I look forward to Thursdays because a new issue of Eurosurveillance appears and they always have outbreak summaries of interest.

French health-types report eight cases of diarrhea, including two cases of hemolytic uremic syndrome (HUS), identified among 22 French tourists who travelled to Turkey in September 2011. A strain of Escherichia coli O104:H4 stx2-positive,eae-negative, hlyA-negative, aggR-positive, ESBL-negative was isolated from one HUS case. Molecular analyses show this strain to be genetically similar but not indistinguishable from the E. coli O104:H4 2011 outbreak strain of France and Germany.

Although the source of infection was not identified, the authors concluded the HUS cases had probably been infected in Turkey but there was no evidence to link this STEC O104:H4 outbreak to the consumption of fenugreek sprouts, as was the case for the German and French outbreaks in May to June 2011. None of the 22 travel group members reported the consumption of sprouts before and during their trip to Turkey.

Except that over there, sprouts are added to everything, more so than a Jimmy John’s sandwich.

Turkey is among several destinations where European tourists had previously travelled before developing STEC O104 infection between 2004 and 2009 (n=4), along with Afghanistan, Egypt and Tunisia. This outbreak supports data suggesting that the STEC serogroup O104 circulates in these areas. Further evidence is provided by the three additional cases that were subsequently identified in Germany and Denmark among persons also returning from Turkey within the same approximate time frame. Public health authorities and clinicians should be vigilant for possible STEC O104 infection in individuals returning from these areas who present with post-diarrheal HUS.

The complete paper is available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20065.

Outbreak of haemolytic uraemic syndrome due to Shiga toxin-producing Escherichia coli O104:H4 among tourists returning from Turkey, September 2011
26.jan.12
Eurosurveillance, Volume 17, Issue 4
N Jourdan-da Silva, M Watrin, F X Weill, L A King , M Gouali, A Mailles, D van Cauteren, M Bataille, S Guettier, C Castrale, P Henry, P Mariani, V Vaillant, H de Valk

Nancy Shute of NPR describes the Jones' Mock Salt recall as a collision of two distressing trends: contamination of herbs and spices, and safety issues with organic products.

It's made by June Jones, a hairdresser in Tacoma, Wash., who invented the seasoning a few years ago, after one of customers complained that the salt-free seasonings in the supermarket tasted terrible. Her little start-up has been a success.

But one of the ingredients in Jones's secret recipe is organic celery seed. And that's the source of the trouble.

Over the past few months Safeway and other big retailers have recalled organic celery seed because a batch of the seeds positive for salmonella, which can cause fatal infections. No illnesses have been reported, but the suspect seeds were distributed from last May through December.

Recalls and outbreaks caused by contaminated herbs and spices are not uncommon. Hundreds of people in 44 states fell ill with salmonella in 2009 and 2010 after eating Italian-style sausage. The culprit was red and black pepper used to season the meat.

We called up June Jones to find out what went wrong. "My supplier actually sent to me a recall letter," she said. "I pulled everything off the shelves in December, and recalled online orders. It's very hard."

Her business will survive, she says, but she has taken a big hit financially. And she's worried because most of her customers use salt substitute because they have health problems.

"It was very disturbing to me. I supply to a heart transplant patient in Minnesota," Jones says. "I take every precaution myself as a manufacturer to make sure my product is totally safe, and I expect other people do to that, too."

Because spices can be contaminated with bacteria and insects, big retailers routinely irradiate spices to kill pathogens.

We asked Jones if the celery seed she bought was irradiated. "Irradiated? I didn't ask about that. I made my product from products that are supposed to be safe."

So we called up her supplier, Starwest Botanicals of Rancho Cordova, Calif. Lisa O'Keeley, the customer service supervisor, told us that the firm had found out about the contamination after a manufacturer using their seeds tested a batch and found salmonella.

"Typically all of our products get run through a full gamut of testing by our quality assurance department," O'Keeley told The Salt. "When that product was approved, there was no evidence of salmonella at the time."

The seeds in question came from Egypt, which also happens to be the source of the tainted fenugreek sprouts that were linked to the E. coli outbreak in Germany last year.

O'Keeley says her Egyptian seeds were given an organic certification by an outside inspector. "We have very strict guidelines on what we can call certified organic. "

Were the seeds irradiated? "We won't purvey irradiated herbs," Keeley said. "Even if it's not organic we don't."

But organic certification doesn't measure food safety; it's only about how a food was grown. Recalls of organic tomatoes, lettuce, and other produce for contamination with salmonella and other deadly pathogens are, alas, common.
Organic foods have even spread botulism — like the Italian stuffed olives we covered last year.

"Consumers think organic is safer," says Doug Powell, a professor of food safety at Kansas State University. "But it doesn't. It's just a word. It really doesn't mean much aside from how it was grown."

He should know; he researches outbreaks, and covers them on barfblog, a go-to source on all things icky in food safety.

He doesn't have much sympathy for June Jones's situation, particularly since there's been an explosion of small food producers like her in recent years.

"If you're going to sell to the public, you'd better know what you're selling. Whether she thinks she's part of the industry or just a small little producer, it doesn't matter. You make people barf, they're doing to come after you."

James Gorman of the New York Times writes that disgust is having its moment in the light as researchers find that it does more than cause that sick feeling in the stomach. It protects human beings from disease and parasites, and affects almost every aspect of human relations, from romance to politics.

In several new books and a steady stream of research papers, scientists are exploring the evolution of disgust and its role in attitudes toward food, sexuality and other people.

Paul Rozin, a psychologist who is an emeritus professor at the University of Pennsylvania and a pioneer of modern disgust research, began researching it with a few collaborators in the 1980s, when disgust was far from the mainstream.

“It was always the other emotion,” he said. “Now it’s hot.”

Speaking last week from a conference on disgust in Germany, Valerie Curtis, a self-described “disgustologist” from the London School of Public Hygiene and Tropical Medicine, described her favorite emotion as “incredibly important.”

She continued: “It’s in our everyday life. It determines our hygiene behaviors. It determines how close we get to people. It determines who we’re going to kiss, who we’re going to mate with, who we’re going to sit next to. It determines the people that we shun, and that is something that we do a lot of.”

It begins early, she said: “Kids in the playground accuse other kids of having cooties. And it works, and people feel shame when disgust is turned on them.”

Dr. Curtis is involved in efforts in Africa, India and England to explore what she calls “the power of trying to gross people out.” One slogan that appeared to be effective in England in getting people to wash their hands before leaving a bathroom was “Don’t bring the toilet with you.”

Whatever the fine points of disgust, its power to affect behavior is unquestioned, and that power ought to be put to good use, Dr. Curtis said. So, in one of her projects, she has worked with an Indian public relations agency to come up with a disgust-based campaign to encourage hand washing among mothers in small villages, which could save countless children’s lives lost to diarrhea and other diseases.

The result, now being tested, is a skit involving two characters, one a supermom and the other a disgusting, dirty man. The man makes sweets using mud and worms, stops in the middle of the performance to rush off because he has diarrhea, never washes his hands and does everything possible to be revolting.

Supermom is scrupulously clean. Her children don’t get sick, the skit makes clear. In fact, her baby grows up to be a doctor. She washes her hands all the time.

The prominence of diarrhea in the skit is no accident. One thing about studying disgust, Dr. Curtis said, is that it makes you realize how important it is to talk about the very things that disgust us, because they often present dangers to public health.

“We need to talk about” excrement, she said, using a punchier single-syllable word for maximum effect — a word she is unapologetic about using, as befits a disgustologist.

“Which is worse?” Dr. Curtis asked. To talk about it, “or to make kids die.

Shock and shame.

We’ve been using disgust for a long time. It is called barfblog.

RiverStone Health in Montana was criticized last month when it raised concerns about a man who wanted to make Christmas dinner in his family’s kitchen and deliver the meals to shut-ins.

Health officials say they were only doing their job.

“Let’s imagine the unimaginable,” said RiverStone Health CEO John Felton. “Suppose 35 people got salmonella. What would the question of RiverStone Health have been at that point? We would not have been the Grinch who stole Christmas. We would have been the folks who allowed 35 people to get sick because we didn’t execute our responsibility.”

RiverStone objected to Cody Walter, owner of Delivery 2u, using private kitchens to prepare and distribute food. RiverStone provided Walter with information on food safety. They also identified a number of commercial kitchens so the holiday meals could be prepared in a facility equipped to safely store and prepare the food and milk donations he was receiving.

Walter said he was “shut down” and suggested the Grinch had stolen Christmas.
Public sentiment overwhelmingly sided with Walter.

“What needs to be clear is that we don’t have any interest whatsoever in preventing churches, nonprofit organizations and others from doing the good they do in the community,” Felton said. “Our compelling interest is to protect the safety and health of the public. What we don’t want is to have a bunch of people get sick because we didn’t provide the information they need.”

RiverStone Health employs nine registered sanitarians, six of whom are involved in food inspections. In fiscal year 2011, they conducted 1,750 unannounced inspections in 1,000 licensed establishments. The number of inspections does not include temporary events such as Christmas Stroll, Saturday Live and the Strawberry Festival.

“Cody Walter was doing a good thing,” Felton said. “If we would have had advanced notice we could have worked closely with him. We don’t want to discourage people from doing those types of things. He seems like a good-hearted guy, but there is a huge difference between cooking for five people and cooking for 50 and then delivering it.”

Walter said he understands now that RiverStone Health was only trying to protect him as well as those to whom he would deliver meals. “There are no hard feelings. They were only doing what they should be doing,” he said. “They are there for a reason.”

Another in the weekly we’ve-been-doing-it-this-way-all-our-lives-and-never-got-sick declarations from a restaurant tentatively fingered in an outbreak of illness.

The Hickory Daily Record reports 40 people have complained to officials at Catawba County Public Health that they got sick after eating a meal at Conover’s Harbor Inn Seafood restaurant.

One thing the victims have in common is that they ate at Harbor Inn on Jan. 13.
Health officials are working to determine what the illness is and what caused it, said Catawba County Public Health Outreach Manager Amy McCauley

The first complaints came in on Jan. 17. As of Monday, 40 cases had been reported. None have required hospitalization, said Catawba County Health Director Doug Urland.

“Our Environmental Health workers have been to the restaurant almost every day to investigate and educate the staff about proper food handling techniques and to make sure they are stringent about safe food handling techniques,” McCauley said.

George Ziogas owns the Conover Harbor Inn and said he has no idea why some of his customers got sick following their Friday the 13th meal.

“The Health Department came in and they could not find anything. All of the food temperatures were OK. All of the salad bar temperatures were OK,” he said. “We’ve been open for 23 years and we’ve never had a problem.”

Recent inspection results have given Harbor Inn consistently high marks.
The most recent inspection came on Dec. 29 and Harbor Inn got an A with a score of 99.5. Three months earlier the restaurant scored 99.5. In June, Harbor Inn earned a 100.5.

“I want people to know we’re going to be here a long time – we’re not going anywhere – we’ve been here 23 years and this was a one-time incident,” Ziogas said.

“I eat here all the time and I like the food – if I didn’t, I wouldn’t come back,” said Cora Greene, of Mountain View, on Tuesday, after sharing a meal of whitefish with her son. “This can happen anyplace, but I’ve never gotten sick. I’ll be back.”

Health officials are working to identify the mysterious illness and its cause, but won’t speculate on what it may be.

On Friday, Catawba County Public Health began distributing stool sample kits to the victims of the illness at the request of the North Carolina Division of Public Health. The people complaining of illnesses related to Harbor Inn meals have been instructed to use the kit and return it to Catawba County Public Health, which will then send the kits to the state lab for testing.

It takes about a week to process the tests, and it won’t be clear what’s been making people sick until the results are in.

None of the distributed kits had been returned to Catawba County Public Health as of Tuesday, McCauley said.

The symptoms associated with the Harbor Inn outbreak are intense nausea, vomiting and diarrhea. The onset came within 12 to 24 hours following the Jan. 13 meal and lasted from 24 to 36 hours for most of the victims, according to reports from Catawba County Public Health.

Maybe a legal jolt will prod Australians out of food safety complacency, but that’s especially challenging in a politico town like the national capital, Canberra.

ABC News reports 10 people are taking legal action against a Canberra bakery after allegedly contracting food poisoning.

Silo Bakery at Kingston was forced to shut for three days in December after ACT Health detected salmonella in mayonnaise used in a chicken roll.

It is believed raw egg in the mayonnaise was to blame for the salmonella outbreak which allegedly affected more than a dozen people.

Gerard Rees from Slater and Gordon in Canberra says some of those who were affected are seeking compensation for pain and suffering induced by the allegedly spoiled sandwiches.

"For five or six of the individuals I understand it ended up in hospital and a couple for relatively lengthy periods of time, weeks rather than days. So obviously people who were seriously affected would be entitled to far greater compensation for general damages or pain and suffering. Those who were off work as a result would be entitled to receive compensation for the time off that they had and if they had medical expenses they're entitled to compensation for the medical expenses they're paid as a direct result of the poisoning.

"What'll happen is we're investigating a claim in negligence. The claim will allege that Silo bakery was negligent in the way it stored and prepared the food. There is an ACT Health investigation underway as well that is looking into this. What we will do is look at each case individually."

At least 22 people were sickened with salmonella in Dec. at the Canberra bakery. In the aftermath of the outbreak, Silo co-owner Leanne Gray said officials have advised buying commercial mayonnaise or using pasteurized eggs. Her response: “That's the foulest thing you've ever seen, so I said no, I won't.''

A table of raw-egg related outbreaks in Australia is available at http://bites.ksu.edu/raw-egg-related-outbreaks-australia.

The social media thing sounds sorta cool until customers complain that your food makes people vomit, you serve pig meat from gestation crates and a burger containing a finger nail.

And it’s all on Twitter for anyone to see.

Jumping on the social media bandwagon, McDonald's last week launched a campaign featuring paid-for tweets, which would appear at the top of search results and designed to get people to share touchy-feely nostalgic stories about the fast food chain.

The company only promoted the hashtag #McDStories for two hours, during which Twitter users told stories of finding gross things in their food, unclean restaurants, and bad experiences working for the chain.

McDonald's social media director Rick Wion says of the incident, "We're learning from our experiences." And they will. And become even more profitable.

The UK Food Standards Agency’s latest public attitudes tracker shows that the main food safety issue people continue to be concerned about is food hygiene when eating out. Other issues include food poisoning and the use of additives in food.

The Agency’s Food Hygiene Rating Scheme in England, Wales and Northern Ireland, and the Food Hygiene Information scheme in Scotland, aim to reduce these concerns by encouraging businesses to improve hygiene standards and reduce the incidence of foodborne illness. The schemes help consumers choose where to eat out or shop for food by giving them information about the hygiene standards in restaurants, cafés, takeaways, hotels and food shops.

In this latest tracker survey, three new questions were asked to measure people’s awareness of food hygiene schemes. The results show that 19% of respondents had seen or heard about this type of scheme. When prompted, 21% of respondents reported that they had seen or heard about the ‘Food Hygiene Rating scheme’, 12% had seen or heard about ‘Scores on the Doors’ and 10% had seen or heard about the ‘Food Hygiene Information Scheme’.

This latest wave of research was undertaken in November 2011, with a total number of 2,076 respondents interviewed via the TNS consumer face-to-face omnibus survey.

 Once again, a seasoning has been fingered as the source of salmonella, although no one is sick this time (yet, or that is know).

Jones’ Seasoning Blends LLC announced a voluntary recall of Jones’ Mock Salt Original as well as Jones’ Mock Salt Spicy Southwest Blend due to the potential contamination of Salmonella.

They probably mean contamination with salmonella. But why get picky; at least they put something out there.

“This recall has been initiated due to possible Salmonella contamination of the celery seeds ingredient used in Jones Mock Salt. Jones Seasoning Blends LLC is not responsible for the contamination of Salmonella. The supplier of the celery seeds has been recalling the product and Jones Seasoning Blends LLC has also taken every action possible in notifying the public.”

Except the notice is not on the Jones website, although there is a cute tale about how the company was created.

Ms. Jones, you are responsible because your name is on the product. I’m sure your ingredients are organic, but that does not equate with microbiologically safe.

The following affected products were directly distributed to grocery stores and markets in California, Minnesota, and Washington and it was also sold through internet orders on www.jonesmocksalt.com:
Jones’ Mock Salt Original: Organic Salt Free Seasoning, 1.6 oz bottles (UPC 0 94922 16616 6), 12 oz bags (UPC 0 94922 07199 6) and 16 oz bags (0 94922 16616 6).
Jones’ Mock Salt Spicy Southwest Blend: Organic Salt Free Seasoning, 1.6 oz bottles (UPC 0 94922 01560 0).

There is no lot number identifying the bottles or bags. Any products purchased from July 1, 2011 to December 14, 2011 should be destroyed.