CDC's Preliminary Investigation Links E. coli Outbreak to Ground Beef

CDC issued a preliminary investigative report that is linking ground beef to the ongoing E. coli outbreak.  In this outbreak, there are now 109 cases with 17 hospitalizations. There have been no cases of HUS.   The last linked illness case started on March 26, 2019

There were no specific supplier, retailer, or brand of ground beef identified at this point.

As we know, there are many out there who undercook ground beef or do not use a valid method to verify cooking (yeah, a thermometer).

CDC - Investigation Notice
https://www.cdc.gov/ecoli/2019/o103-04-19/index.html
Outbreak of E. coli O103
Illustration with a microscope and text reading Investigation Notice
Posted April 12, 2019 at 3:15 PM ET

FDA Issues Final Rule on Antimicrobial Hand Sanitizers

FDA released a final rule on hand sanitizers for assurance of effectiveness and safety.  Basically, they listed three benzalkonium chloride, ethyl alcohol (60 to 95 percent), and isopropyl alcohol (70 to 91.3 percent) that can be submitted for evaluation of safety and effectiveness data necessary "to make a determination regarding whether these active ingredients are generally recognized as safe and effective for use in OTC consumer antiseptic rub products." At this time, the FDA does not intend to take action to remove hand sanitizers containing these three active ingredients from the market - "less than 3% of the marketplace will be affected by the issuance of this final rule, as most OTC consumer antiseptic rubs use ethyl alcohol as the active ingredient."

"The following list includes those active ingredients addressed in the 1994 TFM for use in antiseptic hand washes or healthcare personnel hand washes and identified in the 2016 Consumer Antiseptic Rub proposed rule as having inadequate evidence of eligibility for evaluation under the OTC Drug Review for use in an OTC consumer antiseptic rub:

• Benzethonium chloride
• Chloroxylenol
• Chlorhexidine gluconate [2]  
• Cloflucarban
• Fluorosalan
• Hexachlorophene
• Hexylresorcinol
• Iodine complex (ammonium ether sulfate and polyoxyethylene sorbitan monolaurate)
• Iodine complex (phosphate ester of alkylaryloxy polyethylene glycol)
• Methylbenzethonium chloride
• Nonylphenoxypoly (ethyleneoxy) ethanoliodine
• Phenol (equal to or less than 1.5 percent or greater than 1.5 percent)
• Poloxamer iodine complex
• Povidone-iodine 5 to 10 percent
• Secondary amyltricresols
• Sodium oxychlorosene
• Tribromsalan
• Triclocarban
• Triclosan
• Triple dye
• Undecoylium chloride iodine complex"

DA News Release
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm635793.htm
FDA issues final rule on safety and effectiveness of consumer hand sanitizers
Action completes a series of actions on the FDA’s review of OTC antiseptic active ingredients
For Immediate Release
April 11, 2019

USDA Posts Guide to Food Product Date Coding

USDA posted a guide for food code dating. With a push to curb food waste, uniformity in how products are coded will help consumers.

The guide can be found here
(https://www.fsis.usda.gov/wps/wcm/connect/19013cb7-8a4d-474c-8bd7-bda76b9defb3/Food-Product-Dating.pdf ) and is copied below.

A few key points:

• Code dating is not required by federal regulations except for infant formula.  (the USDA does require a "pack date" for poultry products and thermally processed, commercially sterile products to help identify product lots and facilitate trace-back activities in the event of an outbreak of foodborne illness)
• FSIS recommends that food manufacturers and retailers that apply product dating use a “Best if Used By” date
• Best By dates are based on quality not safety.

USDA FSIS

Food Product Dating

https://www.fsis.usda.gov/wps/wcm/connect/19013cb7-8a4d-474c-8bd7-bda76b9defb3/Food-Product-Dating.pdf?MOD=AJPERES

Food Product Dating
"Best if Used By" is a type of date you might find on a meat, poultry, or egg product label. Are dates required on these food products? Does it mean the product will be unsafe to use after that date? Here is some background information answering these and other questions about product dating.

Ground Beef Recalled After Two Complaints of Hard Plastic

JBS Plainwell, Inc., a Plainwell, Mich. establishment, is recalling approximately 43,292 pounds of ground beef products that may be contaminated with extraneous materials, specifically, pieces of hard plastic.  The problem was discovered when the establishment received two complaints of green hard plastic in the ground beef products. FSIS was notified on April 5, 2019.

https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2019/recall-043-2019-release
JBS Plainwell, Inc. Recalls Ground Beef Products Due to Possible Foreign Matter Contamination 
Class II
Recall  043-2019 
Health Risk:Low
Apr 8, 2019 

Are Gluten-free Restaurant Foods Free of Gluten?

A study out of Columbia shows that gluten-free served in restaurants may contain traces of gluten.  According to FDA regulations, for a food to be considered gluten-free, it must have less than 20ppm of gluten.  "The research showed 32 percent of tests revealed detectable gluten in dishes that were supposed to be gluten-free."

Okay, but how reliable is this study?  The results were uploaded by users (diners) onto a portable device that 'may' be capable of detecting gluten below the 20ppm level.  "And most importantly, these results were voluntarily uploaded by users, who may be more likely to share results that show gluten contamination.”

So  really, we don't know what the true percentage of restaurants that are in error of calling their food gluten-free, or if the food is technically gluten-free according to the regulation.

https://www.mailman.columbia.edu/public-health-now/news/study-measures-gluten-gluten-free-labeled-restaurant-food
Chronic Disease, Food Policy and Obesity Apr. 05 2019
Study Measures Gluten in Gluten-Free Labeled Restaurant Food

USDA FSIS Calls Out Washington Post on Misleading Article on Pork Processing

On the USDA webpage, USDA FSIS posted a rebuttal to an article published in the Washington Post on April 3rd titled" Pork industry soon will have more power over meat inspections".

The main stream media loves to spin new initiatives to make it seem like the government and industry seem like they are in cahoots to make the food supply less safe.  But the reality is that our pork supply is safer and Salmonella, while a concern in all raw meats, has not been involved in major outbreaks.    It was good to see that USDA responded to this article to provide balance.

https://www.fsis.usda.gov/wps/portal/fsis/newsroom/news-releases-statements-transcripts/news-release-archives-by-year/archive/2019/nr-040819-01
USDA’s FSIS Condemns The Washington Post for False Reporting on a Critical Public Health Issue
April 8, 2019

Study Determines via WGS that Product Contamination Issue Actually a Laboratory Cross Contamination Issue

A study in the International Journal of Food microbiology shows that a 2013 Salmonella contamination case, where Salmonella was found in finished chocolate, was determined to be a laboratory cross contamination issue.  Using whole genome sequencing (WGS), researchers matched the product contaminate with an organism from the laboratory.

WGS of contamination cases should become standard practice for commercial laboratories where their findings of a positive sample will result in large value recalls.  Laboratories should have their positive control strains tested as other positive samples recently found.  Additionally, commercial laboratories should already have an aggressive environmental monitoring program.

International Journal of Food Microbiology

Volume 298, 2 June 2019, Pages 39-43
https://www.sciencedirect.com/science/article/pii/S0168160518307785
Whole genome sequencing used in an industrial context reveals a Salmonella laboratory cross-contamination

Outbreak of E. coli O103 - 73 Cases, Source Still Unknown

CDC is investigating an ongoing outbreak of E. coli O103 infection.  To this point, 72 people have become ill in 5 different states.  Eight people have been hospitalized.  While the primary symptom is bloody diarrhea, the infection can progress to cause damage to the kidney, or HUS.  This is a severe complication with loss of kidney function.  There have not been any cases progressing to HUS.

No source has been identified yet.  Historically, outbreaks such as this have been linked to leafy greens such as romaine or spinach, undercooked ground meat, sprouts, and raw flour.

https://www.cdc.gov/media/releases/2019/s0405-multistate-outbreak-e-coli.html
CDC Investigation Notice: Multistate Outbreak of E. coli O103 Infections

April 5, 2109

Flame Broiled Hamburgers Recalled After Complaints of Foreign Material - Soft Purple Plastic

AdvancePierre Foods, Inc., an Enid, Okla. establishment, is recalling approximately 20,373 pounds of ready-to-eat (RTE) beef patties (frozen RTE flame broiled beef patties). that may be contaminated with extraneous materials, specifically soft purple plastic.  The problem was discovered on April 1, 2019 after the firm received two consumer complaints regarding soft purple plastic found in the product.

Perhaps someone confused dinosaur for beef.

https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2019/recall-040-2019-release
AdvancePierre Foods, Inc. Recalls Frozen Beef Patties due to Possible Foreign Matter Contamination
Class II Recall
040-2019
Health Risk: Low
Apr 2, 2019