FDA and CDC Update Cyclospora Outbreak Linked to Salad Items, Source Not Yet Determined

FDA issued an update on the Cyclospora outbreak related to Fresh Express salads.  As of July 22, 2020, there are now 641 cases across 11 states, with majority of cases in Illinois and Iowa.  The last update was issued on July 9, 2020.  The actual food source of the outbreak has still not been determined.

FDA Outbreak Investigation
https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-cyclospora-bagged-salads-june-2020
Outbreak Investigation of Cyclospora: Bagged Salads (June 2020)
FDA’s traceback investigation continues. CDC reports additional cases.
07/24/2020
Case Counts
Total Illnesses: 641
Hospitalizations: 37
Deaths: 0
Illness Onset Date Range: 5/11/2020 – 7/5/2020

This Week in Mislabeled Product for Week Ending July 24, 2020

Supplier Packaging Error - Giant Eagle, Inc. has issued a voluntary recall of Giant Eagle Dried Island Fruit Mix due to the possibility the product may contain undeclared Peanut, Almond, Milk and Soy allergens.  Giant Eagle was made aware of the issue by a guest who purchased the product and the company has since learned that the cause was a packaging error made by the product manufacturer.

Incorrect Label - Winter Gardens Quality Foods, Inc., is voluntary recalling one of its products: Whole Foods Market Spinach Artichoke Dip carrying the lot code 248 and Use By: 07/26/20, because of an undeclared allergen (Egg).   The recall was initiated following an internal review of records identified the incorrect label.

Snack Cakes Recalled Due to the Potential for Mold

Hostess is recalling Raspberry Zinger snack cakes due to the potential for mold.  The release does not say what specific issue led to the recall, perhaps it was a misformulation issue where insufficient anti-molding agents were added?

I always thought these types of snack cakes were bullet proof.

https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/hostess-brands-llc-issues-voluntary-recall-certain-hostessr-raspberry-zingersr-due-potential-mold
Hostess Brands, LLC Issues Voluntary Recall of Certain Hostess® Raspberry Zingers® Due to the Potential for Mold
Summary
Company Announcement Date:  July 20, 2020
FDA Publish Date:  July 21, 2020
Product Type:  Food & Beverages
Reason for Announcement:  Potential to contain mold
Company Name:  Hostess Brands LLC
Brand Name:  Hostess
Product Description:  Raspberry Zingers

Parasite Taxoplasma gondii Found in Scotish Venison Meat

A recently published study looked at the prevalence of Taxoplasma gondii in retail meat samples in Scottland. (Detection of Toxoplasma gondii in retail meat samples in Scotland, FWP 2020).  Results were that "Toxoplasma gondii DNA was detected in 0/39 (0%) beef samples, 1/21 (4.8%) chicken samples, 6/87 (6.9%) lamb samples, 3/71 (4.2%) pork samples and 29/82 (35.4%; Sampling Period 1) and 19/67 (28.4%; Sampling Period 2) venison samples."  The researchers state "This is the first study to report the presence of T. gondii in retail meat products in Scotland and has highlighted venison as a potentially high risk meat."

So, what is the risk for those eating venison?  In 2017, a Wisconsin outbreak was investigated at a hunting camp and in that invesigation, it was believed to be related to undercooked venison.  In this paper, the author points out other outbreaks involving venison, "In 4 other studies of suspected venison-transmitted toxoplasmosis, consumption of undercooked or raw venison was reported [

28–31]. In a follow-up study of the coworkers of the patients in one report, T. gondii seropositivity was significantly associated with having eaten raw or rare venison [31]. Another of the reports describes a toxoplasmosis outbreak among a group of healthy male Canadian hunters who consumed undercooked venison in Illinois, USA [28]. The Canadian outbreak is almost identical to this outbreak in attack rate, incubation period, symptom severity, and the inclusion of one seronegative but presumed exposed individual. As Wisconsin and Illinois share a border, it is possible that similar strains of T. gondii caused the outbreaks. "

Taxoplasma gondii tissue cysts are not overly heat resistance. (link).  "At 61 C (142F) the cysts were generally inac tivated instantaneously as a result of the come up time (2 min) and come-down time (1.5 min)."

But if people follow the recommendation for cooking meats, especially wild meats where the potential for contamination may be higher in that the diet is not controlled, cooking to medium should easily achieve this goal.

FDA Warning Letters - Two Importers Without FSVP For Imported Goods

FDA issued two Warning Letters this week to food importer for lack of FSVP programs for items that they were importing for sale in the USA.

Tiao Peng Trading, Inc.of Hayward, CA did not have an FSVP for these imported items a) Canned black beans, canned red beans, and canned fruit, b) Fish snack foods, and  c)Custard cake.  They also did bit gave documentation that thermally processed low‐acid foods packaged in hermetically sealed containers (low-acid canned foods) was produced in accordance with Low Acid Food Requirements (21 CFR part 113).

Express Trading International Inc.of San Diego did not have an FSVP for a) Canned Coconut Milk and b)  Aloe Vera Drink Pomegranate.

FSVP (Foreign Supplier Verification Program) are required by importers to demonstrate that product had been produced to US food safety standards.


FDA Warning Letter
https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/tiao-peng-trading-inc-603865-05192020
Tiao Peng Trading, Inc.
MARCS-CMS 603865 — May 19, 2020

Does The Amount of COVID Virus Impact Severity - The Importance of Infecting Dose or Viral Load

There has not been much written about the impact of infecting dose  - the amount of virus (viral load) that a person encounters during an infection event - has on severity of illness.  Or whether a high infecting dose (high viral load received when infected) is more likely to lead to illness in someone not considered high risk.  But that concept would certainly make sense.  A person being infected with hundreds of thousands of viral particles at one time (and all contained in a aerosolized droplet) would be harder for the body to fend off than a few viral particles, and this would also lead to a shorter time needed to reach a critical mass in the body.

While this is not an easy to conduct research, a group at Oxford discusses viral load with regard to healthcare workers based upon case histories....cases where those people working with those who are seriously sick and thus these workers are more likely to encounter high loads of virus spewed out by the highly infected.  The paper shows a number of cases where healthcare workers become sick themselves when working with severely ill.

Could this be why in some cases where those people who become infected and end up at the point of hospitalization, but are seemingly in good immune shape?  Could they have taken in a viral load so large it just overcomes the body's defenses, or in this case, triggers that cytokine storm?

Interesting, a Chinese study found that infected people had the highest viral load in their throat before the onset of symptoms.

More reason for everyone to wear masks.  Masks can reduce how much virus a person emits and then can reduce the amount of virus a healthy person takes in.  People will argue that cotton masks do not prevent a virus from getting through...and that is not the goal.  The goal is reduction.

https://covid19-evidence.paho.org/handle/20.500.12663/1368
SARS-CoV-2 viral load and the severity of COVID-19

CDC - Studies on COVID Seroprevalence Indicate Higher Rates of Past Infection

Two reports were posted by CDC MMWR that look at how many people may have actually been infected with the virus versus cases that are actually reported.  By looking at seroprevalence, whether people had antibodies to the virus, both studies showed that at the time of sampling, the actual level or percent of people infected is far higher than what what had actually been reported.   The Indiana study showed that the actual rate may be close to 10 times higher than reported.

• These studies were conducted in late April / early May, and so, if this same rate of non-reported cases of infection is similar, than we do have a much larger population that has encountered the virus.
• These studies show that the mortality rate is lower when looking at the total number of actual cases versus reported.
• They do not know for sure that the presence of antibodies means the people are actually immune.
• The issue of asymptomatic people spreading the virus is a concern, so precautions like mask wearing and social distancing still must be in place.  Protection of high risk populations is also a must.

It is unfortunate that we do not have more information regarding actual rate of infection.  Knowing this would allow better decision making.  This could impact school and business operations.

However, mitigation strategies are still important.  Even though a larger percentage of the population may be infected than we know, there is even a larger percentage that has not been infected.

At this point, reporting negative cases of current infection tells us little.  Not to say testing is not important, but reporting how many people tested negative is not as important as percent positives there are.  Throw in the length of time it is taking to get results back, in same cases 3 to 7 days...or even longer, then the benefit of testing drops, and the reporting becomes less meaningful.

Have you already been infected?

https://www.cdc.gov/mmwr/volumes/69/wr/mm6929e1.htm
Population Point Prevalence of SARS-CoV-2 Infection Based on a Statewide Random Sample — Indiana, April 25–29, 2020
Early Release / July 21, 2020 / 69

Nasty - Fancy LA Restaurant Scrapes Mold Off of Jams

An LA restaurant was called out for being nasty, including scrapping off mold from improperly preserved jams.   In an LA Times report, 

"Most prominent among the allegations was the claim that Koslow had instructed employees to scrape layers of mold from refrigerated jam buckets, serving the remainder to guests at the restaurant or packaging it in jars for retail distribution"

The owner was evidently a high flyer in the LA restaurant scene, and had taken a Master Food Preserver class.  She even wrote a cookbook on making jams?

Koslow has been nominated for a James Beard Award for her work at Sqirl and was in the second class of the Master Food Preserver cohort in Los Angeles, a program run by the University of California’s Cooperative Extension. She is slated to release her second cookbook, covering the topic of jam making, on July 21.

“All of the retail jam we have ever sold — which is to say the jam in jars that is bought from us and at stores — is pasteurized and canned with the “hot pack” method that makes the growth of mold basically impossible. That same recipe is used in the restaurant, but because the jam is low in sugar and we don’t use chemicals or preservatives, there were occasional instances where mold would develop on the surface."

"The restaurant’s social media statement said that the process for dealing with mold growth was done “under the guidance of preservation mentors and experts like Dr. Patrick Hickey, by discarding jam several inches below the mold, or by discarding containers altogether.”

When contacted, Dr. Hickey backed out of that claim.    In the end, not a good idea to scrape mold off of food surfaces.

The restaurant was said to also have sanitary issues in addition to the mold scraping, including poor cleanliness and vermin.

LA Times
https://www.latimes.com/food/story/2020-07-14/sqirl-moldy-jam-safety-allegations
Sqirl owner Jessica Koslow addresses moldy jam and food safety allegations as former employees speak out

By GARRETT SNYDERSTAFF WRITER
JULY 14, 20203 AM

This Week in Mislabeled Products for Week Ending July 17, 2020

Printing Error on Packaging Results in Missed Milk - Happy Colon Foods, LLC of Oklahoma City, Oklahoma is recalling Happy Colon YUM Shortbread Cookie and Happy Colon Mmmm Chocolate Chip Cookie, because they may contain undeclared milk.  The recall was initiated after it was discovered that Happy Colon YUM Shortbread Cookies and Happy Colon Mmmm Chocolate Chip Cookies containing milk were distributed in packaging that did not reveal the presence of milk. Subsequent investigation indicates the problem was caused by a printing error on labeling.

Undeclared Nuts in Product - Operational or Supplier Issue?  Flagstone Foods LLC, of Robersonville, NC, is recalling its 16-ounce packages of Wegmans Pecan Blend Trail Mix because they may contain undeclared almonds and walnuts. The recall was initiated after a customer notified the firm that the product contained almonds and walnuts that are not listed in the ingredient statement on the packaging.