Preliminary Findings from Cyclospora Outbreak Associated with Romaine Lettuce in 2018

A Blue Ribbon Panel was put together to investigate the 2018 cyclospora outbreak associated with Romaine lettuce.   Little is know about this parasite and the goal of the panel was to focus on root-cause assessment, preventive measures/controls, collaborative approach, and testing validation.  "Although several outbreaks attributed to C. cayetanensis occurred during 2018 that were linked to fresh produce — particularly multi-commodity vegetable trays, cilantro, and others — this working group focused initial attention on the outbreak associated with a romaine lettuce mix."

Cyclospora is a human-specfic parasite that has been problematic in RTE produce such as lettuce (2018), veggie trays (2018), raspberries, and cilantro.  Cyclospora is spread by people ingesting food or water that was contaminated with feces from an infected individual.

For this case, "Outbreak investigative evidence, epidemiology, trace-back, and secondary on-farm investigative follow-up strongly indicated raw material contamination to a domestic production source in California"

While the report provides a pretty broad list in the root cause analysis, the recommendations for preventive controls focus on key elements:

"Recommendations

• Source protection for agricultural water should emphasize protection against human fecal contamination.
• Because humans appear to be the primary reservoir for C. cayetanensis, surveillance of diarrheal illness among workers involved in propagation and harvesting of fresh produce should be conducted, and workers with diarrheal illnesses be tested for C. cayetanensis and other enteric infections.
• Equipment used in propagation and harvesting of fresh produce should be maintained and cleaned to prevent C. cayetanensis transmission.
• Prevention measures need to account for the extrinsic maturation period of C. cayetanensis. This should include awareness of events and activities in the field at least 1 to 2 weeks before harvest, or at the time of harvest with regard to water, equipment, or environmental materials that were contaminated 1 to 2 weeks earlier."

The report also provides a summary of why control measures for STEC (pathogenic E. coli are different than for Cyclospora.

"Although industry-wide efforts to prevent contamination of romaine lettuce by pathogenic bacteria focus on the use of agricultural water, several key features of C. cayetanensis differ from STEC and need to be addressed in preventing Cyclospora transmission.

• Cyclospora is more resistant to routine chemical disinfection processes than STEC. Thus, water testing and treatment targeted to control STEC may not be adequate to control C. cayetanensis
• Water source protection is focused on animal reservoirs, primarily cattle, whereas C. cayetanensis is not known to have an animal reservoir hosts. Though animals may ingest C. cayetanensis oocysts and mechanically spread them through their feces, they are not known to become infected or to amplify the number of oocysts. Thus, prevention of human fecal contamination appears to be the primary need for water source protection.
• C. cayetanensis appears to require at least 1 to 2 weeks under favorable environmental conditions to become infectious. This lengthy extrinsic maturation period must be taken into account when considering the possibility and plausibility of fresh produce becoming contaminated through various means and for the oocysts (if not already infective when the produce becomes contaminated) to have sufficient time, under favorable conditions, to become infective by the time that the contaminated produce is consumed."

There were additional recommendations made on surveillance and testing.

https://www.freshexpress.com/sites/default/files/brp_interim_report_6.5.19-final.2_2.pdf
Interim Report:
Blue-Ribbon Panel on the Prevention of Foodborne Cyclospora Outbreaks
June 5, 2019

From the Stupid File - Man-Who-Eats-Expired-Food-For-A-Year Becomes Poster Child for the Eating Foods Past Code Date

An article in the Washington Post discusses shelf-life stating with the example of a guy who ate expired food for a year.  We hear this all the time -  foods beyond a Best-By Dates are safe to eat....well mostly safe.  There can be some issues once some foods get beyond the stated best-by date, depending upon the type of food product.

• Listeria risk does increase if there is presence of the organism on certain foods.  Manufacturers go to great lengths to control Listeria, but if a single organism gets onto the product, like a sliced deli meat, that risk increases the longer the product is held.
• Mold - the risk of mold growth increases in products that are drier in nature, breads or cheeses for example, as well as produce.  Many molds produce mycotoxins, which can be really harmful.  And people can have allergic reactions to food with mold present.
• Acid foods in cans can leach tin into the food - as acid foods go beyond the stated date, that  will eventually deteriorate the can and with that, tin can leach into the product.  High levels of tin are not healthy.  Further, that acid will eventually cause the container to leak.
• Oxidized fat - In foods with fats/oils, such as potato chips, the oils will go rancid as product gets beyond the stated shelf-life..that is really the limiting factor that determine shelf-life.  Oil breakdown products due to rancidity are extremely unhealthy over the long term (Link). If the level of rancidity is high, it can cause gastro-intestinal distress (link)
• And high levels of spoilage bacteria are going to produce a number of byproducts that can cause gastrointestinal distress.  Much of that is determined by not only the number of organisms but the type or organisms present.  In milk for example, homofermentive lactic acid bacteria with lactic acid as the primary byproduct is one thing, but if spoilage is due to gram-negative spoilage organisms, this is a different thing.  We do not have control over what organism decides to spoil our food.

We are all for standardized terminology for shelf-life, but the manufacturer has the right to set that date and should expect people to eat that food before it hits that date...because that is when the product will be at its best.  If people eat the food beyond that date, it will not be as tasty and that will not increase the chance that the person buys that product again.  As consumers, we should be focused on eating food in its prime.

Unfortunately, for many reading this article, the main takeaway will be that they can and probably should eat expired food regardless of what it is or how far past the date it is.  The need to for standardized terminology and understanding that terminology gets lost with narrative of someone eating expired food for a year.

Our focus should be on using food when it is at its best....that means consumers should, in some cases, buy less.  In other cases, rotate their inventory.  Eating expired foods is not really a good idea.
Unfortunately we are going to hear...go ahead and eat it, that goof ate expired foods for a year and was fine, you can just wash off that spoiled slice of bologna...are you kidding me?  (And Jared ate subs for a year and look what happened to him....just kidding.)

Washington Post
https://www.washingtonpost.com/business/2019/06/17/this-man-ate-expired-food-year-heres-why-expiration-dates-are-practically-meaningless/?utm_term=.2d9486350125
Business
This man ate ‘expired’ food for a year. Here’s why expiration dates are practically meaningless.

Breakfast Wraps Recalled After Complaints of Rocks....ROCKS?

Ruiz Foods Products Inc., a Denison, Texas, establishment, is recalling approximately 246,514 pounds of frozen, not ready-to-eat (NRTE) breakfast wrap products  (frozen egg, potato, bacon and cheese wraps) because the bacon may be contaminated with extraneous materials, specifically small rocks....ROCKS????   The problem was discovered on June 14, 2019, when Ruiz Foods advised FSIS of three consumer complaints regarding foreign material in the wrap products.   The company received a report of a potential injury associated with the consumption of this product.

The firm continues to investigate the source of the foreign material.

https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2019/recall-069-2019-release
Ruiz Foods Products Inc. Recalls Bacon Breakfast Wrap Products Due to Possible Foreign Matter Contamination
Class I Recall 069-2019
Health Risk: High
Jun 14, 2019

More Flour Recalled Due to Potential E. coli Contamination

Two specific lot codes of its Pillsbury® Best 5 lb. Bread Flour  were recalled due to a potential presence of pathogenic E. coli. The product was manufactured by ADM Milling Co., at the company’s mill in Buffalo, NY.  :Approximately 4,620 cases of impacted Pillsbury® Best 5 lb. Bread Flour were distributed to a limited number of retailers and distributors across the following 10 states: Connecticut, Delaware, Maryland, Maine, New Hampshire, New Jersey, New York, Ohio, Pennsylvania and Virginia."

ADM flour with potential E.coli contamination was also involved in recent recalls under brands foe Aldi and King Author Flour.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/cooperation-adm-milling-co-hometown-food-company-issues-voluntary-recall-specific-lot-codes
In Cooperation with ADM Milling Co., Hometown Food Company Issues Voluntary Recall of Specific Lot Codes Pillsbury® Best Bread Flour Due to Possible Health Risk

Summary

Company Announcement Date: June 14, 2019

FDA Publish Date: June 14, 2019

Product Type: Food & Beverages 

Bakery Product/Mix

Reason for Announcement: E.coli

Company Name: Hometown Food Company

Brand Name: Pillsbury BEST

Product Description: Flour

Frozen Red Raspberries Recalled for Potential Norovirus Contamination

An Idaho company, WinCo Foods, LLC. is recalling 12 oz bags of Frozen Red Raspberries because it has the potential to be contaminated with Norovirus.   The produce was manufactured in Washington state.

While this recall is not connected to the frozen black raspberry recall from last week - that one was for Hepatitis A and this one is for Norovirus.   This appears to be part of the FDA sampling protocol for viruses in frozen RTE produce.   For both to have become contaminated, someone handling the product during production or processing had the virus.  And since there is a high likely the berries will be eaten with minimal processing, the virus if present can be passed onto the consumer.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/winco-foods-llc-recalls-frozen-red-raspberries-because-possible-health-risk
Winco Foods, LLC. Recalls Frozen Red Raspberries Because of Possible Health Risk

Summary

Company Announcement Date: June 14, 2019

FDA Publish Date: June 14, 2019

Product Type: Food & Beverages  Fruit/Fruit Product

Reason for Announcement: Norovirus

Company Name: WinCo Foods, LLC

Brand Name: WinCo Foods

Product Description: Frozen Red Raspberries

This Week in Mislabeled Product for Week Ending June 15, 2019

Labels Misses Eggs in Quiche..Can You Have a Quiche Without Eggs? - Taylor Farms Illinois, Inc., a Chicago, Ill. establishment, is recalling approximately 51 pounds of cheese and bacon quiche products due to the product containing eggs, a known allergen, which is not declared on the product label.   The problem was discovered on June 8, 2019 when Taylor Farms Illinois, Inc. notified FSIS that the incorrect bottom package label had been applied to the product.


https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2019/recall-067-2019-release
Taylor Farms Illinois, Inc. Recalls Bacon Quiche Products due to Misbranding and Undeclared Allergens
Class I Recall
067-2019
Health Risk: High
Jun 9, 2019

It Is Important to Get the Food Safety Communication Right

Update - the incorrect temperature posted has been corrected.

A food safety news release by a news channel in Virginia quotes a nutritionist at medical hospital.  While the RD gets most things right, the news article does state an incorrect internal temperature for cooking pork...she states 140F and this should be 145F.  Perhaps instead, they should have spoken with our friends at Virginia Extension.  (Someone may have already contacted the author regarding the correction and provided a link to Virginia Extension).

https://www.whsv.com/content/news/Dietitian-reminds-of-food-safety-amid-cookout-season-511241412.html
Dietitian says to keep food safety in mind during cookout season

Thu 2:17 PM, Jun 13, 2019  | 

Updated: Thu 7:33 PM, Jun 13, 2019

Difficulties in Developing a Vaccine Against Norovirus

Norovirus is considered the leading cause of foodborne illness in the US.  The main reasons for this is how easily it spreads (acute onset vomiting), low infectious dose, and ability to remain active in the environment.  Another key is that the body does not easily become immune to the virus, and with that, there are no available vaccines.

The reason for this is the changing complexity of the outer capsid structure.  This shell changes structure significantly from strain to strain.  And of course this structure is what antibodies find and lock onto in order to eliminate from the body.

Technology Networks
https://www.technologynetworks.com/biopharma/news/steps-towards-a-food-poisoning-vaccine-320589
Norovirus Structure Far More Complex Than First Thought 
News   Jun 13, 2019 |

Are Nitrates in Water A Cancer Risk?

A peer reviewed study published by the Environmental Working Group proposes that nitrate pollution of U.S. drinking water may cause from 2300 to 12,594 cases of cancer per year.  Most of these cases are in the rural farmland area where agronomic inputs, septic systems and home lawns becomes the source of this contamination.  Currently, the EPA acceptable level is 10ppm, but the EWG wants to see a lower level, about 0.14 ppm.

These statistical studies make a lot of inferences based on diverse data, so it is important to recognize the limit of this.

Jeff Stoltzfus, Penn State's Farm Food Safety Educator, was kind enough to provide some facts.  First, the baseline level, or background level, found in undisturbed aquifers is 1ppm and as high as 3ppm.  Vegetables and meat also contribute significant amounts of nitrates to our diet.  Finally, there are many, many activities we engage in each day that represent a higher risk than this.

Environmental Research, online 11 June 2019, https://doi.org/10.1016/j.envres.2019.04.009

https://www.sciencedirect.com/science/article/pii/S001393511930218X?via%3Dihub
Exposure-based assessment and economic valuation of adverse birth outcomes and cancer risk due to nitrate in United States drinking water.
 Alexis Temkin a, Sydney Evans a, Tatiana Manidis b, Chris Campbell a, Olga V. Naidenko a
https://doi.org/10.1016/j.envres.2019.04.009

Highlights

• First of its kind national analysis assessing nitrate exposure from drinking water for the entire U.S. population.
• 2,300 to 12,594 nitrate-attributable cancer cases annually in the U.S., of which 54-82% are colorectal cancer (CRC) cases.
• Up to $1.5 and $6.5 billion in medical and indirect costs may be associated with annual nitrate-attributable cancer cases.
• Meta-analysis of eight studies assessing nitrate in drinking water and CRC supports a health benchmark of 0.14 mg/L