Study Links Pathogenic E. coli (STEC) to Flour in 2016 Outbreak

A study published in the New England Journal of Medicine shows that flour was the source of a 2016 pathogenic E. coli (STEC) outbreak. In this outbreak 56 cases were identified in 24 states, with more than a quarter of those cases developing hemolytic–uremic syndrome - very severe kidney damage.   Although there were many challenges related to flour as an ingredient, this study was able to conclude that the flour was the source of the contamination. In concluding, the study highlights the risky behaviors that led to infection - "These behaviors included the consumption of raw or undercooked homemade dough or batter, which has long been discouraged because of the known risk of salmonellosis from consuming raw eggs, as well as allowing children to play with raw dough in restaurants and using flour to make play-dough for children at home. Our data show that although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens."

Still, people continue to eat raw dough
New England Journal of Medicine
http://www.nejm.org/doi/full/10.1056/NEJMoa1615910#t=article
Shiga Toxin–Producing E. coli Infections Associated with Flour

FDA Warning Issued to a Processor of RTE Salads

A NC refrigerated ready-to-eat (RTE) salad manufacturing facility was issued a warning letter.

FDA found two positive Listeria monocytogenes samples in the processing area - one from a wheel of (?) that was supported by a stack of lids located in the back kitchen. The lids contained accumulated water and debris and were continuously leaking product at connection junctions.  And another positive sample from under the packer [equipment?] in the back kitchen.  Potato salad was being manufactured in the back kitchen during the inspection.

The WGS analysis found two different strains of LM, and both of these strains had been found in the company's other processing facility during a previous year's sampling.  Because of this, FDA deemed that the plant did not have adequate control of Listeria.

• One of the strains of LM found was genetically identical to isolate found in thier other processing facility.  "that it is identical to (b)(4) FDA environmental swabs collected from your Chester, SC facility in May 2012, August 2013, and April 2015. This strain was also found in (b)(4) isolates that were obtained from USDA samples of chicken salad and ham salad from your Charlotte, NC facility, and (b)(4) of USDA’s environmental swabs collected from your Charlotte, NC facility in 2015."
• The other strain of L. monocytogenes  "shows that it is identical to L. monocytogenes isolated from FDA’s February 2017 sample of your Chester, SC facility’s pimento spread, the state of North Carolina’s 2017 sample of your pimento cheese and old fashioned spread, and FDA environmental swabs collected from your Chester, SC facility in May 2012, August 2013 and April 2015. This evidence demonstrates that L. monocytogenes had maintained a presence in your Chester, South Carolina facility from 2012-2017 and an identical strain of L. monocytogenes has been isolated in your Charlotte, NC processing environment."

The facility was sited with numerous GMP violations.

• The production sprayers and the water bath hose were observed pooling water throughout the entire production room floor and splashing water onto food contact surfaces
• Soiled garments of employees including hair nets, arm guards, and aprons coming into direct contact with raw ingredients and in-process finished product.
• An employee was observed using a probe thermometer to check the temperature of each batch of pimento spread without cleaning or sanitizing it between uses.
• Employees storing and resting food contact equipment such as product scoops and spatulas on non-food contact surfaces such as brown paper towels and tables then using them to manipulate raw materials and/or in process finished product without first washing or sanitizing them.
• After sanitation operations, had been completed in the back kitchen a mixer had chicken salad residue and dried mayo debris on the paddle, the interior and the mixer stand attachment. The equipment was used for the next production run without any additional sanitation being performed
• A bucket labeled as sweet pickle relish to contain bleach, a bucket labeled as diced celery to contain quaternary ammonia, and an unidentified container, which reportedly contained bleach, was found to contain a 50ppm chlorine solution.
• Chemicals were observed to be stored directly adjacent to the potato washer and the potato conveyor where food items were actively undergoing processing. In addition, the investigators observed sanitizer overspray to be inside an open box containing finished product containers as well as wetting boxes containing finished product container.
• Finished product troughs, raw ingredient transport bowls, and mixers were observed to be pitted and cracked, cutting boards contained numerous gauges and cuts and salad tubs were heavily gouged.
• Two pallets of canned pimentos and one pallet of canned jalapenos were observed to be stored in the maintenance shop. The pallet of jalapenos had opened motor oil containers and lubricants stored on top. The front pallet of pimento had a viscous black liquid spilled onto the middle cans on the pallet. Chemical drums stored adjacent to the rear kitchen were observed to be leaking onto open boxes of finished product containers
• Condensate was observed dripping onto packaged product, exposed raw materials such as relish and cabbage, and food contact surfaces. Condensate was also observed pooling where sanitized production equipment was being stored. 
• Accumulated condensation from a shop fan in the front and was blowing onto sanitized cooked potato containers.
• An employee in the front kitchen was observed using gloved hands to assemble sanitized production equipment. This employee stopped assembly to manipulate the hose that had been on the floor and then resumed assembling the sanitized equipment without first washing and sanitizing or changing the gloves.
• Multiple employees were observed returning from breaks without washing their hands or washed their hands and then put on hairnets and earphones, without first re-washing their hands, before resuming production activities in the front and back kitchens and the spice room.
• The equipment washing sink in the front kitchen was observed to be directly plumbed into the sewer system without an air break or a backflow prevention device.

FDA Warning Letter
https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2017/ucm586088.htm

November 14, 2017

 WARNING LETTER

18-ATL-01

Stanley C. Bracey, President
Bill R. Rudisill, General Manager
B&H Foods
2122 Thrift Road
Charlotte, NC 28208

Dear Mr. Bracey:

The United States Food & Drug Administration (FDA) inspected your refrigerated ready-to-eat (RTE) salad manufacturing facility located at 2122 Thrift Road, Charlotte, NC 28208 from May 9 through 31, 2017. During our inspection, FDA collected environmental samples (i.e., swabs) from various areas in your processing facility, including areas that are near food and food contact surfaces.  FDA laboratory analyses of the environmental swabs found the presence of Listeria monocytogenes (L. monocytogenes), a human pathogen in your facility. Additionally, FDA investigators observed serious violations of the Current Good Manufacturing Practice (CGMP) in Manufacturing, Packing, or Holding Human Food regulation, Title 21, Code of Federal Regulations, Part 110 (21 CFR Part 110) [1]. Based on FDA’s analytical results for the environmental sample and inspectional findings documented during the inspection, we have determined that your RTE food products are adulterated within the meaning of section 402(a)(4) of the Federal Food, Drug, and Cosmetic Act (the Act) [21 U.S.C. § 342(a)(4)], in that they were prepared, packed or held under insanitary conditions whereby they may have been rendered injurious to health. You may find the Act and FDA's regulations through links in FDA's home page at http://www.fda.gov.

Protein Bars Recalled After Single Complaint of Foreign Material in the Form of Plastic

Leclerc Foods has initiated a limited voluntary recall of a single lot of Fit & Active Chocolatey Chip Protein Meal Bars The recall was initiated as a precautionary measure after a small piece of yellow plastic was discovered by a consumer.


https://www.fda.gov/Safety/Recalls/ucm586503.htm
Leclerc Foods Issues Limited Voluntary Recall of Fit & Active Chocolatey Chip Protein Meal Bars – Due to Presence of Plastic Piece
For Immediate Release
November 23, 2017

Flies as a Vector for Foodborne Illness and Human Disease - What is the Risk?

A recent study originating from Penn State's College of Science and published in Scientific Reports evaluates the microbiome of house flies (grey) and blow flies (metallic green or blue, larvae live off of dead animals) and their ability to transfer bacteria.  But as reported in many mass media articles, the assertions drawn from this study may have people avoiding flies like the plague.

As an example from the The Telegraph
http://www.telegraph.co.uk/science/2017/11/24/flies-carry-bacteria-first-thought-warn-scientists/
Title:  Don’t eat food if a fly lands on it, as they carry more dangerous bacteria than previously thought, warn scientists

• "But a new study suggests the insects carry far more dangerous bacteria than previously thought, meaning sandwiches are best avoided if they have been contaminated by flies."
• "Flies in urban areas were found to carry more bacteria than the countryside leading scientists to suggest avoiding city parks for a picnic, and eating food into more rural locations."
• "It might be better to have that picnic in the woods, far away from urban environments, not a central park."

The metgenomic analysis of the fly microbiome  in the study does show that flies can carry a number of bacterial pathogens, however the presence may not translate to absolute risk.  Like the metagenonic analysis conducted on surfaces in the city environment  that showed the presence of  a number of different bacterial pathogens in the subway and other places, that presence doesn't mean there is a huge risk.   A fly landing on your food doesn't necessarily mean that the food is now contaminated to a point that makes it unsafe.  Or, I wouldn't skip the opportunity of having a picnic in a city park because a fly may land on my food.

So perhaps some more reasonable takeaways from the study:

• Don't swat a fly when it is on your food.  If you swat it on the counter, clean that surface.  The majority of bacteria will be in the fly or on various parts that will more likely transfer to the food or food contact surface when the fly is splattered.
• The higher transfer rate of bacteria will be from a surface the fly was just on.  So if you are eating lunch in a pasture full of cow patties where numerous flies are landing on cow poop and then landing on your sandwich, then one would consider that a higher risk than having a fly land on your sandwich when eating it in your home. See this link - https://www.hindawi.com/journals/isrn/2013/718780/
• When preparing food, especially food for others, it is important to keep flies away the best you can.  Keep doors and windows closed or screened.  It is still important to avoid risks where we can.

Scientific Reports

https://www.nature.com/articles/s41598-017-16353-x
The microbiomes of blowflies and houseflies as bacterial transmission reservoirs
Ana Carolina M. Junqueira, Aakrosh Ratan, Enzo Acerbi, Daniela I. Drautz-Moses, Balakrishnan N. V. Premkrishnan, Paul I. Costea, Bodo Linz, Rikky W. Purbojati, Daniel F. Paulo, Nicolas E. Gaultier, Poorani Subramanian, Nur A. Hasan, Rita R. Colwell, Peer Bork, Ana Maria L. Azeredo-Espin, Donald A. Bryant & Stephan C. Schuster
Scientific Reports 7, Article number: 16324 (2017)
doi:10.1038/s41598-017-16353-x
Received:29 June 2017Accepted:10 November 2017Published online:24 November 2017

Abstract

Blowflies and houseflies are mechanical vectors inhabiting synanthropic environments around the world. They feed and breed in fecal and decaying organic matter, but the microbiome they harbour and transport is largely uncharacterized. We sampled 116 individual houseflies and blowflies from varying habitats on three continents and subjected them to high-coverage, whole-genome shotgun sequencing. This allowed for genomic and metagenomic analyses of the host-associated microbiome at the species level. Both fly host species segregate based on principal coordinate analysis of their microbial communities, but they also show an overlapping core microbiome. Legs and wings displayed the largest microbial diversity and were shown to be an important route for microbial dispersion. The environmental sequencing approach presented here detected a stochastic distribution of human pathogens, such as Helicobacter pylori, thereby demonstrating the potential of flies as proxies for environmental and public health surveillance.

FDA Warns About Giving Bones and Bone Treats to Dogs

FDA issued a consumer warning about giving bones including commercially-sold bones and bone treats to dogs. Also included of course are chicken and turkey bones.

As dog owners know, some dogs can handle a bone, while others want to swallow it whole. If your dog is one that can't resist knocking back the whole bone, then even a commercially-sold bone can be a problem.  The hard part for owners is overcoming 'the stare'.

FDA Warning to Consumers
https://www.fda.gov/forconsumers/consumerupdates/ucm208365.htm
No Bones (or Bone Treats) About It: Reasons Not to Give Your Dog Bones

Bone Treats Pose Risks for Dogs 
Bone treats are real bones that have been processed, sometimes flavored, and packaged for dogs. Giving your dog a “bone treat” might lead to an unexpected trip to your veterinarian, a possible emergency surgery, or even death for your pet.

Many dog owners know not to toss a turkey or chicken bone to their dog; those bones are just too brittle. But the U.S. Food and Drug Administration (FDA) says the risk goes beyond that, especially when it comes to the “bone treats” you may see at the store.

Catered Thanksgiving Event Results in Numerous Cases of Foodborne Illness

Update - 10/27 According to a report, the causative agent was determined to be Salmonella.  No specific product was identified as the source, but it looks as though a local pizza shop was the caterer.

A catered Thanksgiving event in northern GA resulted in numerous cases of foodborne illness. At least two have been hospitalized, and the total number of cases may be as high as 1800. Reported symptoms of foodborne illness includes upset stomach, stomach cramps, diarrhea, vomiting, and fever.

No specific pathogen or suspect food has been identified at this point.

We can add this to our Thanksgivings past and foodborne illnesses outbreak list – something to consider for your holiday celebrations – warning to our late shift employees on being served food from earlier in the day.

• 2016 - C. perfrigens Identified as Cause of Thanksgiving Foodborne Illness Outbreak - Shortly after Thanksgiving, an outbreak of foodborne illness was reported in California that was linked to a Thanksgiving charity event. There were 3 deaths and another 22 others who were ill. The causative agent was found to be Clostridium perfringens, a sporeforming pathogen that can grow rapidly when food is temperature abused.
• A 2015 Thanksgiving Luncheon Becomes Scene for C. perfringens Outbreak - A CDC Report - With Thanksgiving leftovers still in the fridge, it is a good time to review a 2015 outbreak that occurred during a Thanksgiving luncheon. About 40 people who attended a catered company Thanksgiving lunch became ill with diarrhea and abdominal pain the following day (roughly 13 hours later). C. perfrignes entrotoxin was found in the patient stool samples and C. perfrigens was isolated from the turkey as well as the patients. According to the CDC report "The caterer had previously maintained a permitted facility, but reported having prepared the lunch food served at this event in an uninspected, residential kitchen. Turkeys were cooked approximately 10 hours before lunch, placed in warming pans, and plated in individual servings. Food was then delivered by automobile, which required multiple trips. After cooking and during transport, food sat either in warming pans or at ambient temperature for up to 8 hours. No temperature monitoring was conducted after cooking."
• 2012 Martha Stewart, celebrity chef and author, contracts Salmonella - Martha Stewart contracted Salmonella over Thanksgiving from mishandling food in the form of raw turkey. While we hate to see anyone become ill, having a celebrity chef come down with Salmonella can have a positive outcome. Too often we see these celebrity chefs demonstrating poor practices, whether it is inadequate hand washing, cooking to the incorrect temperatures, or canning foods using the oven technique. But my hope is that Martha will use this experience as motivator to endorse good safety practices.
• 2015 Fifteen Postal Workers Ill from Potluck Leftovers - Potlucks are one thing, but leftovers from potlucks..... In this case, 15 postal workers become ill after consuming leftovers from a potluck dinner held for 200 to honor veterans. Officials at the facility said nearly 200 employees participated in a potluck dinner Tuesday evening to honor co-workers who are veterans. Some of the food was refrigerated overnight Tuesday. Employees and managers returning to work Wednesday night helped themselves to the leftovers and after consuming them, some complained of stomach pains, officials said.
• 2014 Catered Office Party Is the Site of Staph Aureus Intoxication - Approximately 60 people became ill after attending an office party in Florida. About 25 were taken to the hospital. The catered event served turkey, ham, stuffing and green bean to some 700 people. The caterer was identified as Kitchen Divas, which from the website, appears to be a legitimate operation. It sucks when staff parties turn into 'staph' parties
• Advice on handling leftovers.

Rome News Tribune

http://www.northwestgeorgianews.com/region/health-department-investigating-likely-foodborne-illness-outbreak-at-toyo-tire/article_3e226290-ce36-11e7-bef0-03c2be8bd607.html
Health department investigating likely foodborne-illness outbreak at Toyo Tire event
Press release
11/20/17

Store Caramel Apples At Refrigeration Temperatures

Unfortunately, we are still seeing caramel apples at retail being displayed at room temperature.  Less than two years ago, a Listeria outbreak was linked to caramel apples.  It was later determined that if those apples had been stored at refrigeration temperatures, there would not likely have been an issue.

Penn State News
http://news.psu.edu/story/490097/2017/10/24/impact/caramel-apples-stored-room-temperature-extended-periods-can-pose-risk
Caramel apples stored at room temperature for extended periods can pose risk
October 24, 2017

Trader Joe's Chicken Salad Products Recalled After Complaints of Glass-like Foreign Material

Green Cusine, a CA establishment, issued a recall for 36,854 pounds of Trader Joe's chicken and turkey salad after the company received consumer complaints of glass shards / silica foreign material.

News Release
https://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2017/recall-125-2017-release
Green Cuisine Recalls Poultry Products Due To Possible Foreign Matter Contamination
Class I Recall 

125-2017
Health Risk: High 

 Nov 18, 2017

Dairy Calves Linked to Outbreak of Antibiotic Resistant Strain of Salmonella

CDC has identified an ongoing Salmonella outbreak associated with dairy calves.  The calves originated in Wisconsin.  The ongoing outbreak has progressed for some time, dating back to January 2015, with now 54 people in 15 states.  It is a multidrug resistant strain of Salmonella Heidelberg.

Dairy Herd Management
https://www.dairyherd.com/index.php/article/cdc-links-salmonella-outbreak-contact-dairy-calves
CDC Links Salmonella Outbreak to Contact with Dairy Calves
John Maday
November 16, 2017 10:18 AM