Food Poisoning, Foodborne Illness Information and Research : International Food Safety Network : BarfBlog

Stephen Smith of the Boston Globe writes this morning,

The signs of trouble arrived deep in the night: first, bloody diarrhea, then nausea

Austin Richmond nor his mother knew it at the time, but he had been infected with a potentially lethal germ known as E. coli O157:H7. And, according to a lawsuit filed yesterday, the 11-year-old from Lincoln, R.I., caught it doing what many children do when they are away at camp, by eating a cheeseburger.

There were trips to the emergency room, trips to the doctor’s office, and initial confusion over what was causing him to be so sick. For more than two weeks, Austin, a sixth-grader, has been banished from school and not just because of his own illness. There is also concern that, because his immune system has been so ravaged battling the E. coli infection, he might prove especially susceptible to swine flu, which killed another student at Lincoln Middle School over the weekend.

Austin’s mother, Jaimee Richmond, said,

“He just wants to go back to being him. He wants to be able to play soccer. He wants to go to Boy Scouts. He wants to go back to church, which are words I never thought I would hear coming out of his mouth. … “I’m angry, I’m sad, I’m confused, I’m overwhelmed. I just want to go back to normal life. Tuesday night, it used to be Ponderosa night because it’s cheap, it’s family, the kids loved it. I just want it to be Ponderosa night again.’’
 

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From the growing catalogue of worst things to say after an outbreak of foodborne illness, Dan Moore, the owner of the Wendy's franchise on Prospect Street in New Brunswick said yesterday,

“The senior vice-president of Wendy's was here (on Saturday) to inspect the restaurant."

Further, all required precautions have been taken, and customers can safely eat salads, as well as any other menu items.

The Wendy’s outlet was linked to an E. coli O157 outbreak that hit four people who ate Wendy’s salads.

What any consumer would want to know is, where did the lettuce or tomatoes come from, and what kind of on-farm food safety program is being used by the producer, including water testing, testing of soil amendments, and employee sanitation. Don’t want employees wiping their butts and picking fresh lettuce; same with the Wendy’s staff.

If it only takes a senior vp to make food safe, in the absence of any evidence, then lots more food should be safe because there are lots of senior vps.

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USDA FSIS has announced a recall of 545,699 pounds of fresh ground beef products that may be contaminated with E. coli O157:H7 and distributed in seven states. According to FSIS, the product has been linked to a cluster of illnesses in New England.

There are quite a few recalls going on most of the time; this one is notable because this product has been linked to an outbreak of illnesses at a camp in Massachusetts. It's also notable because bulk amounts of the product were shipped down the East Coast for further processing. Retail outlets receiving some of this product include Shaw, Giant, Price Chopper,Trader Joe's, BJs and others.

From the press release:
"Products for further processing:
Cases of 10-pound "FAIRBANK FARMS FRESH GROUND BEEF CHUBS."
     Each case bears the establishment number "EST. 492" inside the USDA mark of inspection; has package dates of "09.14.09," "09.15.09," or "09.16.09;" and sell-by dates of "10.3.09," "10.4.09," or "10.5.09. These products were distributed to retail establishments in Maryland, Massachusetts, North Carolina, New Jersey, New York, Pennsylvania, and Virginia for further processing. However, these products at retail will likely not bear the package dates and sell-by dates listed above. Customers with concerns should contact their point of purchase."

It is unlikely that any of the product is still being sold fresh at retail stores (the best-if-sold-before dates range from mid-September to early October) but it's likely that the affected beef is still around in freezers. The meat juices from thawing can provide a nice vehicle for pathogen transfer.

Stick it in with a tip-sensitive digital thermometer (in multiple spots) to ensure that ground beef has reached a safe temperature and be vigilant in containing meat juices when thawing frozen meats. Juicy is good, nasty meat juice spread around the kitchen isn't.

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Hold me closer, tiny dancer, there will be no dueling pianos in Portland: The Elton John and Billy Joel concert originally scheduled for the Rose Garden November 10 was postponed after John was diagnosed with an E. coli infection.

Live Nation and The Rose Garden said Friday that John was advised by his doctor to postpone these performances due to a serious case of e-coli bacterial infection and the flu.

No word on what kind of E. coli had stricken Mr. John or possible sources.
 

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The petting farm at the centre of an E.coli outbreak that left several children seriously ill and more than 90 people reporting symptoms of the infection, has reopened despite a storm of criticism from parents.

Godstone Farm in Surrey opened its play areas yesterday but kept all visitors out of contact with animals. The attraction, which is still under investigation by the Health Protection Authority, will hold Halloween-related events this weekend.

Tracy Mock, whose two-year-old twins spent weeks in hospital fighting the bug after visiting the site said she was "shocked" to hear of the opening.

"I was under the impression the farm was going to stay closed until they had finished their investigations."

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Staff at the Stonebridge City Farm want to reassure potential visitors that the farm has never been affected by E. coli as the number of visitors continues to decline in the wake of a petting zoo outbreak that sickened 93 children.

Mark Barry, funding development worker at the farm in St Ann's, said,

"We've been quite severely affected by E.coli scare stories, but luckily, the last week has been excellent. We're E.coli free, like most city farms, and that message needs getting across."

Does that mean no illness or death has ever been connected to the farm? Does that mean the owners are routinely screening the animals for dangerous E. coli and have test results they can share with the public to bolster confidence?

The story also says that only one in 50 of all E. coli cases are linked to petting farms.

Such statistics may be factually correct but get sorta lost when 93 kids become unnecessarily sick from a leisure activity. People need to eat – they don’t need to kiss turtles and they don’t need to visit petting zoos.
 

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Today’s USA Today offered up its point-counter-point editorial space this morning to the persistent problem of dangerous E. coli in ground beef.

From the newspaper:

Too many Americans get sick and too many die from eating that most all-American of foods, the hamburger. …

The U.S. Department of Agriculture, which has seemed confused as to whether its job is to protect consumers or producers, urges testing by hamburger makers and could require it. But it has not done so, apparently because of industry resistance. It should.

A second problem is that it's physically impossible and economically unrealistic to test every bit of meat. … Though numerous studies have shown that irradiation is safe and effective, public suspicion has helped prevent its spread. USDA, which has approved irradiation, needs to counter the myths and campaign for its wider use.

Because producers and the USDA admit that they can't guarantee germ-free meat, they urge consumers to handle ground beef carefully and cook it to 160 degrees, which kills most bacteria. That should be a last line of defense, not a primary one. You shouldn't be taking your life in your hands if the bun holds an undercooked burger.

From the government, U.S. secretary of Agriculture, Tom Vilsack:

The following are just a few key steps USDA has taken recently:

— Launched an initiative to cut down E. coli contamination, including stepped up meat facility inspections to involve greater use of sampling to monitor the productsgoing into ground beef.

— Appointed a chief medical officer within USDA's Food Safety Inspection Service to coordinate human health issues within USDA and build bridges with the public health community and senior leaders throughout the federal, state and local sectors to establish a consistent approach and heighten food safety awareness.

— Issued consolidated, more effective field instructions on how to inspect for E. coli O157:H7 contamination.

— Started testing additional components of ground beef, including bench trim, and issued new instructions to our employees asking that they verify that plants follow sanitary practices in processing beef carcasses.

Protecting public health is the sole mission of USDA's Food Safety and Inspection Service, and we will not rest until we have eliminated food-borne illnesses, hospitalizations and deaths.

If only foodborne illness was as cute as a Kevin Bacon and Elizabeth Perkins movie.
 

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Amy is a carnivore. First time I went to dinner at her place, almost four years ago, we couldn’t decide what to eat. Eventually, Amy said, let’s go to the supermarket, get a couple of steaks, and grill at home.

I was in love.

Amy’s grill (right) served us well, but the years took its toll. So we splurged and got a new BBQ – the Weber Genesis -- which I used for the first time last night. Whenever we get a new car, or grill, or pretty much anything, since I insist on owning things for 10 years until they are completely spent, I marvel at the technological advances. It was awesome.

We grill meat and vegetables pretty much every day. And maybe it’s not so cool after last weeks tragic story of E. coli O157:H7 victim Stephanie Smith, but we eat hamburgers – make them at home from ground beef and turkey.

The news is confusing: The N.Y. Times feature by Michael Moss that started the latest round of confusion said hamburger trim was mixed together from all sorts of places and no one wanted to test for E. coli O157:H7 (that’s what happens with a zero tolerance policy; don’t test, don’t tell). Subsequently the Times said in an editorial that the only way to be safe was to cook hamburger to shoe leather, and former Centers for Disease Control-type, Richard Bessler told Diane Sawyer on Good Morning America the only way to cook meat safely is to "cook it to the point where most people wouldn't want to eat it."

Former U.S. Department of Agriculture Undersecretary for Food Safety, Richard Raymond, responded on his blog that the Times story simplified a few things about testing and mixing, and that, “raw meat and raw poultry should not be considered to be pathogen free—ever.”

Then yesterday, the Minnesotans, home of Cargill, tried to poke a few more holes in the Times story.

Craig Hedberg, professor of environmental health sciences at the University of Minnesota, said,

“Testing of product, either raw materials or finished products, is something that has limited usefulness. We can’t test every square inch of an animal’s carcass to see if there’s bacteria present … it just would be too expensive.”

I’m not sure who we is, and playing cost off against human health is never a good tactic.

Ryan Cox, professor of meat science at the University of Minnesota said,

“If you were to go into a modern meat facility, it looks very similar to a surgical suite in a hospital.”

Especially with the sick people.

Cox explained that meat industry practices are so stringently regulated that “to infer in some way that we have an unsafe system would be certainly an error.”

Pete Nelson , who spent 35 years running a USDA-inspected facility, defended the multiple sourcing used by large processing plants. He cited the need for a steady supply of beef in case an individual slaughterhouse is not able to deliver on time, as well as the need for a variety of meats to ensure consistency. …

Both Nelson and Cox said consumers have an important role in food safety, especially in the handling and cooking of raw meats.

“We both agree on the fact that there really wouldn’t have been much of a story to begin with, particularly with the instance [The New York Times] cited with the food sickness, if the product had been cooked to the correct internal temperature.

Ouch. Blame the consumer. USDA stopped that in 1994.

Cross-contamination is a serious issue, as repeatedly pointed out on this blog and in our research, and that’s why pathogen loads have to be reduced as much as possible before entering a further processing plant, a restaurant, a grocery store or someone’s kitchen. And then, as Raymond says, never assume meat – or any raw food – is pathogen free. Same with animals. Those 90 kids that got sick with E. coli O157:H7 at a petting zoo in the U.K. weren’t dealing with meat from different sources.

And no one has to cook to shoe leather. Meat thermometers can help, and stick it in until 160F for hamburger.

Our steaks were a delicious 125F, climbing to about 135F over time.

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The season premier of South Park took a shot at those dead celebrities that just won’t go away – Hi! Billy Mays here … -- , and a lovely sub-plot aimed at the sanctimonious Chipotle, and how their food makes your ass bleed.

Maybe Trey Parker and Matt Stone have been reading up on E. coli O157:H7 symptoms.

You love to eat Chipotle, but you hate those blood stains in your underwear?

Now you can eat all the Chipotle you want, and still have clean underwear with ChipotliAway.

Stan: Why would you keep eating something that made you crap blood?

Cartman: Dude have you ever eaten Chipotle, it’s really good.

I love that the adopted Canadian kid, Ike, and all the other Canadians, have flapping heads (who can forget, Blame Canada, from the movie?). And bring on more Terrance and Phillip. Video which may offend, below.
 

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The BBC has just reported that a child from Devon has died after being infected with E. coli.

The Health Protection Agency (HPA) has refused to release any details about the child, thought to be a toddler.

But the agency would say that no clear source for the infection has been found and that no other cases have been linked to the infection.

The HPA has also confirmed that it does not think the child's death is connected to an outbreak which centred on a petting farm in Surrey.
 

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In Sunday's New York Times, journalist Michael Moss profiled a 2007 outbreak of E. coli O157:H7 linked to ground beef. The tragic story focused on one of the victims, Stephanie Smith, a 22-year-old woman who was in a coma and paralyzed after acquiring the pathogen.

The video (which I can't seem to embed, but it can be viewed on the Times site) was particularly impactful and shows some of the devastating consequences of foodborne illness.

That story is the focus for this week's food safety infosheet

Food Safety Infosheet Highlights:
- Ground beef has been linked to at least 16 outbreaks since 2007.
- In 2009, this pathogen led to the recall of beef from nearly 3,000 grocers in 41 states.
- Cook all ground beef to 155°F for 15 seconds or 160°F for an instant kill.
- Clean and sanitize all surfaces (cutting boards, counters) where ground beef items were prepared.

The food safety infosheet can be downloaded here.

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Any time there’s an outbreak of foodborne illness, and someone says, “We’ve always done things this way and never had a problem,” there is an immediate cloud of suspicion hanging over that producer or retailer.

It’s probably the worst thing someone facing a food safety crisis can say.

The Brits are particularly pissed that Godstone Farm in Surrey, a petting zoo which appears to be the source of 87 E. coli O157 illnesses, including 12 kids in hospital, stayed open as long as it did.

It’s going to get worse.

According to the Times this morning, a five-year-old girl who suffered kidney failure in March is thought to have been made ill by E coli contracted at the same farm.

Holly Nethercoat (right) was kept in an isolation unit at Great Ormond Street hospital, London for two weeks after a visit to Godstone farm in Surrey.

The story says that despite the likelihood Holly contracted the bug at the farm, it was not informed. It is not mandatory to report E coli cases to the Health Protection Agency.

The agency refused to say whether it had been told of Holly’s case. However, Jackie Flaherty, owner of Godstone farm, said:

“We absolutely haven’t heard of any cases before August.”

Great Ormond Street said “good public health practice” meant the case should have been reported to the local health protection unit but it refused to say whether it had done so in Holly’s case because of patient confidentiality.

Mark Nethercoat, Holly’s father, said,

“My daughter went to hell and back, and I can only conclude it was because something was grossly wrong with both the farm and the Health Protection Agency.”
 

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The number of E. coli cases believed to be linked to the PNE has climbed from 13 last week to 18, and the mother of one sick child is questioning health officials' response.

Coquitlam, B.C., mother Caroline Neitzel says her 14-month-old daughter, Jacklyn (right), was infected with E. coli after a visit to the annual Vancouver fair on Sept. 5.

Neitzel said her daughter touched a number of different animals at the petting farm. She said she did her best to wipe her daughter's hands with wet wipes during that visit.

Despite her efforts, Jacklyn became very ill. At first doctors thought the toddler had the flu. Jacklyn was sent home twice before being admitted to Royal Columbian Hospital, according to her family.

"By that time, her eyes were rolling into the back of her head. She was just so lethargic," Neitzel told CTV News on Friday.

The toddler spent four days in hospital. Neitzel said she thinks her daughter would have been diagnosed earlier if health officials had issued a public warning when a cluster of E. coli cases was discovered.

Anna Marie D'Angelo, a spokeswoman for Vancouver Coastal Health, said the public was not alerted because there was no risk at the time.

"We became aware of the situation three days after the PNE had closed. So there was no risk to any future people getting this E. coli," she said.

Health officials say an alert would not have changed how a patient was treated at the hospital.

The PNE says E. coli has never been a problem in the past at the petting farm and that the fair has stringent hygiene measures in place, including signs and staff directing visitors to hand-washing stations.
 

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Gemma Weaver, 24, of Bramley Close, has vowed to "never forgive the farm" after her three-year-old son, Alfie (right), suffered kidney failure following a visit to Godstone Farm.

“We are taking legal advice at the moment. I will never, ever be setting foot in a farm with my children again. Not just Godstone Farm but any farm."

Mrs Weaver said she still hadn't heard from (farm manager) Mr Oatway, who added,
 
“We will definitely be opening again. There are still ongoing investigations but we are sure we will open again."

Three more cases of E.coli linked to a children's petting farm have been confirmed - taking the number of people affected to 79.
 

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The BBC is reporting that lambs, pigs, goats, cattle, ponies and rabbit droppings at a Surrey farm at the centre of an E.coli outbreak have tested positive , with a whopping 33 of 102 samples likely to contain the O157 strain of the infection.

The Health Protection Agency (HPA) said the total number of E.coli cases linked to Godstone Farm had risen to 67.

Eight children remain in hospital in a "stable or improving condition."
 

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Harry Dolby, three (right, photo from Telegraph) has become the latest victim of E.coli at a petting farm after being recetly hospitalised with swine flu.

He visited Godstone Farm with his mother Louise and friends on September 4, after the initial E. coli cases came to light.

Speaking from his bedside at Queen Mary's Hospital in Sidcup, Kent, Harry's father, Lee Dolby, said he was ''disgusted'' at the failure of the farm and the HPA to act promptly.

Mr Dolby spoke of his anger at the actions taken over Godstone Farm.

''As soon as the first case came to light, the place should've been closed until it had been given the all-clear. 'These are kids' lives being put at risk here. I'm just disgusted at both the farm and the HPA, which is meant to be protecting us. Both are in the wrong for keeping the farm open. They realised it would be one of the last times for the kids to be able to visit and have a treat before the school holidays finished and they returned to classes."

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With 13 kids in hospital and 37 sick after visiting a UK farm, Health Protection Agency chief executive Justin McCracken has phoned parents of the children most seriously affected to apologise to them.

"If this information had been taken into account on 27 August, then the advice given and the steps taken on 3 September would have been introduced earlier and the farm might have been closed earlier.

"I wanted to speak personally to the parents of those children who are most seriously ill in hospital to explain what has happened and, however inadequate under the circumstances, to apologise.

"The position they find themselves in is unbearable and it is of course worse that what has happened might have been avoidable."

The farm was closed on Saturday - although the first E.coli case was reported on 27 August.

A pair of two-year-old twins, from Paddock Wood in Kent, have suffered acute kidney failure.

Initially, the HPA said the first case came to light on 27 August.

It later emerged that the agency had received a report of two cases in the previous week.
 

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Two-year-old twins Aaron and Todd Furnell went to visit the farm and in this picture, from the Mirror, lie motionless on their stomachs in adjacent hospital cots.

Todd underwent a second blood transfusion yesterday - the day a 13th child was hospitalised - after the brothers had suffered acute kidney failure.

Ms Mock said: "They're much the same, but now they are eating a little bit, rather than having it done for them through a feeding tube. When Aaron isn't asleep, he seems a bit more alert, but Todd is struggling a little."

Tracy Mock is among a group of parents calling on health officials to explain why they were able to visit Godstone Farm, Godstone, near Redhill, Surrey, after the first case of E.coli was brought to manager's attention there on August 27.

Ms Mock, from Kent, and her sons visited the farm four days later.

Four young children remained seriously ill in hospital last night following the outbreak on the popular petting farm.

Twenty four adults fell ill after visiting. Yesterday the Health Protection Agency (HPA), which faced calls for a public inquiry into its handling of the outbreak, confirmed there were a total of 37 cases of E.coli infection linked to the farm, including another child who had been recently diagnosed.

Another toddler, Alfie Weaver, was being monitored by doctors at East Surrey Hospital in Redhill, where he also had blood transfusions.

The little boy was left screaming in agony when his kidneys shut down following the outbreak. He was cared for in an isolation ward but is now understood to have begun talking.

His grandfather, from Redhill, who did not want to be named, said the three-year-old has since shown signs of improvement.

"It was like a dream come true, he has been in agony for nine days," he said.

The child and his six-year-old sister were taken to Godstone Farm on the August bank holiday – several days after the first case of E.coli was reported.

His mother, Gemma Weaver, said: "We deserve answers from the farm and the Health Protection Agency about this horrific bug. This farm should have been shut down earlier in August if kids tested positive for the bug then."

In Vancouver, where another dozen kids got sick from the petting zoo, the local paper can’t decide whether it was the food or the petting zoo.

Mark Neale writes in the Belfast Telegraph this morning that those who have investigated E. coli O157  "know the risk it poses on open or petting farms. A quick scan of the literature suggests one outbreak a year can be associated with open or petting farms. E.coli, particularly the virulent 0157 variant, has always been associated with farms and farm animals. Hand-washing, alcohol gels and all manners of materials used to remove the bacteria ultimately will prove useless."
 

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Another child is being treated in hospital following an outbreak of E.coli at a farm in Surrey.

The Health Protection Agency (HPA) said there were now 13 youngsters being treated, of which four were seriously ill and six were in a stable condition.

Three are improving in hospital, with the total number of cases of E.coli 0157 linked to Godstone Farm now at 37.

The farm, near Redhill, was closed on Saturday - although the first E.coli case was reported on 27 August.
 

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It’s like people in the U.K. had never heard of E. coli O157. Despite outbreak after outbreak – often involving children at nurseries -- public inquiries and a single food safety agency, the Brits just seem oblivious when it comes to dangerous pathogens that send kids to the hospital.

This morning, the London Times reported that

“Thousands of children across the South of England may be at risk from the E. coli bug in what looks to be the largest UK outbreak linked to transmission from farm animals."

Godstone Farm in Surrey, a popular family attraction where children are encouraged to stroke and touch animals, is closed while the Health Protection Agency (HPA) conducts tests to find out the cause of the outbreak which has left 12 children in hospital, four of them in a serious condition.

About 1,000 children, mainly from South London, Surrey, Kent and Sussex, visit the farm every day during the school holidays and at weekends. It is feared that 30,000 children could be at risk of infection.

It has emerged health officials knew about the outbreak among people who visited the farm days before it was closed to the public.

The Health Protection Agency became aware of the outbreak in late August after cases were traced to the farm.

One parent has expressed her anger, saying the decision for the farm to remain open was an "absolute disgrace".

But farm manager Richard Oatway said the farm had acted responsibly and was co-operating with the investigation.

Richard, please share with us your knowledge of natural reservoirs of E. coli O157, and the steps you’ve taken to control such dangerous pathogens from infecting children who visit your farm. Handwashing isn’t enough.
 

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Best award for original song remake has to go to Cake’s 1996 version of the Gloria Gaynor disco classic, I Will Survive. Searing guitar solos, an infectious bass line, and the spoken word singing of John McCrea combine to make this an iPod workout favorite. And CAKE was the first concert Amy and I went to in Kansas City and was unexpectedly good.

Dr Karin Heurlier and colleagues at the Universities of Nottingham and Birmingham in conjunction with Biolog Inc of California told the Society for General Microbiology's meeting at Heriot-Watt University, Edinburgh, today that pathogenic strains of E. coli could survive in different conditions compared to the standard laboratory, non-pathogenic strain.

Contamination by foodborne E. coli occurs in processed foods such as ready prepared salads, fermented sausages (e.g. salami), dairy products and fruit juices as well as more usually in raw and partly cooked meat products, indicating that the bacteria are able to survive modern food processing techniques. The researchers found differences between strains in how they responded to antimicrobial compounds, and in their reactions to oxygen availability, acidity and chemical stresses. They could also use different constituents in foods for their nutrition compared to standard laboratory E. coli strains.

"The laboratory E. coli strain K-12 is one of the best understood organisms on Earth," said Dr Heurlier, "But because it has become so used to being grown in laboratory conditions, it may not react to stresses in the same way as pathogenic strains – such as E. coli O157:H7 can. Our research shows that there are definite growth and nutrition differences between E. coli strains and therefore results obtained with laboratory strains may not be typical of what happens in the 'real' world."
 

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This weekend during a mini-adventure an hour north I got to tick two things off my Things to do in New Zealand list: drive on the left side of the road and pet a lamb. While the former turned out to be easier than initially presumed (aside from roundabouts), it was the latter that had me giddy.

Hills covered in sheep were everywhere and I couldn’t resist the temptation to hop a fence (despite the electrical shock endured) and cartwheel the fields (right), scaring sheep and likely placing my hands in sheep poo. I didn’t wash them, though I really should have.

Sheep, like cows and goats, are ruminant mammals and therefore can carry E. coli O157:H7. If you cartwheel in [sheep] doo doo, wash your hands.

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That’s the title of a book chapter that’s just been published and attempts to answer the question: what does it take for farmers, processors and retailers to pay attention to food safety risks – in the absence of an outbreak?

Last week, trade magazine The Packer did a story about Earthbound Farms, the producer of E. coli O157:H7 tainted-spinach in 2006, which quoted president Charles Sweat as saying,

“Now that we are three years beyond that, it’s almost always hard to go back and put our mind where it was in 2005 and 2006 because we know so much more today than we knew then.”

What Ben Chapman, Casey Jacob and I asked in the book chapter is, why didn’t companies like EarthBound know a lot more about microbial food safety before over 200 became ill and four died in 2006?

In October, 1996, a 16-month-old Denver girl drank Smoothie juice manufactured by Odwalla Inc. of Half Moon Bay, California. She died several weeks later; 64 others became ill in several western U.S. states and British Columbia after drinking the same juices, which contained unpasteurized apple cider -- and E. coli O157:H7. Investigators believed that some of the apples used to make the cider might have been insufficiently washed after falling to the ground and coming into contact with deer feces (Powell and Leiss, 1997).

Almost 10 years later, on Sept. 14, 2006, the U.S. Food and Drug Administration announced that an outbreak of E. coli O157: H7 had killed a 77-year-old woman and sickened 49 others (United States Food and Drug Administration, 2006). The FDA learned from the Centers for Disease Control and Wisconsin health officials that the outbreak may have been linked to the consumption of produce and identified bagged fresh spinach as a possible cause (Bridges, 2006a).

In the decade between these two watershed outbreaks, almost 500 outbreaks of foodborne illness involving fresh produce were documented, publicized and led to some changes within the industry, yet what author Malcolm Gladwell would call a tipping point -- "a point at which a slow gradual change becomes irreversible and then proceeds with gathering pace" (http://en.wikipedia.org/wiki/Tipping_Point) -- in public awareness about produce-associated risks did not happen until the spinach E. coli O157:H7 outbreak in the fall of 2006. At what point did sufficient evidence exist to compel the fresh produce industry to embrace the kind of change the sector has heralded since 2007? And at what point will future evidence be deemed sufficient to initiate change within an industry?

We conclude:

Ultimately, investigators showed that the E. coli O157:H7 was found on a transitional organic spinach field and was the same serotype as that found in a neighboring grass-fed cow-calf operation. These findings, coupled with the public outcry linked to the outbreak and the media coverage, sparked a myriad of changes and initiatives by the industry, government and others. What may never be answered is, why this outbreak at this time? A decade of evidence existed highlighting problems with fresh produce, warning letters were written, yet little was seemingly accomplished. The real challenge for food safety professionals, is to garner support for safe food practices in the absence of an outbreak, to create a culture that values microbiologically safe food, from farm-to-fork, at all times, and not just in the glare of the media spotlight.

Powell, D.A., Jacob, C.J., and Chapman, B. 2009. Produce in public: Spinach, safety and public policy in Microbial Safety of Fresh Produce: Challenges, Perspectives, and Strategies ed. by X. Fan, B.A. Niemira, C.J. Doona, F.E. Feeherry and R.B. Gravani. Blackwell Publishing.

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The bites/barfblog French team of correspondent Albert Amgar and Manhattan (Kansas) translators Abby Herald and Amy Hubbell have provided news of the latest E. coli related recall from France, this time in Carrefour Discount Frozen Hamburger Patties (right).

Product recalled by: Carrefour

Department: Food and Drinks

Brand: Carrefour

Product: Lot Number/Serial Number: The aim of this recall is for lot number IE 565 EC with a “best by” date of August 5th, 2010.

Reason for recall: Discovery of contamination by the E.coli bacteria

Recommendation: Consumers having bought this product are asked not to consume it.

Place of recall: Consumers who have purchased the product are asked to bring it back to the store where they will be reimbursed.

Additional information: Carrefour states that they have received no consumer complaints. According to the distributer this bacteria is destroyed at a temperature of 65° C (149° F) and the hamburgers are of no risk if they have been thoroughly cooked. The products related to this recall have been removed from Carrefour, Carrefour Market and Champion stores.

Consumer Hotline: For more information, call the toll free hotline 0 805 90 80 70

Again, the recommended cooking temperature seems low, and it’s really risky to say there’s no-risk with any product. Cross-contamination in any food preparation area is a huge issue. That’s why everyone tries to get the pathogens out, rather than blaming the cook.
 

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The first thing I bought when we arrived in Florida a couple of weeks ago was a meat thermometer: groceries, wine, toilet paper – and a digital, tip-sensitive meat thermometer.

Can’t cook burgers without them.

Yesterday I ventured from our Venice Beach hideaway to the University of Florida in Gainesville to hang out with my friend Michael Batz and deliver a seminar at the Emerging Pathogens Institute about food safety culture stuf.

Michael and I went to lunch at some Spanish/Cuban place that seemed quite friendly, so, being the nerd I am, I ordered a hamburger.

The server asked me how I would like it, and I asked, what are my options?

She said however I wanted it (that’s really what she said).

I said, 160 F.

She said, we don’t do that.

I said, well-done.

Stick it in.
 

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In 2007 owners of a St. Catharines, Ontario restaurant made the poor decision to continue preparing and serving food after water to the establishment had been cut off. The result: at least six people became violently ill, of which three children were hospitalized.

The owners of Yamen restaurant are appealing the court’s verdict regarding two lawsuits totaling 4.3 million in damages, reports The Standard.

Senan Daoud and Mahmoud Asaad are being sued by two families who say they were “violently ill” and continue to suffer after being fed contaminated food.

The Yaman Restaurant co-owners were in court Monday to argue they should be allowed to appeal a March 27 ruling that found them guilty of five counts each of selling food unfit for human consumption.

The cases happened at the Merritt Street restaurant in May 2007, when Asaad and Daoud continued to run the business, despite the fact its water was cut off because of a water-main break. The restaurant was shut down by the Region after several people got sick in May 2007 and reopened in August 2007 with a clean bill of health.

Meanwhile, the families of three girls in St. Catharines and Niagara Falls who were hospitalized following the outbreak have launched lawsuits… Robert and Arlene Willis, with daughter Sara Willis, are suing after eating at the restaurant on May 25, 2007…Jennifer Boehm and 10- and six-year-old daughters Brooklyn and Kassidy Hamelin, ate at the restaurant the following day and are suing, along with the girls’ father, Robert Hamelin.

The court documents say the plaintiffs became “violently ill” within a week of eating at Yaman and were in need of “extensive” medical treatment for their injuries.
Some of those conditions included cramping, abdominal pain, bloody diarrhea, vomiting, fatigue, sleep disturbance, loss of appetite, nausea and headaches.

… [A]ll three children were admitted to local hospitals, while Kassidy was so ill, she was transferred to McMaster Children’s Hospital in Hamilton and was hospitalized for two weeks.
 

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A three-year-old girl who needed dialysis after being caught up in an E coli outbreak is beginning to recover in hospital, her parents said today.

Abigail Hussey suffered kidney failure after eating from a takeaway in Wrexham, north Wales, and is one of two people undergoing hospital treatment after the outbreak last month. Karen Morrisroe-Clutton, a new mother who also had kidney failure, remains in a medically induced coma at Wrexham Maelor hospital. The North East Wales NHS trust said she was in a serious but stable condtion.

She is in Alder Hey Children's hospital in Liverpool, which today released a statement from her mother, Sarah, who also fell ill, and her father, Jeff.

"Abigail's condition deteriorated and she was eventually referred to Wrexham hospital, who transferred her immediately to Alder Hey on Monday 27 July. She tested positive for E coli and was placed on dialysis. We are very relieved that Abigail is beginning to recover, is off dialysis and is eating and drinking quite well."

Sharon Mills, the mother of E. coli victim Mason Jones (left) said the latest Wales outbreak has brought horrific memories flooding back.

“It’s terrible that more people are having to go through this. Mason fought for two weeks until he couldn’t fight any more and ever since I have fought on for him as I don’t want his death to be in vain.”

While the cause of the North Wales outbreak remains under investigation, Mills said she believes both the authorities and the public still fail to fully appreciate the terrible consequences of E.coli infection.

The Llay Fish Bar was allowed to continue business even though environmental health inspectors found poor hygiene conditions and was awarded the lowest rating of no stars during the August 2008 inspection.

Mills said:

“The threat of E.coli is not being taken on board. People really need to start listening and they need to start listening now. The message needs to be drummed home that E.coli is serious and can affect anyone, not just those with underlying health problems. it’s such a powerful bacteria.”
 

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The BBC reports that Llay Fish Bar in Wrexham, suspected as the source of an E. coli O157 outbreak that has left a new mother on life-support and a 3-year-old with renal failure, received zero out of five in a 2008 hygiene inspection.

The Llay Fish Bar has been closed by local council -- but only since the severe illnesses emerged.

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The Mountain Mail reports that local and state medical officials Tuesday confirmed six children in Chaffee County have been infected with Escherichia coli in the incident that began earlier in July.

With the incubation period for the bacteria nearing its end, Chaffee County Public Health Nurse Susan Ellis said Tuesday no new cases have been reported since about July 14.

She said 30 people will have been tested by Friday as investigators continue to seek the source of contamination.

Ellis said DNA from stool samples is being examined at the state laboratory in Denver. DNA samples from two of the children, she said, were identified as matching.

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Eurosurveillance today reports an outbreak of Shigella dysenteriae type 2 infections during May-June 2009 in Sweden, involving 47 suspected cases of whom 35 were laboratory-confirmed.

The epidemiological investigation based on interviews with the patients pointed at sugar snaps from Kenya as the source. Shigella was not detected in samples of sugar snaps. However, Escherichia coli was confirmed in three of four samples indicating contamination by faecal material.

During April to May 2009 outbreaks with Shigella connected to sugar snaps from Kenya were reported from Norway and Denmark. In the three countries trace back of the indicated sugar snaps revealed a complex system with several involved import companies and distributers. In Sweden one wholesale company was identified and connections were seen to the Danish trace back. These three outbreaks question whether the existing international certification and quality standards that are in place to prevent products from contamination by faecal pathogens are strict enough.

No, they’re not.
 

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Bill Marler writes:

Lauren Beth Rudolph (below, right) died on December 28, 1992 in her mother’s arms due to complications of an E. coli O157:H7 infection - Hemolytic Uremic Syndrome. She was only 6 years, 10 months, and 10 days old when she died. Her death, the deaths of three other children, and the sicknesses of 600 others, were eventually linked to E. coli O157:H7 tainted hamburger produced by Von’s and served at Jack in the Box restaurants on the West Coast during late 1992 and January 1993. Roni Rudolph, Lauren’s mom, I have known for 16 years.

Dave Theno became head of Jack in the Box’s food safety shortly after the outbreak. I too have known Dave for 16 years. However, I only learned recently a significant fact about Dave – one that made me admire him even more – one that I think, not only that all leaders in corporate food safety should emulate, but one that both Secretaries Vilsack and Sebelius should pay attention too.

Dave and I shared the stage at the Nation Meat Association annual convention a few months ago. The NMA is an association representing meat processors, suppliers, and exporters. Dave, spoke just before I did and was rightly lauded as someone who takes food safety to heart. However, it was his story about Lauren Rudolph and his relationship with Roni that struck me. Dave told the quiet audience about Lauren’s death. Dave also told us that the death of Lauren and his friendship with Roni had changed him. He told us all that he had carried a picture of Lauren in his brief case everyday since he had taken the job at Jack in the Box. He told us that every time he needed to make a food safety decision – who to pick as a supplier, what certain specifications should be – he took out Lauren’s picture and asked, “What would Lauren want me to do?”

I thought how powerful that image was. The thought of a senior executive holding the picture of a dead child seeking guidance to avoid the next possible illness or death is stunning, but completely appropriate. I wonder if Secretaries Vilsack and Sebelius do anything similar when they do their work on President Obama’s Food Safety Working Group? If they do not, perhaps they should?

Secretaries Vilsack and Sebelius right now there are hundreds of families struggling right now due to illnesses and death related to food that you oversee that has been tainted with E. coli O157:H7.
Yesterday, I spent time with a family in South Carolina whose 4 year old ate cookie dough and suffered months of hospitalizations, weeks of dialysis and seizures. She faces a lifetime of complications. And, there is a woman in Nevada who is still hospitalized, who has lost a portion of her large intestine, was on dialysis until a few days ago. She faces months if not years of rehabilitation.

Both ate cookie dough that was watch over by Secretary Sebelius’s FDA.

Today I sat across the kitchen table with a family who lost their only daughter because she died from an E. coli O157:H7 infection from meat inspected by Secretary Vilsack’s USDA/FSIS. I then visited families in a Cleveland hospital whose children are struggling in their battle against Hemolytic Uremic Syndrome – again E. coli O157:H7 tainted hamburger is to blame.

Secretaries Vilsack and Sebelius you should be like Dave Theno. Run your departments like Dave ran food safety at Jack in the Box. Go meet these families. Sit across their kitchen tables. Go to their child’s hospital room and see more tubes and wires than you can count. Understand what these people have lived though. Take their stories into your heart. It is hard, very hard, but it will give you a real reason to do your jobs.

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“If only” is often how statements begin by food safety wannabes who are sure they have stumbled upon a vast conspiracy meant to subjugate society.

If only Monsanto didn’t genetically-engineer seeds …

If only products like milk were served raw and natural …

If only cattle were fed grass, there would be no E. coli O157:H7.

When someone makes such proclamations, or says they speak fact, usually with an air of authority, I immediately think that person is full of it. People who say “trust me” are immediately untrustworthy.

Megan Jacob, Todd Callaway, and T.G. Nagaraja of Kansas State University write about the dietary interactions and interventions affecting Escherichia coli O157 colonization and shedding in cattle in an upcoming issue of Foodborne Pathogens and Disease. It’s not a movie, not a blog, not a pulp fiction, so they sorta have to get it right. And they do, when they write:

“The specific mechanisms responsible for increased or decreased E. coli O157 shedding or survival are not known … results of studies are conflicting or not repeatable, which speaks to the complexity of the hindgut ecosystem, variation in animal feed utilization, and variation within feed products.”

The complete abstract is below.

Escherichia coli O157 is an important foodborne pathogen affecting human health and the beef cattle industry. Contamination of carcasses at slaughter is correlated to the prevalence of E. coli O157 in cattle feces. Many associations have been made between dietary factors and E. coli O157 prevalence in cattle feces. Preharvest interventions, such as diet management, could reduce the fecal prevalence and diminish the impact of this adulterant. Dietary influences, including grain type and processing method, forage quality, and distillers grains have all been associated with E. coli O157 prevalence. In addition, several plant compounds, including phenolic acids and essential oils, have been proposed as in-feed intervention strategies. The specific mechanisms responsible for increased or decreased E. coli O157 shedding or survival are not known but are often attributed to changes in hindgut ecology induced by diet types. Some interventions may have a direct bacterial effect. Frequently, results of studies are conflicting or not repeatable, which speaks to the complexity of the hindgut ecosystem, variation in animal feed utilization, and variation within feed products. Still, understanding specific mechanisms, driven by diet influences, responsible for E. coli O157 shedding will aid in the development and implementation of better and practical preharvest intervention strategies.

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Brian Hartman of ABC News is reporting that investigators have linked at least three different kinds of E. coli to Nestle’s cookie dough but they remain stumped as to just how the bacteria got in the product.

DNA testing of E. coli found in an unopened package of cookie dough at Nestle’s plant in Danville, Va., determined the genetic fingerprint of the E. coli found at the plant is different than E. coli that has been linked to a 30-state outbreak that has sickened at least six dozen people, and that an altogether different strain of E. coli was found in dough recovered from the home of a victim.

Dr. David Acheson, the Food and Drug Administration’s assistant commissioner for food safety said,

“The investigation is winding up. It is not exactly over yet. But we have not figured out the likely ingredient. … It is unlikely that we will ever make a final determination of how this contamination occurred. … Theres no indication that this was deliberate.”
 

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KSFY is reporting that a one-year-old boy from Sioux Center, Iowa is in a Sioux Falls hospital tonight, fighting hemolytic uremic syndrome or HUS.

His dad told Action News today that Isaiah is normally an active kid, but this has slown him down and their time in the hospital has been heart-wrenching saying "you never think you're going to see your child in the hospital and the reality of it is, is that it can happen to anyone. … It's hard on us, but with God's help we're doing OK."
 

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The Cuyahoga County Board of Health confirms that three children have been exposed to the E. coli bacteria. Two more cases are under investigation.

"Five cases is very unusual for us to have," says Terry Allan, the health commissioner in Cuyahoga County.

The three children with confirmed cases also have what's known as Hemolytic Uremic Syndrome (HUS).

Allan says the children must have contracted E. coli in one of two ways: either from a batch of meat that is contaminated or from just undercooked beef. Testing will be conducted on meat in the area, but so far, there is no indication that any particular batch of beef in Ohio is contaminated.

Or from thousands of other ways that E. coli O157:H7 can get into food or water or petting zoos.

Allan also says,

"If you don't have a thermometer, it's important that you cook that hamburger until it's no longer pink in the middle."

This is wrong. Color is a lousy indicator. Use a meat thermometer, be careful about cross-contamination, and have more microbial awareness than the health commissioner in Cuyahoga County.
 

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Anyone can bitch. My colleagues and I try to provide solutions.

So Ben, Casey and I jumped at the chance to write the concluding chapter  for a new book, "The Produce Contamination Problem: Causes and Solutions," slated for release July 15 from Academic Press.

"We should eat fresh produce because it's good for us, but it's also a significant cause of foodborne illness," said Doug Powell, an associate professor of food safety at Kansas State University.

The Centers for Disease Control and Prevention recently reported that when leafy vegetables are counted with fruits and nuts, they account for the majority of foodborne disease outbreaks in 2006. Together, these types of produce are blamed for 33 percent of outbreaks. In comparison, poultry was the culprit of 21 percent of outbreaks that year.

One of the main things the authors convey is that the tomato grown in your home garden is as likely to make you sick as is the tomato purchased at a big-box grocery store or discount chain.

"Everyone is big on their local garden, but it's no different whether I have a thousand acres or a little plot in my backyard," Powell said. "You have to keep dog, cat and bird poop out of the product you eat."

Although factory farms often take the blame for outbreaks, Powell points out that the contaminated spinach circulating in 2006 came from a farm with a 70-head cattle operation.

"It was nothing near to being a factory farm, but cattle were kept next to the spinach," he said.

"With produce, anything that comes in contact with it has the potential to contaminate, whether it's people's hands, irrigation water or manure.”

The authors suggest that changes in food safety practices have to begin with producers.

"Other than asking questions about food safety practices, there isn't much consumers can do," Powell said. "Contamination has to be prevented on the farm."

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Brian Hartman of ABC News appears to be first off the block reporting that U.S. Food and Drug Administration investigators today found E. coli in an unopened package of raw chocolate chip cookie dough at the plant in Danville, VA where Nestle makes Toll House cookie dough.

A FDA type said the dough had been manufactured on February 10, 2009 but had not yet been shipped.

Investigators still do not know how the E. coli got into the dough. But finding this “smoking gun” package confirms they pushed for a recall of the correct product.

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Sigh. Another E. coli O157:H7 outbreak, with at least 18 suspected cases in the U.S. linked to beef produced by JBS Swift Beef Company, a Greeley, Colo., establishment that is voluntarily expanding its June 24 recall to include approximately 380,000 pounds of assorted beef primal products.

The beef products were produced on April 21, 2009 and were distributed both nationally and internationally.

Each box bears the establishment number "EST. 969" inside the USDA mark of inspection as well as the identifying package date of "042109" and a time stamp ranging from "0618" to "1130." However, these products were sent to establishments and retail stores nationwide for further processing and will likely not bear the establishment number "EST. 969" on products available for direct consumer purchase. Customers with concerns should contact their point of purchase.

The recalled products include intact cuts of beef, such as primals, sub-primals, or boxed beef typically used for steaks and roasts rather than ground beef. FSIS is aware that some of these products may have been further processed into ground products by other companies. The highest risk products for consumers are raw ground product, trim or other non-intact product made from the products subject to the recall.

 

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A relative of a north-east Fife toddler who contracted E. coli O157 has died of the infection.

The Courier reports that the child, who became ill around a month ago, was treated at home.

NHS Fife, whose public health department was investigating the case, confirmed that no one outside the family had contracted the illness and that a woman—an older relative of the child—had died in Ninewells.
 

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Is E. coli O157:H7 associated with things other than feedlot cattle?

I had a few people call me recently, saying, I saw that movie, Food, Inc., which says that E. coli O157:H7 is predominately in feedlot cattle because of the grain they are fed, and that’s how the bug came to exist. So how did it get into Nestle cookie dough?

It’s sort of a mantra of raw milk enthusiasts and wannabe food safety types that E. coli O157:H7 is a product of feedlot cattle, and that grass-fed creatures are benign entities for the dinner plate.

A blogger yesterday wrote, “… hamburger tainted by e-coli, a virus that breeds in a cow’s stomach when it is feed grain instead of grass (which, of course, most cows are nowadays in order to fatten them quickly and cheaply).”

It’s a bacterium, not a virus.

Nicholas Kristof, a columnist for the N.Y. Times, wrote yesterday, on Sunday, June 21/09, that, “There is some evidence that pathogens, including E. coli, become much more common in factory farming operations. Move feedlot cattle out to a pasture for five days, and they will lose 80 percent of the E. coli in their gut, the film says.”

That evidence is about as strong as the whisps of evidence compiled by Danny Sugarman that The Doors’ frontman Jim Morrisson is still alive and didn’t die from excess in a Paris bathtub in 1971. But, every teenager goes through their Doors phase (I can only find the clip below in Spanish, but Canada’s The Guess Who stands up much better with the hindsight of time; they know they are drunken buffoons, and not a drunken buffoon trying to be a poet).

Scientific uncertainty can easily be exploited by the certainty of filmmakers, who cherry pick facts and flourish on rhetoric. And I guess if it’s repeated ad nauseum for 11 years by writers from the N.Y. Times to your-favorite-bullshit blogger it becomes fact.

That line, “Move feedlot cattle out to a pasture for five days, and they will lose 80 percent of the E. coli in their gut,” comes from a 1998 paper published in the journal Science by Diez-Gonzalez of Cornell University, and colleagues.

I had one of my colleagues, Rena Orr, write a review of the controversy back in Nov. 2000.

Since September 1998, there has been conflicting information on the effect of diet on E. coli shedding from cattle. The conflict arises in part from the effect of diet on the ability of E. coli to develop acid resistance. … Diez-Gonzalez et. al demonstrated that feeding a high-grain diet to cattle results in an acidic environment in the colon. Because the animals incompletely digested the starch in grains, some starch was able to reach the colon where it fermented, producing fermentation acids. The researchers believe an acidic environment selects for or induces acid resistance among the Escherichia coli population. … Diez-Gonzalez et al. concluded that if cattle were given hay for a brief period (five days) immediately before slaughter, the risk of foodborne E. coli infection would be significantly reduced because the acidity in the colon is greatly reduced. "Our studies indicate that cattle could be given hay for a brief period immediately before slaughter to significantly reduce the risk of food-borne E. coli infection."

The Science article received mainstream media attention, and was covered by the Associated Press and The New York Times, as well as scientific releases and reports. In the Irish Times, it was cited as the basis for concluding that because Irish cattle are fed a grass-based diet rather than grain, Ireland has a low incidence of E. coli O157:H7. Hancock et al. contend that this conclusion is unsupported or contradicted by several lines of evidence. The E. coli that contaminate beef typically originate from the hide, the hooves, or the equipment used in slaughter and processing rather than directly from the colon, and likely replicate in environments unlike the colon. Therefore, the induced acid resistance of E. coli contaminating beef is likely to be unrelated to the pH of its ancestral colonic environment. The E. coli O157:H7 bacterium uses several mechanisms to survive acid environments, some of which are innate and are not influenced by environment . Although acid resistance is likely a factor in an infective dose, induced acid resistance has not been shown to be a factor in E. coli O157:H7 infectivity by experimental (dose-inoculation) or observational (epidemiological) data . Therefore, acid resistance induced by exposure to weak acid may not influence the virulence of this pathogen.

Published data on E. coli O157:H7 tends to contradict or does not support the effects of the dietary change proposed by Diez-Gonzalez et al. In a recent study on three different grain diets (85% cracked corn, 15% whole cottonseed and 70% barley, or 85% barley), the fecal pH of the animals fed the corn diet was significantly lower (P < 0.05) than the fecal pH of the animals fed the cottonseed and barley and barley diets, likely resulting in a less suitable environment for E. coli O157:H7 in the hindgut of the corn fed animals (2000, Buchko et al). In the Journal of Food Protection, researchers concluded that changing from grain to a high roughage diet did not produce a change in the E. coli concentration that was large enough to deliver a drastic improvement in beef carcass hygiene. Sheep experiencing an abrupt diet change have higher concentrations and increased shedding of fecal E. coli O157:H7 for longer periods than sheep fed a consistent high-grain diet. Another study compared the duration of shedding E. coli O157:H7 isolates by hay-fed and grain-fed steers experimentally inoculated with E. coli O157:H7 as well as the acid resistance of the bacteria. The hay-fed animals shed E. coli O157:H7 longer than the grain-fed animals, and irrespective of diet, these bacteria were equally acid resistant.

These results suggest that the proposed dietary change would actually increase contamination with E. coli O157:H7. Also, the 1,000-fold reductions in total fecal E. coli demonstrated by Diez-Gonzales et al. are far greater than those recorded in cattle experiencing similar ration changes . Finally, extensive surveys show that grain-fed feedlot cattle have no higher E. coli O157:H7 infection prevalence than similarly aged dairy cattle fed forage (hay) diets. Abrupt feed change immediately before slaughter could have unexpected deleterious effects. The proposed diet change has the potential to increase the risk of bovine salmonella infections, a potential source of food poisoning. The dietary change results in sharply reduced volatile fatty acid concentrations in the large intestine as well as changes in the bacteria, allowing for colonization of Salmonella.

See, that’s a really long explanation. It’s not as soothing as, change cattle diet, disease prevented. And that was written nine years ago.

Mike Osterholm, director of the Center for Infectious Disease Research and Policy and professor in the School of Public Health at the University of Minnesota wrote a cleaner critique in 2007 in the Minneapolis-St. Paul Star Tribune:

"Russo cited conclusions from a 1998 study from Cornell University that cattle fed a diet of grass, not grain, had very few E. coli, and that those bacteria that survived in the cattle feces would not survive in the human when eaten in undercooked meat, particularly hamburger. This statement is based on a study of only three cows rotated on different diets and for which the researchers did not even test for E. coli O157:H7. Unfortunately, the authors extrapolated these incredibly sparse results to the entire cattle industry. The Cornell study is uncorroborated in numerous published scientific papers from renowned research groups around the world. Finally, work conducted by the Minnesota Department of Health as part of a national study on foodborne disease recently showed that eating red meat from local farms was a significant risk factor for E. coli infection. ...

And as my colleague David Renter wrote in Sept. 2006,

"Cattle raised on diets of 'grass, hay and other fibrous forage' do contain E. coli O157:H7 bacteria in their feces as do other animals including deer, sheep, goats, bison, opossum, raccoons, birds, and many others.

"Cattle diet can affect levels of  E. coli O157:H7, but this is a complex issue that has been and continues to be studied by many scientists.  To suggest switching cattle from grain to forage based on a small piece of the scientific evidence is inappropriate and irresponsible.  Several pieces of evidence suggest that such a change would not eliminate and may even increase E. coli O157:H7 in cattle.

"The current spinach outbreak may be traced back to cattle manure, but there are many other potential sources.  Simplistically attacking one facet of livestock production may be politically expedient, but instead provides a false sense of security and ignores the biological realities of E. coli O157:H7. In 1999, for example, 90 children were felled by E. coli O157:H7 at a fair in London, Ont. The source? A goat at a petting zoo, hardly an intensively farmed animal."

Last time I looked, E. coli O157:H7 and about 60 other shiga-producing E. coli that are known to cause illness in humans are present in about 10 per cent of all ruminants – cattle, sheep, goats, deer, elk -– and I can point to outbreaks associated with all of those species. Pigs, chickens, humans, birds and rodents have all been shown to be carriers of shiga-producing E. coli but the resevoir appears to be ruminants. The final report of the fall 2006 spinach outbreak identifies nearby grass-fed beef cattle as the likely source of the E. coli O157:H7 that sickened 200 and killed 4.

How the E. coli O157:H7 got into the cookie dough remains to be seen. Biology is complex and constantly changing – even at farmer’s markets, which was the big solution of Food, Inc. But it’s only a movie.

That Cornell paper can be found here:

Diez-Gonzalez, Francisco, Todd R. Callaway, Menas G. Kizoulis, James B. Russell. Grain Feeding and the Dissemination of Acid-Resistance Escherichia coli from Cattle. Science: Sept 11, 1998. Volume 281, Number 5383, pages 1666-1668.

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During the evening of Thursday, June 18, the Colorado Department of Public Health and Environment urged Coloradans not to eat raw Nestle Toll House cookie dough because of possible contamination with E. coli O157:H7.

The next morning, the U.S. Food and Drug Administration warned consumers not to eat any varieties of prepackaged Nestle Toll House refrigerated cookie dough due to the risk of contamination with E. coli O157:H7. At the same time, Nestlé announced a voluntary recall of all Toll House refrigerated cookie dough products, “out of an abundance of caution.”

About 4:30 p.m. central time on Friday, June 19, 2009 (happy birthday, daughter Jaucelynn, avoid the raw cookie dough) colleague Evan reported that he had successfully obtained a package of Nestle Toll House refrigerated cookie dough (above, right, exactly as shown). I say obtained because he didn’t have to pay for it. Evan went to a local supermarket, and saw, “a young kid, armed with a box cutter, standing beside a cart full of Nestle Toll House products.

“I asked if I could have one of them, to which he replied, 'you're not going to get a refund for it are you?' I told him no, but he said he had to cut open the package so I couldn't return it. The kid wasn't wearing any gloves and was sweating, so I'm guessing he was out there for a while handling a potentially contaminated product.”

And he gave Evan the raw cookie dough, which Evan triple-bagged and refrigerated until Saturday.

Amy and Sorenne and I went grocery shopping this morning, and observed that the Nestle refrigerated products had been dutifully cleared out (left, exactly as shown). We did, however, buy a couple of other raw cookie dough products. I never eat the stuff, but understand that many are quite passionate about their raw cookie dough.

There are at least two potential problems with raw cookie dough: eating it, and cross-contamination. Evan and I videotaped a cooking experiment and the cookies get plenty hot to kill off potential pathogens (we’ll post that later).

Bill Marler has written about the uh, inadequacies of the labels on Nestle raw cookie dough. Not that anyone reads labels, or that everyone speaks English, but maybe there shoud be more of a declaration of potential risk.

And bigger type: not to sound like ole-man-grouchy-Powell, but even with my reading glasses I could barely read a damn thing on the label. The Kroger private selection brand says,

Keep refrigerated
Use before date on package
Do not eat unbaked cookie dough.

The Pillsbury refrigerated cookie dough says,

Do not microwave unbaked Poppin Fresh dough
Bake before enjoying
Do not use if unsealed.

It would seems with at least 66 people sick with a serious illness – E. coli O157:H7 – of which 25 had to be hospitalized and seven will suffer long-term kidney damage, these labels sorta suck.

Oh, and according to a story carried by Bloomberg,

“The Toll House cookie brand is named for the Toll House Inn in Whitman, Massachusetts, whose owner, Ruth Wakefield, is credited with inventing the chocolate chip cookie in the 1930s."
 

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Another reminder to play safe on the farm.

An open farm in West Lancashire has been temporarily closed after eight people, including three children, were struck down with E.coli O157.

One of the children affected is currently in hospital and is described as ‘poorly but stable’.

The eight people are from two families that both recently visited Windmill Animal Farm, on Red Cat Lane, in Burscough.

The farm is being considered as one possible source of the infection and the farmer is co-operating fully with the investigations.
 

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The Daily Times reports that an eight-year-old Blount County, Tennessee boy, who loved more than anything spending time with his identical twin, lost his fight for life at 6:31 a.m. Monday after contracting E. coli and suffering the after-effects of the disease.
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Joseph Coning, 8 (right), and his twin, Jesse, were looking forward to a family vacation on the Outer Banks of North Carolina. …

The family does not know where Joseph contracted E. coli and an autopsy will be done to try and find answers.
 

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Almost 100,000 pounds of ground beef are being recalled today after an epidemiological investigation linked E. coli O157:H7 infections in three states to the products.

The meat—sold frozen as ground beef, chopped steak, and pre-formed patties—was produced by Valley Meats LLC of Coal Valley, Illinois, on March 10, 2009 and distributed to various consignees nationwide.

A USDA FSIS press release states,

“The problem was discovered through an epidemiological investigation of illnesses. On May 13, 2009, FSIS was informed by the Ohio Department of Health of a cluster of E. coli O157:H7 infections. Illnesses have been reported in Ohio, Pennsylvania, and Illinois.”

The pathogen, found in the poop of warm-blooded animals, can be killed with sufficient heat. 

However, as the president and chief executive of the American Frozen Food Institute, Kraig R. Naasz, stated today in a letter to the editor of the New York Times,

“While food safety is a shared responsibility among food producers, government agencies and consumers, we recognize that the primary responsibility rests with food producers. Providing consumers with safe and nutritious products is a responsibility frozen food producers stake their names and reputations on.”

The letter was written in response to the Times’ May 15 article on frozen entrees, which Naasz felt did not “fully depict the frozen food industry’s commitment to product safety.”

With the name and reputation of Valley Meats on the line, will they be able to demonstrate a similar commitment to the safety of food? As the data on those sickened by Valley Meats' products are released, it's likely we'll find out.
 

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In his report into the 2005 epidemic that struck down more than 150 people, most of them children, across the South Wales Valleys and claimed the life of Mason Jones, aged five (right), Professor Hugh Pennington found that all of the inspections made at the premises of the butcher responsible in the months before people became ill had been pre-arranged.

This allowed Bridgend-based William Tudor time to clean up and to doctor cleaning records to mislead Bridgend Council’s inspectors.

Prof Pennington has now recommended all inspections, primary and secondary, must be unannounced unless “there are specific and justifiable circumstances or reasons why a pre-arranged visit is necessary”.

The parents of four of the victims want to go further and Julie Price, Jeanette Thomas and Mason’s mother Sharon Mills, are re-forming an action group in a bid to achieve their aim.

“We want to make it illegal for hygiene inspectors to carry out announced visits of butchers and other places where food is prepared,” said Mrs Price, mother of 13-year-old Garyn, who was left fighting for his life after contracting the food poisoning bug which spread through school dinners.

“We want that set in stone.”

Unannounced inspections are recommended in The Food Law Practice Guidance (Wales). But announced inspections remain lawful and continue to happen.

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The New York Times picked up on the burgeoning food safety conspiracy theory business that’s been flooding the Intertubes.

There’s been a lot of outbreaks of foodborne illness and a lot of people barfing. So politicians have been busy bill-making bees, with numerous proposals before the U.S. House and Senate.

As the Times story put it,

“… small farmers, who are most accountable for their food's freshness and health, may suffer the heaviest burden under proposed new food rules. … Small farmers argue that they are already much more accountable to their customers for the quality of their product than are mass-production facilities, and that they will be crushed under the weight of well-meaning laws aimed at large industrial offenders.”

Farmers, regardless of size, are accountable for food’s freshness and health, and more importantly, the microbial food safety of that food. Farmers, big and small, are accountable to their customers. Small is not better, and there is no evidence that smaller is safer. Small, local, organic, whatever, can be microbiologically safe, but that requires attention to sources of dangerous microorganisms and effective measures to reduce levels of risk – regardless of farm size.

And before someone chimes in with the smaller-is-easier-to-trace-and-contain line, there is no evidence to support that argument other than wishful thinking. To make an effective comparison, the number of illnesses per conventional or local/small/organic meal consumed would have to be calculated. And because a lot more people eat, say, conventional tomatoes compared to local/small/organic tomatoes, illnesses with conventional product are more likely to be detected. The data simply is not available to make any meaningful comparison.

What can be said is that local/small/organic is a lifestyle choice. And like any lifestyle choice, go for it but play safe. Try not to make people barf  and even embrace evidence-based microbiologically safe food. Sales will probably increase.

Back to the story. Alexis Baden-Mayer, political director of the Organic Consumers Association, said,

"Organic standards specifically say you are supposed to cultivate the wild land on your farm, and having the area filter water has a lot of benefits. One of the principles is just that -- we're going to farm in a way that's not disruptive to nature."

Farming is not natural; any type of farming is disruptive to nature. So produce food in a way that minimizes the impact on the natural environment, and doesn’t make people barf. But that isn’t what organic is about. As Katija and I showed in our 2004 paper, organic guidelines could be adjusted to incorporate microbial food safety standards, but as they stand, organic standards are a specification for growing organic -- not microbiologically safe -- food.

The best and most dangerous mythology in the story is this:

Critics say the rules unfairly penalize small farmers who grow crops and raise cattle on the same farm, while failing to address what they believe is the root of the E. coli problem -- large, mismanaged feedlots that cram cattle together and spew waste runoff.

A percentage of all ruminants carry E. coli O157:H7. Feedlots are an easy target. But there are lots of outbreaks. Like E. coli O157:H7 in spinach in 2006 that sickened 200 and killed at least three. The source of the E. coli O157:H7 in the transitional organic spinach was a neighboring cow-calf operation – not a feedlot.

Any bill that gets past the discussion stage will be considerably modified and even if passed into law will accomplish … nothing. Conspiracy theories are fun, as is busy bee bill making, but will either result in fewer sick people? Growers, processors, retailers, restaurants and consumers should do what they can today to produce microbiologically safe food.

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Do more inspectors make food safer?

No.

The latest evidence is from Professor Hugh Pennington, who concluded in a report last week that serious failings at every step in the food chain allowed butcher William Tudor to start the 2005 E. coli O157 outbreak, and that while the responsibility for the outbreak, “falls squarely on the shoulders of Tudor,” there was no shortage of errors.

Welsh First Minister Rhodri Morgan picked up on that theme yesterday and pledged to do everything possible to prevent a repeat of the E.coli outbreak of 2005 – for the sake of the families affected.

“Poor hygiene practices at the abattoir and the butcher’s premises” caused the outbreak, but he added,

“These failings were not dealt with effectively by the Meat Hygiene Service or local authority environmental health officers. …” Environmental health inspectors need to “sharpen up” and “drill down beyond the box-ticking part of the inspection process to the potential danger of the reality beyond.”

In his report Pennington said an inspector who made four pre-arranged visits to Tudor’s in the run-up to the outbreak, should not have allowed him to continue using one vacuum-packing machine for both raw and cooked meat because of the risk of cross contamination.

Among his 24 recommendations, Pennington said all checks should be unannounced, unless there were exceptional circumstances.

Don’t tell mom the babysitter’s dead.
 

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Epidemiological studies conducted in France show that beef burger consumption is the main risk factor of a serious disease caused by Shiga toxin-producing Escherichia coli bacteria or STEC.

A quantitative risk assessment for the consumption of beef burgers containing STEC by the Agence Francaise De Securite Sanitaire Des Aliments concluded that almost 50% of children under the age of 5 eat well-done beef burgers (as well as 29% and 24% of 5-10 year olds and 10-15 year olds respectively). The proportion of beef burgers consumed rare increases with the children’s age: 10%, 17% then 20% for each of the age groups defined (under 5, 5-10 year olds and 10-15 year olds). Regarding the effectiveness of cooking (a frozen beef burger being pan-fried and turned over once), it should be noted that cooking “rare” is associated with a percentage of STEC destruction of 0% to 87% ; “medium” 37% to 96% and “well done” 94% to 99.8%. Concerning the consumption habits that prevail in French households today, these results highlight the importance of the length of cooking on STEC destruction (currently not enough), and the hygiene of beef burger production.

A place to start might be to accurately define what rare, medium and well-done actually mean, as quantified by time and temperature

Eurosurveillance reports that the Netherlands experienced a nationwide outbreak of Shiga toxin-producing Escherichia coli (STEC) O157 with onset of symptoms from the end of December 2008 until the end of January 2009. A total of 20 laboratory-confirmed cases were linked to the outbreak strain, serotype O157: H-, stx1, stx2, eae and e-hly positive.  The investigation into the source of this outbreak is still ongoing, but evidence so far suggests that infection occurred as a result of consuming contaminated raw meat (steak tartare). 

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Last week I dusted off some old slides to talk with an industry group about best practices in food safety. I got bored of hearing myself say the same thing about 10 years ago, but sometimes, it’s best to stick to basics.

Risk analysis is composed of risk assessment, management and communication. Over the years I’ve studied dozens of outbreaks of foodborne illness and concluded that a producer, or processor, or retailer needs to be excellent at all three—assessment, management and communication – and if they fail at just one, they will suffer the economic and associated hardships.

There is no doubt that Michael McCain and Maple Leaf Foods has practiced excellent risk communication since being fingered as the source of a listeria outbreak in Canada that killed at least 20 and sickened 60. I’ve said so from the beginning. I’ve also said that

it is impossible to judge whether Maple Leaf was practicing good risk management and assessment because no one will come clean on who knew what when as the outbreak was developing.

But that hasn’t stopped Canadians from gushing in a blindly patriotic way about how McCain set the ‘gold standard’ for reputational and financial management.

Maybe, but communications alone is never enough, just like science alone is never enough. And precisely because no one – government or industry – has come clean on who knew what when, it’s not surprising to hear

the Canadian federal government has delayed for months the release of notes on conference calls

held at the height of last summer's deadly listeriosis outbreak — a lag some experts say breaks Ottawa's own information laws.

At issue is an Access to Information request by The Canadian Press to the Privy Council Office for “all transcripts and minutes” of the crucial exchanges last August and September.

The Odwalla 1996 outbreak of E. coli O157:H7 in unpasteurized juice was also textbook risk communication, but the company was eventually revealed to have cut corners and ignored warning signs. Will Maple Leaf undergo similar scrutiny?

Below is an except from my 1997 book, Mad Cows and Mother’s Milk, about the Odwalla outbreak.

Sometime in late September 1996, 16-month-old Anna Gimmestad of Denver has a glass of Smoothie juice manufactured by  Odwalla Inc. After her parents noticed bloody diarrhea, Anna was admitted to Children’s Hospital on Oct. 16.  On 8 November 1996 she died after going into cardiac and respiratory arrest.  Anna had severe kidney problems, related to hemolytic uremic syndrome and her heart had stopped several times in previous days.

The juice Anna — and 65 others who got sick — drank was contaminated with E. coli O157:H7, linked to fresh, unpasteurized apple cider used as a base in the juices manufactured by Odwalla.  Because they are unpasteurized, Odwalla’s drinks are shipped in cold storage and have only a two-week shelf life.  Odwalla was founded 16 years ago on the premise that fresh, natural fruit juices nourish the spirit.  And the bank balance: in fiscal 1996, Odwalla sales jumped 65 per cent to $60 million (U.S.).  Company chairman Greg Steltenpohl has told reporters that the company did not routinely test for E. coli because it was advised by industry experts that the acid level in the apple juice was sufficient to kill the bug.

Who these industry experts are remains a mystery.  Odwalla insists the experts were the U.S. Food and Drug Administration.  The FDA isn’t sure who was warned and when.   In addition to all the academic research and media coverage concerning VTEC cited above — even all of the stories involving VTEC surviving in acidic environments — Odwalla claims ignorance.

In terms of crisis management — and outbreaks of foodborne illness are increasingly contributing to the case study literature on crisis management — Odwalla responded appropriately.  Company officials responded in a timely and compassionate fashion, initiating a complete recall and co-operating with authorities after a link was first made on Oct. 30 between their juice and illness.  They issued timely and comprehensive press statements, and even opened a web site containing background information on both the company and E. coli O157:H7.  Upon learning of Anna’s death, Steltenpohl issued a statement which said, “On behalf of myself and the people at Odwalla, I want to say how deeply saddened and sorry we are to learn of the loss of this child.  Our hearts go out to the family and our primary concern at this moment is to see that we are doing everything we can to help them.”

For Odwalla, or any food firm to say it had no knowledge that E. coli O157 could survive in an acid environment is unacceptable.  When one of us called this $60-million-a-year-company with the great public relations, to ask why they didn’t know that E. coli O157 was a risk in cider, it took over a day to return the call.   That’s a long time in crisis-management time.  More galling was that the company spokeswoman said she had received my message, but that her phone mysteriously couldn’t call Canada that day.

Great public relations; lousy management.  What this outbreak, along with cyclospora in fresh fruit in the spring of 1996 and dozens of others, demonstrates is that, vigilance, from farm to fork, is a mandatory requirement in a global food system.  Risk assessment, management and communication must be interlinked to accommodate new scientific and public information.  And that includes those funky and natural fruit juices.

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Our French correspondent Albert forwarded a press release issued yesterday by the French Ministry of Health and Sports; Amy translated.

Following notification on February 11, 2009 to InVS (The French Institute for Public Health Surveillance) of a case of hemolytic uremic syndrome in a child who is hospitalized in the Parisian region, health authorities have begun an investigation to identify the source of contamination.

The tests done on the child indicated he or she was infected with E. coli.

Among the foods consumed was frozen ground beef patties on which tests were conducted. The results of these tests were relayed today to health authorities and demonstrated the presence of E. coli. The link between this case and the consumed food will only be confirmed after further testing which is currently in progress.

While waiting for those results, the authorities have asked the producer to proceed with a  recall of CERGEL brand frozen ground beef patties sold in boxes of 10 with a best-by date of 10/31/09.

The health authorities are asking people who have bought these patties to not eat them and to return them to where they were purchased.

The Ministry also has some general advice, which seems a bit lacking, but maybe it got lost in translation.

Generally you are reminded that:

-    Ground meat ordered at the butcher shop must be consumed that day and frozen ground meat must be used without any prior defrosting;

-    Cooking the ground beef patties through to the center prevents the consequences of E. coli contamination. The bacteria is destroyed by a temperature of 65°C (149°F). Children and pregnant women should not consume rare meat.

-    Hemolytic Uremic Syndrome (HUS) is an illness most frequently originating in food, rare in France, and potentially serious for the very young and very old. It can cause acute renal insufficiency in children under the age of 3.
 

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The Denver Department of Health says three more cases of E. coli have been discovered in the past week in an outbreak believed to have started at the National Western Stock Show, bringing the total number of cases to 23.

Many of the cases are in children along the Front Range, from Boulder to El Paso County.

Several of the sick children go to day care and at least two of the cases appear to have happened after ill children came into contact with other sick children, according to the Colorado Department of Health and Environment (CDPHE).

It is unclear how the E. coli first spread at the Stock Show.
 

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Raleigh ABC 11 reports the possibility of a pathogenic E. coli outbreak at the  Emerald Pond retirement home in Durham, NC. It's early on, when information sometimes get's messed up, but the report says:

A spokesperson from the Durham County Health Department told Eyewitness News the department learned of at least four patients and staff members at Emerald Pond who have the bacterial illness.
Some strands (sic) of the bacteria can cause diarrhea, while others cause urinary tract infections, respiratory illness, pneumonia and other illnesses.
The initial report of E. coli cases was made over the weekend, but the Health Department is just beginning its investigation.
Emerald Pond has closed its dining room as a precaution.
The retirement home said it's cleaning the facility and "precautions are in place."

If the outbreak does happen to be pathogenic E. coli it could get messy for elderly individuals, and is often misdiagnosed.  In a 2006 article published in the Journal of the American Geriatrics Society, Reiss and colleagues write:

A growing pool of epidemiological surveys reveals that geriatric populations are at risk of severe manifestations of EHEC O157:H7 infections. A 5-year review of cases in Alberta, Canada, and in Scotland found that morbidity rates, defined as need for hospitalization, in those aged 60 and older were similar to or worse than those in young children. Of 703 patients requiring inpatient medical treatment in Alberta, Canada, during the study period, rates of hospitalization in persons aged 60 and older were nearly twice as high (68.9% of reported cases) as those of children younger than age 5.

Given the absence of fever, and often only the complaint of ‘‘bleeding per rectum,’’ it is not surprising that cases will be initially misdiagnosed as hemorrhoids, diverticulosis, or another source of painless lower gastrointestinal bleeding.

A review of nursing home outbreaks and epidemiological data indicate that nursing home patients are indeed at high risk for EHEC O157:H7 infection and related complications, although common perception may still place EHEC and associated HUS/TTP in the category of a pediatric infectious disease.

The mention of infected staff member(s) puts an interesting twist on things -- raising the possibility that an infected food handler is involved.

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Any cases of E. coli O157:H7 are "heart-wrenching.”

That’s what Tanya Maksymic, whose daughter Julia became seriously sick with E. coli in 2007, told the Calgary Herald after hearing that public health types are investigating a cluster of five cases in Calgary, which appear related to additional cases in Edmonton and Saskatchewan.

Dr. Richard Musto, Calgary medical officer of health for Alberta Health Services, said,

"We think we see some patterns here. It's still early, but it looks like there is some . . . connection between these cases."

Two of the people required hospitalization, according to sources, who added the Calgary cases appear linked to three unnamed Vietnamese restaurants. …

In the latest cases, the seven people fell ill between Nov. 26 and Jan. 2.

Maksymic went on to add,

"I never let my guard down, I'm always taking extra precautions. You don't live normally after that (experience)."
 

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Demonstrating once again that dangerous E. coli like O157:H7 exist in all ruminants, 7-year-old April Lambert of Beckley, West Virginia underwent a horrific yet typical encounter with E. coli as her kidneys shut down and doctors scrambled to save her life.

The Charleston Daily Mail reports that April’s father, Red, had shot a deer the Friday after Thanksgiving and she helped him skin it and prepare bigger cuts to send off to a local butcher, but Red cut the tenderloin himself.

April placed the pieces of meat into freezer bags, handling the meat with her hands.

The family and the doctors concluded that April likely hadn't washed her hands afterward as well as she could have. In fact, April recalls she may have rinsed them and not used soap.

Dr. Amana Nasir, a West Virginia University pediatric gastroenterologist who was on the team that treated April in Charleston said she and fellow doctors have treated four similar cases traced to handling of deer meat, adding,

"Deer harbor infection - it's estimated that 17 percent of the whitetail population harbors E.coli.”

The natural reservoirs for E. coli O157:H7 and other verotoxigenic E. coli is the intestines of all ruminants, including cattle -- grass or grain-fed -- sheep, goats, deer and elk.
 

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There are now seven confirmed cases of E. coli O157:H7, all University of Guelph students, and 43 probable cases, as part of a larger Ontario outbreak believed to involve romaine lettuce.

Cameron Clark, health protection program manager with Wellington-Dufferin-Guelph Public Health said the outbreak served “as a reminder for anyone who ate at the campus from that date on, or has experienced symptoms of extreme diarrhea, stomach cramps, nausea and vomiting to contact public health.”

I thought it would be a reminder for food service to check their suppliers of lettuce and ask what is being done to ensure the microbial safety of fresh produce.

Clark also said it's important to continually remind people to wash their hands to prevent human-to-human spread and to thoroughly wash fruits and vegetables.

Does continual reminding work? Or is it nagging? Is washing the lettuce in a Pita Pit wrap -- believed to be the Guelph source -- an effective consumer strategy?

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Two local health units said today that lettuce – specifically Romaine lettuce –was the common factor in an E. coli O157:H7 outbreak linked to food service operations in four southern Ontario towns that has sickened 130 people.

The Canadian Food Inspection Agency responded by saying,

“Canadians are reminded that the best way to prevent foodborne illness is by handling their food safely. … Canadians can also refer to CFIA’s detailed four point plan to prevent E. coli in the home.”

All of the people got sick at restaurants or cafeterias – not in their homes. And contamination of lettuce and other fresh produce needs to be prevented on the farm – there is little consumers or food service can do when contaminated product arrives.
 

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Canada has the best healthcare system in the world.

At least that’s what Canadians are taught to believe. Never underestimate the persuasive power of wanting to believe.

The family of a seven-year-old boy who suffered complications from the North Bay, Ontario, E. coli outbreak which has sickened 249, needs help as they remain with their young son in a Toronto hospital.

Sylvie MacDonald, Carter’s mother, said,

“This is a nightmare. And asking for help is definitely one of the hardest things I’ve had to do. We don’t like to do this, but I don’t know how long this could last. It could last forever.”

The child from Mattawa was airlifted to Toronto after he was brought into the North Bay and District Hospital Oct. 24.

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Three months after University of Guelph spokesthingy Chuck Cunningham said, "It seemed to me like it was business as usual," after an E. coli O157:H7 outbreak struck 20 people, the same bug has struck again.

The Wellington-Dufferin-Guelph Public Health unit says that four confirmed cases of E. coli O157 are all U of G students. To date, the only commonality among the four students is that they ate at the Pita Pit in the University Centre, so as a precaution, the University is voluntarily closing the UC Pita Pit until Public Health completes its investigation.

In Aug., Cunningham said, "It's a surprise and a shock to us that this has happened.”

So what is it now?

The great food safety school seems to have a lot of poop in their food.

In Aug., a  press release from the University said,

“Although health officials said it's unlikely that the source of the outbreak will ever be identified, they believe it's an isolated incident.”

How do they know it’s an isolated incident if the source of the outbreak is never identified?

For a self-proclaimed food safety school, Guelph really sorta sucks. Sorry for the sick kids.
 

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At least one media outlet is reporting this morning that outbreaks of E. coli O157:H7 in southern Ontario have been linked by DNA fingerprinting.

But I'd like to see that confirmed elsewhere.

Dr. Robin Williams, medical officer of Health for Niagara Region, said,

"We are trying to track through the supply and the source of the foods ... we're not just looking at the restaurants (involved) we're also looking at the cross-link between distributors.”

So far 208 food samples have been taken from those restaurants for analysis

The Little Red Rooster in Niagara-on-the-Lake, Ont., was closed last Friday to let Niagara Region Public Health officials investigate potential sources of contamination. On Tuesday, M.T. Bellies in nearby Welland, Ont., was closed. The number of sick related to these two eateries has climbed to 31, with nine confirmed.

Thursday afternoon, Johnathan's Family Restaurant of Burlington, Ontario, after the Halton Region Health Department linked several new cases of E. coli O157:H7 to the '50s-style diner.

Owner Greg Tasoulis told the Toronto Star yesterday he had no option.

"A health department representative came and said `I want you to close the restaurant down.' … How do they know it doesn't come from the lettuce I got from our supplier. What if it's not us? The cost is tremendous to us ... over 5,000 people come through here in a week.”

An outbreak at a Harvey's fast-food restaurant in the central Ontario city of North Bay has led to 237 cases of E. coli O157:H7, of which 46 are laboratory confirmed. At this time there is no link between the southern Ontario outbreak and the North Bay outbreak.

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The E. coli O157:H7 outbreak linked to a North Bay, Ontario, Harvey’s burger joint, is going from bad to worse.

The North Bay Parry Sound District Health Unit said today there are now a total of 207 cases, of which 39 are lab confirmed for E. coli O157:H7.

“Although we can reveal few details to avoid identifying anyone, there is one child who is very ill and in hospital,” said Dr. Catherine Whiting, Medical Officer of Health. “This person meets the criteria for complications from an E. coli infection, specifically Hemolytic Uremic Syndrome or HUS.”

The restaurant has been closed since Oct. 12. That’s more than enough time for DNA fingerprinting and to see if there are any matches with rather numerous E. coli outbreaks going on throughout North America. The CBC reports food samples have tested negative for the E. coli strain, and the Canadian Food Inspection Agency's investigation has turned to testing food handlers. After only 11 days? Wow.  If this was an animal disease, CFIA would be all over it. But, it’s just people.
 

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The use of video is changing public perceptions of foodborne illness outbreaks. At least that’s what we hypothesized after the 2006 E. coli in spinach outbreak. But check it out for yourself. Next time, get the head of CFIA or FDA on camera, explaining the basis for going public.

As of Monday, Oct. 20, 2008, there were a total of 141 cases, of which 28 are lab confirmed for E. coli O157:H7, which includes cases being investigated by six other health units in Ontario. The case numbers are down because further information has shown that 18 people are not part of this outbreak.

Does that mean there were 18 people who were sick that were part of another outbreak?

At this time, all of the 141 cases are linked to one location - the Harvey’s Restaurant in North Bay.
 

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A Harvey’s restaurant in North Bay, Ontario, Canada,  remains closed as the number of confirmed and suspected sick with E. coli O157:H7 climbed to 159 today.

The public health folks in North Bay must be going nuts, but they, along with the operators of Harvey’s, have put public health first and closed the restaurant until more is known.

Locust Grove, Oklahoma, was also hammered by an E. coli outbreak, E. coli O111, linked to dining at the Country Cottage restaurant in August.. One person died, 72 were hospitalized and 241 others got sick before the outbreak was contained.

Today it was revealed that State Health Department officials allowed the Country Cottage to stay open temporarily — even after confirming six of eight initial food poisoning victims had eaten its food, internal documents show. That decision may have resulted in additional people getting sick.

Health Department officials admitted last week there is no set threshold in such cases for closing a restaurant suspected of being the source of an outbreak.

There are no guidelines. Epidemiological investigations are full of uncertainty. So is most of what is known about foodborne illness. But after the Salmonella-in-tomatoes-jalapenos outbreak this summer, public health officials are seemingly reluctant to go public. Industry has attempted to take matters into their own hands – which they should have been doing anyway – and is increasingly challenging public health investigations with its own test results, and unfortunately overstating the value of their own tests.

Listeria in Maple Leaf deli meats, Salmonella in produce, E. coli in Ontario and Oklahoma. There are no guidelines on when to go public. Federal agencies like the U.S. Food and Drug Administration and the Canadian Food Inspection Agency must come clean with the public and industry and articulate the basis for public notification, or even restaurant closures, during outbreaks of foodborne illness. Until then local health units are left cleaning up the mess.
 

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The North Bay Parry Sound District health unit reports there are now a total of 131 cases of which 22 are lab confirmed for E coli O157:H7, and 22 people are still under investigation.

The investigation is localized to Harvey’s Restaurant on Algonquin Avenue in North Bay. Included are cases being investigated by 4 other health units.

The people who are ill range from 1 to 84 years old. Symptoms of illness from E. coli O157:H7 include diarrhea which may be bloody, stomach cramps, and/or vomiting and possibly a fever. Anyone suffering with these symptoms is advised to seek medical attention.

Dr. Catherine Whiting, Medical Officer of Health, stresses “that people who are ill with E. coli must take precautions to prevent the spread of the bacteria to other people. Thorough hand washing, using soap and hot running water, particularly after toileting, before any food contact, or changing diapers is a must.”

As I told the Toronto Globe and Mail, the source could have been contaminated meat coupled with a failure in cooking, fresh produce such as lettuce used in burgers and salads, or an employee.

“Just because it's a Harvey's, you can't assume it's the hamburger,” said Doug Powell, associate professor of food safety at Kansas State University. “It could be a fresh product, something that's not cooked and it could be distributed to other places.”