin) Due to Potential Undeclared Peanut Allergens

Contact:
Consumer:
1-800-222-2460

FOR IMMEDIATE RELEASE — January 9, 2015 — New Castle, PA and Zelienople, PA — Con Yeager Spice Company has issued a voluntary recall for multiple sized packages under multiple brand names of ground cumin and multiple seasoning blends (containing ground cumin) due to undeclared Peanut allergens in the ground cumin.

People who have an allergy or severe sensitivity to peanuts run the risk of serious or life threatening allergic reaction if they consume these products. To date, there have been no consumer complaints or reports of allergic reactions at this time. Con Yeager Spice Company is asking customers at risk for peanut allergies to discontinue using the product immediately.

Con Yeager Spice Company was notified by the supplier Morris J. Golombeck Inc. that the ground cumin product had tested positive for traces of peanut protein. This spice is used in a variety of Con Yeager Spice Company seasoning blends and sold as a single ingredient product. Product packaging includes clear plastic bag in a box, clear plastic minijar, pint, quart, gallon jug containers and plastic bags. Our product identifiers are the product’s 5 digit item key and 6 digit item lot number beginning with a decimal point located on the labeling.

Mining Tweets for Targeting Restaurant Inspections

A number of cities have begun analyzing Twitter or other web-based public review/grading systems such as Yelp as a way to target restaurant inspections.  Basically, they have computer systems which search through tweets and/or reviews looking for specific indicators, collect the data and spit out restaurant names that meet the criteria warranting inspection.

 In the Chicago initiative, using data from March 23, 2013 and November 10, 2014, they flagged 3,594 tweets as potential food poisoning cases. Of these tweets, they determined 419, roughly 12 percent, as likely cases.   While not clearly stated if it is in the same time frame, they conducted 133 inspections and found that 40% of them had serious violations, or 53 establishments.
I guess I am supposed to think this is cool, but it just seems so backwards.  Using resources to scour through people's comments that they post in a few seconds, it just seems a bit, passive. And knowing that foodborne illness can occur in any length of time, from minutes to days after eating a food, what is the chance that someone is going to know which food made them sick.  Also considering that the occasional belly ache is often attributed to some food they ate, and that rarely does one attribute the illness to food they made at home, will inspectors be chasing after establishments that don't deserve to be scrutinized. Clearly, 60% of those inspected did not have significant issues.

Using those same resources, and having a designated line for complaints, would they have not found those 53 establishments, or even better, using those resources to fix issues in establishments before those issues led to someone becoming ill.  

The financial costs of establishing and maintaining these systems were not provided in the HPR piece attached here, so it is hard to say if they are getting bang for the buck. If the cost is minimal, then it is no big deal, especially if they are using this to augment their current inspection system.   But I am inclined to think that more of a direct approach to ensuring safety...regular on site inspections and requirements for establishments to have trained manager/employees. 



Harvard Political Review
http://harvardpolitics.com/united-states/food-safety-numbers/
Food Safety in Numbers
By Advik Shreekumar

On March 23, 2013, the civic organization Smart Chicago launched an ambitious program to enhance the city’s food safety efforts: Foodborne Chicago. Using a mix of statistical techniques and computer science, Foodborne searches Twitter for complaints of food poisoning, then follows up with users and generates formal investigations. Chicago is not alone in these efforts; San Francisco, Boston, and New York City are all in the process of implementing similar initiatives to better enforce their health codes.

Foodborne Chicago and its sibling programs are bold attempts to modernize governance, harnessing the massive streams of information on social media sites. However, while these initiatives have the potential to dramatically improve public health, they also grant additional power to the companies holding the data. This, in turn, will challenge traditional notions of privacy and property.

Walnut Pieces Recalled After Retail Sample Tests Positive or Salmonella

A Wisconsin company is recalling walnut pieces after  a sample of the product was found to be positive for Salmonella, discovered during FDA routine retail testing.

 FDA recall notice

The Morning Call
http://www.mcall.com/business/mc-candy-sold-in-pa-recalled-for-possible-salmonella-contamination-20150106-story.html
Candy sold in Pa. recalled for possible salmonella contamination
By Morning Call staff
   
Walnut candies sold in 27 states including Pennsylvania were recalled Monday for possible salmonella contamination. Eillien's Candies Inc. said in a press release issued through the Food and Drug Administration that it is voluntarily recalling Walnut Pieces candy because some of the products may be contaminated with salmonella.