Friday, August 14, 2015

Report on Antimicrobial Resistance in Salmonella and Campylobacter

The FDA released its 2012-2013 National Antimicrobial Resistance Monitoring System (NARMS) Integrated Report.  The results are mostly encouraging.  From the report:
  1. About 80% of human Salmonella isolates are not resistant to any of the tested antibiotics.
  2.  Salmonella multi-drug resistance (resistance to three or more classes of antibiotics) in human, cattle, and chicken isolates has not changed (~10%) in the last decade, and the numbers of multi-drug resistant Salmonella isolates in retail chicken have gone down (~3%).   
  3. But two types of Salmonella do show some increases.  Multidrug resistance (MDR) in human isolates of a common Salmonella serotype (l 4,[5],12:i:-) continues to rise. Resistance has more than doubled from 18% in 2011 to 46% in 2013.  And anincrease in MDR and ceftriaxone resistance was also observed in Salmonella serotype Dublin isolated from cattle and human sources.
  4. Campylobacter jejuni resistance to the fluoroquinolone ciprofloxacin, the most common antibiotic used to treat human C. jejuni illness, was at its lowest level in retail chicken to date (11%).
 FDA News Release
FDA Releases 2012 and 2013 NARMS Integrated Annual Report; Finds Some Improvement in Antibiotic Resistance Trends in Recent Years
August 11, 2015
The U.S. Food and Drug Administration has released its 2012-2013 National Antimicrobial Resistance Monitoring System (NARMS) Integrated Report. This report replaces FDA’s annual NARMS Executive Summary report and highlights antimicrobial resistance patterns in bacteria isolated from humans, retail meats, and animals at slaughter. Specifically, the report focuses on major foodborne pathogens that are resistant to antibiotics that are considered important to human medicine, and on multidrug resistant pathogens (described as resistant to three or more classes of antibiotics).

Sprouter Issues Third Recall Notice Due to Listeria

A Virginia company has issued a recall for soybean sprouts and mung bean sprouts after the samples of the product were found to be positive.  The testing was conducted by Virginia Laboratory Services.

This is the third recall issued by this producer, with earlier recalls coming in May and June.  Do you think they have a problem?  One could also wonder what was required of this company before they were allowed to begin producing again.

Further, this shows how Listeria can be difficult to eliminate once it becomes established.


FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm458037.htm
Good Seed Inc. Recalls Soybean Sprouts & Mung Bean Sprouts Due To A Possible Health Risk

Contact:  Consumer:  (703) 392-0075

FOR IMMEDIATE RELEASE – August 3, 2015 – Springfield, VA – Good Seed Inc. of Springfield, VA is voluntarily recalling all packages of soybean sprouts and mung bean sprouts because they have the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections to individuals 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.

MMWR - Outbreaks Associated with Drinking Water - 2011-2012

 We generally regard drinking water safe, and rightfully so.  For the amount of water that is consumed each day, there have been relatively few issues.  An MMWR article reports that in the two year period reviewed, 2011-2012, there have been 32 water related outbreaks resulting in 431 cases of illness, 102 hospitalizations, and 14 deaths.

The biggest culprit was Legionella and this was primarily related to drinking water in hospitals affecting at-risk patients.  While we hear of Legionella in air conditioning systems, such as the current issue in NY where over 100 have become ill and 12 have died (Legionella grows in the cooling water systems and then is inhaled through the water vapors), evidently Legionella is an issue in hospitals (along with other HAIs (hospital acquired infections) including Clostridium difficile, MRSA, etc).  "Legionella outbreaks are particularly challenging to prevent and control, in part because the organism lives and multiplies in building plumbing systems, which usually fall outside water utility and regulatory oversight (6,7). One Legionella outbreak occurred in a hotel that used point-of-entry water filters, which effectively dechlorinated all water entering the building, and illustrates the importance of maintaining sufficient residual disinfectant in plumbing systems."

EPA has a publication on Legionella in drinking water.

The other issue was non-community water systems.  "All five noncommunity outbreaks originated from groundwater sources. Specifically, four occurred in outdoor camp or work settings where a source spring was contaminated directly or by inflow from a stream, and the fifth occurred at a meeting facility where a well was contaminated with septic tank overflow."  In these cases, Norovirus, non-Legionella bacteria, and Giardia (a parasite) were responsible.   (You are probably wondering how you ever made it through summer camp as a kid considering the pond water where you swam and that nasty spigot you drank from....and you are also then wondering why your parents sent you there.)

Here, an elk enjoys a drink of water from a spigot used for filling water bottles at Grand Canyon National Park (photo courtesy of Nika Bucknavage).


CDC MMWR
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6431a2.htm?s_cid=mm6431a2_e
Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water — United States, 2011–2012

Weekly
August 14, 2015 / 64(31);842-848
Karlyn D. Beer, PhD1,2; Julia W. Gargano, PhD2; Virginia A. Roberts, MSPH2; Vincent R. Hill, PhD2; Laurel E. Garrison, MPH3; Preeta K. Kutty, MD3; Elizabeth D. Hilborn, DVM4; Timothy J. Wade, PhD4; Kathleen E. Fullerton, MPH2; Jonathan S. Yoder, MPH, MSW2

Advances in water management and sanitation have substantially reduced waterborne disease in the United States, although outbreaks continue to occur (1). Public health agencies in the U.S. states and territories* report information on waterborne disease outbreaks to the CDC Waterborne Disease and Outbreak Surveillance System (http://www.cdc.gov/healthywater/surveillance/index.html). For 2011–2012, 32 drinking water–associated outbreaks were reported, accounting for at least 431 cases of illness, 102 hospitalizations, and 14 deaths. Legionella was responsible for 66% of outbreaks and 26% of illnesses, and viruses and non-Legionella bacteria together accounted for 16% of outbreaks and 53% of illnesses. The two most commonly identified deficiencies† leading to drinking water–associated outbreaks were Legionella in building plumbing§ systems (66%) and untreated groundwater (13%). Continued vigilance by public health, regulatory, and industry professionals to identify and correct deficiencies associated with building plumbing systems and groundwater systems could prevent most reported outbreaks and illnesses associated with drinking water systems.

Cyclospora Update - 457 reported cases

As of August 11, 2015, CDC is reporting that there have been 457 cases of Cyclospora infection.  Cilantro has been identified as a potential source.
 
   
CDC News Release
Cyclosporiasis Outbreak Investigations — United States, 2015
 
Last Updated August 11, 2015 4:00 PM EDT
 
Read the related statement from the U.S. Food and Drug Administration
Cyclospora cayetanensis is a single-celled parasite that causes an intestinal infection called cyclosporiasis.
  • As of August 10, 2015 (3pm EDT), CDC had been notified of 457 ill persons with confirmed Cyclospora infection from 29 states in 2015.
  • Most of these persons—275 (60%) of 457—experienced onset of illness on or after May 1, 2015, and did not have a history of international travel within 2 weeks before illness onset. These 275 persons were from the following 22 states: Arkansas (2), California (2), Connecticut (3), Florida (11), Georgia (22), Illinois (6), Iowa (1), Kansas (2), Maryland (1), Massachusetts (9), Michigan (2), Missouri (1), Montana (3), Nebraska (1), New Jersey (6), New Mexico (1), New York (excluding NYC) (8), New York City (21), Texas (157), Utah (1), Virginia (3), Washington (2), and Wisconsin (10).

Raw Whole Pigs Recalled Due to Link to Salmonella Outbreak

A Washington slaughter facility is recalling raw whole pig carcasses due to the fact they were tied to a number of salmonellosis cases which now stands at 134.
 
While we know raw pig can contain Salmonella, this recall was probably issued due to the number of cases as well as the uniqueness of the Salmonella strain.  The questions that will hopefully be answered - what was the level of Salmonella present, was there any contributing factors that provided opportunity for the organism to proliferate within the facility, and what can said about the virulence of this particular strain of Salmonella.


USDA News Release
 http://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2015/recall-110-2015-release
Kapowsin Meats Recalls Pork Product Due To Possible Salmonella Contamination
Class I Recall 110-2015
Health Risk: High Aug 13, 2015

Congressional and Public Affairs  Gabrielle N. Johnston   (202) 720-9113 

WASHINGTON, Aug. 13, 2015 – Kapowsin Meats, a Graham, Wash. establishment, is recalling approximately 116,262 pounds of whole hogs that may be contaminated with Salmonella I 4, [5],12:i:-, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The whole hogs for barbeque item were produced on various dates between April 18, 2015 and July 27, 2015. The following products are subject to recall:
Varying weights of Whole Hogs for Barbeque

Friday, August 7, 2015

FDA Listeria Sampling at Cantaloupe Packing Houses

In a recent sampling of cantaloupe packing houses, FDA testing results found that while Listeria was present, there was little risk in the facilities.  Of 17 facilities, 8 had Listeria species present and only one had Listeria monocytogenes, (but probably not food contact).  The FDA found some problems:
  • food contact surfaces that were not cleanable, often due to construction with damaged, corroded, or porous materials;
  • build-up of debris, dirt and damaged plant material on equipment;
  • hand washing facilities in inappropriate locations; and
  • drain valves left open during work hours allowing water drained from a dump tank to pool outside adjacent to a partially-enclosed packinghouse.
But these would be typical issues seen in packing houses.  The concern of course, relates back to the 2011 Listeria outbreak associated with cantaloupes.  In that case, unsanitary equipment lead to a buildup of Listeria in the wash water which subsequently contaminated the surface of the cantaloupes.  
 
Facilities have been taking corrective action, but clearly, more work is needed.  And with Listeria, continual vigilance is needed in order to control.  One never completely rids a facility of the presence, rather it is kept in check.

The Packer
http://www.thepacker.com/news/fda-reports-cantaloupe-safety-inspections
FDA reports on cantaloupe safety inspections
By Coral Beach August 06, 2015 | 2:04 pm EDT

After inspecting 17 operations, federal officials report that fresh cantaloupe packinghouses are generally following good agriculture practices even though tests at nine of the companies showed listeria contamination.

The inspections by the Food and Drug Administration were part of the agency’s follow-up efforts after a 2011 cantaloupe-related listeria monocytogenes outbreak that sickened more than 150 nationwide and killed more than 30.

Thursday, August 6, 2015

Recent Listeria Outbreaks In Ice Cream and Carmel Apples - Time to Reassess Food Safety Systems

From time to time, there are unfortunate food related outbreaks that cause food establishments to reassess their food safety systems.   The cantaloupe-Listeria outbreak was one such case that caught many off guard and prompted a new look at Listeria in fresh produce.  The Salmonella outbreak associated with chicken pot pies was another case that resulted in the need to validate microwave cooking instructions for frozen food.

Along with these, we can add the Listeria in Ice Cream and Listeria in Carmel Apples.

To this point, much of the focus of Listeria was on products that would support growth.  Ice cream, a frozen pasteurized product, was not viewed as risky as refrigerated products such as deli meats, or refrigerated products containing dairy like coleslaw or cheese.  So while indications are that the levels of Listeria in the ice cream were low, two factors come into play....one was that the ice cream impacted individuals with underlying health issues, and that the ice cream was used to make shakes and those shakes could have been held at room temperature for some time.  Research is ongoing and may provide more insight.

Camel apples weren't even on the radar.  There was concern with sliced apples, where Listeria could grow on the cut surface albeit slowly, but this was whole apples.  However in this case, the stick may have caused a similar action (surface damage) within the apple as the stick was inserted that may have provided conditions more apt to support growth.  Or high levels of the organism were forced into the apple.  Here again, research into this outbreak is ongoing.

So for products that support little or no growth potential for Listeria in their original state, we need to ask:
1) Will the level of Listeria contamination on a ready-to-eat product be high enough to impact the health of those with severe underlying health issues?  Then, maintaining a clean environment is needed prevent contamination regardless of whether the product supports growth.
2) Will the properties of the product change where those changes can support growth?  Such changes can occur anywhere downstream including other food operations, foodservice or retail establishments, or even by consumers.
3) Will the item be used as an ingredient in other products where those other products are more apt to support the growth of Listeria.  So if apples will be added to a slaw type of salad, what will be the impact in the slaw if a small level of listeria are present on the apples?

Of course one other thing that is important to consider - will product be tested by the customer, a government agency, or some other interested party.  Many recalls are started when someone tests product and find something that can be considered dangerous...including Listeria.  And it could be a strain of LM that is not overly pathogenic.

Wall Street Journal
http://www.wsj.com/articles/ice-cream-recall-sends-chill-through-food-industry-1438437781
Ice-Cream Recall Sends Chill Through Food Industry
Blue Bell’s problems prompt rethinking of measures to prevent bacteria contamination


By Jesse Newman

Updated Aug. 2, 2015 7:28 p.m. ET  63 COMMENTS  

As Blue Bell Creameries LP prepares to resume production of its ice cream after a sweeping recall, its mistakes are fueling broader rethinking of how to keep ice cream and other foods free of deadly bacteria.

Federal records show that Blue Bell failed to follow practices recommended by government and industry groups that might have prevented listeria contamination of ice cream at all three of its main plants. At the same time, some food-safety professionals say the crisis is indicative of insufficient attention, beyond Blue Bell, of the risks of listeria.

“It’s really been a wake-up call for the food industry, and not just for dairy but for other companies as well who thought they were in good shape but are now asking, could this happen to me,” said Joe Stout, a food-safety consultant who was previously a senior manager at Kraft Foods.

Wednesday, August 5, 2015

Cider Product Recalled Due to Post-Bottling Fermentation

Angry Orchards is recalling bottled cider after two lots began undergoing post-bottling fermentation.  The fermentation produces gas which can cause product to overflow when opened, in some cases the caps to pop, or may even result in broken bottles.



FDA Recall Notice
http://www.fda.gov/Safety/Recalls/ucm457397.htm
Angry Orchard Cider Company Announces Voluntary Recall of Select Cases of Angry Orchard Crisp Apple Hard Cider

Contact: Consumer: 1-800-362-7110
Media: Jessica Paar, Angry Orchard Cider Company 617-368-5060
Jessica.Paar@angryorchard.com

FOR IMMEDIATE RELEASE – August 4, 2015 – Cincinnati, Ohio – Angry Orchard Cider Company, LLC, Cincinnati, Ohio, today announced that it is conducting a voluntary recall of select cases (24/12oz bottles), 12-packs and 6-packs of Angry Orchard Crisp Apple Hard Cider.

The precautionary action comes after the Company received inquiries from consumers that had experienced broken bottles or bottles overflowing when opened. After conducting follow-up quality testing, the Company determined that the affected cider is limited to two batches, produced on June 15 and June 29, 2015.

Monday, August 3, 2015

Was Salmonella Invited to the Pig Roast?

Going to a pig roast or even hosting a pig roast?  Well guess what.....pork can contain Salmonella so make sure those who are cooking the pig and then handling the cooked meat do it properly.  There have been 8 illness clusters with approximately 90 reported cases in Washington State that have been associated with pig roasts.

So you get invited to a pig roast....don't be afraid to ask questions.....
Who the heck is cooking it, and have they cooked pigs before?   Dr. Campbell, PhD Meat Scientist or Hogs Galore, pig-cooking specialists...great.  Jimmy, lawn boy, first time pig roaster....maybe not.
Do they have equipment?  A BBQ pit specifically built for cooking pigs....excellent.  Jimmy's dug-out-pit in his back yard....yikes...
How big is the pig and how long are they cooking it?  Jimmy is picking up the pig in the morning and serving it that afternoon....seriously?
What kind of beverages are they serving?  Because if things don't look right when you get there (no thermometers being used, uncleaned surfaces, etc), be sure there are some tasty beverages........that may be all that you want to consume.

USDA Release
FSIS Issues Public Health Alert for Pork Due to Possible Salmonella Contamination

http://www.fsis.usda.gov/wps/portal/fsis/newsroom/news-releases-statements-and-transcripts/news-release-archives-by-year/archive/2015/pha-073115

Congressional and Public Affairs   Gabrielle N. Johnston   (202) 720-9113

WASHINGTON, July 31, 2015 – The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) is issuing a public health alert due to concerns about illnesses caused by Salmonella that may be associated with pork products, specifically whole pigs used for pig roasts.