Ever wonder what to do in an ice storm. A tornado? How about a flood? Living in the Midwest, we get everything.

Now imagine it’s not just you and your family. It’s a restaurant, a store, even a really big store.

The Conference for Food Protection (CFP) has released “practical guidance for retail grocery and food service establishments to plan and respond to emergencies that create the potential for an imminent health hazard.”  It includes a list of on-line resources.

It’s a great starting point.

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The Dallas Morning News ran a couple of excellent features on the flow of food from Mexico to the U.S. Yesterday's story was about the lack of inspectors, how little product was actually inspected, and, perhaps unwittingly, the problem of inspecting fresh produce for microbial contaminants.

“In December, officials took a sample for testing from a 5,500-pound load of Mexican basil moving through the Otay Mesa border crossing in San Diego. The basil continued on to its destination and was sold to restaurants and other customers in California, Texas and Illinois the next day. When the test results came back two weeks later, they suggested salmonella contamination, sparking a late recall.”

It's much better to design safety into all operations, beginning on the farm.

Glenn Fry helps run Taylor Farms de Mexico's new $14 million plant in San José Iturbide, Mexico. He picked the land where it sits, designed just about every facet of it, and he manages more than 800 workers who plant, harvest and package produce – including lettuce, onions and broccoli – for export to the U.S.

Today’s story says that Taylor Farms is just one of a handful of U.S. companies lured by Mexico's ideal year-round growing climate, proximity to Texas, low labor costs and plentiful workforce.

During a recent lettuce harvest, quality-control supervisor Laura Patino pointed to an aide who monitors workers coming out of the mobile toilets at the end of the fields to make sure they wash their hands before returning to work.

"Many of our workers don't even have toilets at home, so this is new to them," Ms. Patino explains. "We've literally taught many of them how to go to the restroom. It's that basic."

The lettuce field – owned by Oscar A. Bitar Macedo and leased by Taylor – is fenced off from outside "contamination." Heavy strips of yellow plastic keep out dogs, cattle and other livestock.

Mr. Bitar, owner of Rancho Don Alberto, leases all of his 100 hectares (about 247 acres) to Taylor. And he's responsible for maintenance, water wells, monthly water testing, fencing, security guards and, yes, even toilet paper. …

Within two hours, 24 boxes, each holding about 850 pounds of lettuce, are transported to Taylor's plant a few miles down the road for the first of several safety checks.

At the entrance, 19-year-old Efigenia Rosas checks the boxes to make sure they're labeled with bar codes identifying the owner's farm, crew supervisor, field and time of harvest – a crucial step in the process. If a consumer later finds a problem, Taylor can trace the produce back to the field and farmer. …

At 6 p.m., driver Roman Ayala, an employee of Flensa Trucking, begins the drive north on Mexico's Highway 57. He's in no rush because he has no chance of getting to Nuevo Laredo before Customs shuts down the bridge at 11 p.m. And it won't reopen until 8 a.m., something that frustrates Mr. Fry to no end.

"How can the U.S. government be serious about food safety when they shut down the border overnight and perishable goods have to sit there and wait?" he asks.

There is also a good video overview of the lettuce harvesting procedures available along with the story at http://www.dallasnews.com/sharedcontent/dws/news/world/mexico/stories/063008dningproducttaylor.40d72a3.html

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The Sydney Morning Herald reports that coroner Jane Culver has found that a Sydney restaurant served asparagus sauce contaminated with bacteria in January last year, leading to the death of William Hodgkins, 81, because of slack procedures in its handling of the sauce.

The sauce, which was served with the fish of the day at Tables restaurant in Pymble on January 12, 2007, had 9.8 million colony-producing units of Bacillus cereus per gram.

Ms Culver said the sauce was made at 3pm the day before, on January 11, and refrigerated. It was taken out of the refrigerator on January 12 but not discarded after four hours of use. Four hours is the recommended amount of time for the sauce to be used after being refrigerated, Ms Culver said.

Instead of being thrown out, it was placed in a coolroom so that it could be used for serving meals.

Ms Culver said the container for the sauce had no label showing when it was made or when it should be discarded.

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Deborah Shelton of the Chicago Tribune gave me a call Friday morning before spending the day with a food inspector at the annual Taste of Chicago event, expected to draw some six million people.

Last year, some 800 visitors to the Taste were sickened with Salmonella, traced to hummus served at the Pars Cove Persian Cuisine booth. It may have been the sesame seeds, or tomatoes, in the hummus; it may have been a hand hygiene issue.

"Handwashing, avoiding cross-contamination and monitoring food temperatures are important efforts, but for a lot of foodborne illness, these aren't enough," said Doug Powell, scientific director of the International Food Safety Network based at Kansas State University. "What people are missing is that many of these outbreaks are caused by foods contaminated at their source."

Last year, I said the Chicago Department of Public Health engaged in “a breathtaking example of doublespeak,” and “what is possibly the biggest piece of PR puffery I've ever seen” as the Department insisted:

"The Pars Cove situation represents the first confirmed outbreak of illness associated with the event in at least 20 years. In the larger context of having safely served tens of millions of people in recent years, the Taste remains quite possibly the safest food service operation in the city."

The sick people were probably interested to know they were a statistical anomaly.

But it continues.

Dr. Terry Mason, commissioner of the Chicago Department of Public Health, said yesterday,

"The Taste of Chicago is the most highly regulated, tightly scrutinized event in the city, perhaps even in the nation."

Mason said food inspections will take place at booths four times a day to ensure the public's safety.

"One case of illness is one case too many, but the fact remains that no other major outdoor food event in the nation has a better track record of safety than this one.”

Show me the data. Or show the data to the 800 sick people from last year. And, Dr. Mason, you can inspect 20 times a day; until you have a plan to verify that raw ingredients are coming from safe – or at least microbiologically aware -- sources, your Taste is a vulnerable to foodborne illnesss as any other eating event.

Sure, asking questions is hard. But public health inspectors are ideally suited to ask those hard questions. Restaurants that want to avoid Bill Marler need to be able to answer those questions.

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The U.S.Center for Disease Control and Prevention reports that since April, 810 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 36 states and the District of Columbia.

The number of ill persons identified in each state is as follows: Arkansas (10 persons), Arizona (39), California (10), Colorado (8), Connecticut (4), Florida (1), Georgia (18), Idaho (3), Illinois (78), Indiana (11), Kansas (14), Kentucky (1), Maine (1), Maryland (25), Massachusetts (18), Michigan (4), Minnesota (2), Missouri (12), New Hampshire (3), Nevada (4), New Jersey (4), New Mexico (85), New York (25), North Carolina (5), Ohio (6), Oklahoma (19), Oregon (7), Pennsylvania (6), Rhode Island (3), Tennessee (6), Texas (342), Utah (2), Virginia (22), Vermont (1), Washington (4), Wisconsin (6), and the District of Columbia (1).

Among the 523 persons with information available, illnesses began between April 10 and June 15, 2008. Patients range in age from <1 to 99 years; 51% are female. At least 95 persons were hospitalized. No deaths have been officially attributed to this outbreak. However, a man in his sixties who died in Texas from cancer, had an infection with the outbreak strain of Salmonella Saintpaul at the time of his death. The infection may have contributed to his death.

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Raw egg dishes have been linked to numerous Salmonella outbreaks (check out CSPI's outbreak database for a list of egg-related outbreaks since 1990).

Today's infosheet  focuses on a couple of recent outbreaks where raw egg dishes were implicated on Guernsey Island and in Australia.  Raw egg dishes including Caesar salad dressing, Hollandaise, mayonnaise, mousses, icings and homemade ice cream have been linked to Salmonella outbreaks.

Click here to download the infosheet.

Infosheets are created weekly by iFSN and are posted in restaurants, retail stores, on farms and used in training throughout the world. If you have any infosheet topic requests, or photos, please contact Ben Chapman at bchapman@uoguelph.ca

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Gus the dog is anything but a beauty queen, but on Saturday he won a contest for his looks.  The World’s Ugliest Dog of 2008 is a three-legged, one eyed, Chinese crested dog, named Gus.  The Chinese crested dog is a popular breed in the contest; in fact eleven of the seventeen contestants for this year are of this breed.  (See all there pictures here)

The World's Ugliest Dog contest has taken place each year in Petaluma, California since 1976, and each year many people gather to look at faces of dogs that only a mother could love.  It’s kind of like a bad car wreck, these dogs are so disgustingly ugly, but you can’t look away.

There are numerous sites on the web that showcase photos of the cutest, cuddliest pets.  So why do people care about the ugly ones?  I suppose that just as beauty is celebrated throughout the media, it would be only fair to display the ugliness as well.  Many magazines at the checkout line in the grocery stores have photos of celebrities on the red carpet in all their glory, and they also have photos of celebrities looking their worst, without any makeup or fancy clothes.

American culture will continue to celebrate the cutest of the cute pets, but there will always be a special place in our hearts for those truly ugly dogs.

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The Guernsey Press – of the Guernsey Islands – reports that an outbreak of salmonella, blamed on raw eggs used in mayonnaise, has left 18 customers and staff at an unamed island catering establishment needing treatment.

Environmental health inspectors visited the premises last week and a spokesman said the infection had been contained.

The spokesman would not confirm the location of the outbreak as he said the premises had been deemed fit to continue catering.

Sounds surprisingly similar to an outbreak in Tasmania earlier this year,

Tasmanian Director of Public Health, Dr Roscoe Taylor, said at the time that given the national increase, and the local experience of salmonella outbreaks associated with eggs, his department was proposing to introduce new measures to control the safety of raw egg products in Tasmania as a matter of urgency.

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Since April, 613 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 33 states and the District of Columbia. These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization.

The marked increase in reported ill persons since the last update is not thought to be due to a large number of new infections. The number of reported ill persons increased mainly because some states improved surveillance for Salmonella in response to this outbreak and because laboratory identification of many previously submitted strains was completed. In particular, one new state, Massachusetts reported ill persons.

The number of ill persons identified in each state is as follows: Arkansas (3 persons), Arizona (34), California (8), Colorado (4), Connecticut (4), Florida (1), Georgia (14), Idaho (3), Illinois (45), Indiana (9), Kansas (9), Kentucky (1), Maryland (18), Massachusetts (12), Michigan (4), Missouri (12), New Hampshire (1), New Jersey (1), New Mexico (79), New York (18), North Carolina (1), Ohio (3), Oklahoma (17), Oregon (5), Pennsylvania (5), Rhode Island (2), Tennessee (4), Texas (265), Utah (2), Virginia (21), Vermont (1), Washington (1), Wisconsin (5), and the District of Columbia (1). Among the 316 persons with information available, illnesses began between April 10 and June 13, 2008. Patients range in age from <1 to 99 years; 50% are female. At least 69 persons were hospitalized. No deaths have been officially attributed to this outbreak. However, a man in his sixties who died in Texas from cancer had an infection with the outbreak strain of Salmonella Saintpaul at the time of his death. The infection may have contributed to his death.

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The Boston Globe reports that inspectors found recently that a restaurant at the home of the Inspectional Services Division at 1010 Massachusetts Ave., as well as a cafe in City Hall that has been visited by the mayor, violated some of the most serious public health codes.

Cafe 1010, located on the first floor of the Mass Ave. building, flunked inspections earlier this month and in December by failing to keep hot foods at 140 degrees or warmer and cold foods at 40 degrees or cooler. Both violations are considered critical because they could cause food poisoning. They had been corrected when inspectors followed up last week.

Boston food safety consultant Lisa Berger said,

"You would think it would be a deterrent that they're right in the middle of the city offices, but it's clearly not for some places. Everybody knows they get inspected by the health department, yet why do places get in trouble? It's amazing to me how some of them can't quite grasp the seriousness of it sometimes, even with the threat of closure."

City Council member John Tobin suggested using a grading system for restaurants.

"It's kind of like a scarlet letter. If your place is clean and up to code you have nothing to worry about. You've got people going in and eating, and people can get really sick if they're eating in a place infested with rodents or people aren't washing their hands or going by basic procedures to keep food fresh and the condition sanitary."

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Andrew Schneider??? of the Seattle P-I, writes in a decent raw milk piece  this morning that consumers almost always link arms with government public health agencies banning the sale of food believed to contain dangerous pathogens. But that spirit appears to vaporize when the consumable is raw milk. Below are some excerpts:

“Although the number of cases nationwide is low, contaminated raw milk can contain a strain of E. coli that sometimes causes hemolytic uremic syndrome, a life-threatening complication that can cause kidney failure and death.

It took a 2005 outbreak of E. coli in raw milk that sickened 18 people in Washington and Oregon and put two children on life support to get all the players -- the dairy and raw milk communities, lawmakers, the state agriculture and health departments -- together to try to figure out what to do, Gordon said.

Last week, the owners of the dairy that sold the tainted milk, Michael and Anita Puckett, pleaded guilty in federal court in Seattle to the charge of distributing adulterated food.

Claudia Coles, food safety manager for the state Department of Agriculture, agreed that something had to done, that "in these outbreaks, it is almost always the children that become the victims."

The state's options for trying to control the sale of raw milk products were limited. In other states where it was banned completely, a black market flourished. So the question facing regulators is whether public health is better protected by regulating, testing, licensing and inspecting the raw milk or just by banning it so it goes underground with no oversight.

Doug Powell says he's not surprised that government health officials denounce the dangers of raw milk then turn around and license the sale of the same milk.

"In part, it's because of the almost evangelical way people talk about raw milk and that America is founded on consumer choice," said the associate professor of food safety at Kansas State University.

"The numbers of illnesses from outbreaks caused by unpasteurized milk are not that high. You could very easily make the cases that 'Wow, maybe tomatoes should be regulated a whole lot more than we do now because the numbers of cases of salmonella saintpaul are up to 550 now,' " said Powell, who is also scientific director for the International Food Safety Network.

"I don't care if people drink raw milk. What I'm particularly concerned about is them then imposing their choice on their kids, because they're the ones who get sick. People have the right to sell a product, but if it makes people sick, they have a right to sue."

Seattle food safety lawyer Bill Marler is up to his neck in many of those lawsuits. He grew up drinking raw milk on the farm "because that's what my dad wanted us to do," he said. He has tried injury suits stemming from most of Washington's raw milk outbreaks and is now handling similar cases in California and Missouri.

"The entire raw milk debate is so emotionally charged that there's no common ground at all," Marler said. "The reality is if you poison a little child by selling a product that could easily be pasteurized, you're going to have to deal with the legal issues surrounding that," he said.

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When Amy and I were in Guelph, Ontario a few weeks ago, she aksed, “what’s with all the dandelions.”

I tried to explain how municipalities, and now the province of Ontario, were proposing bans on the so-called cosmetic use of pesticides, even if the use of such chemicals had been declared safe by scientists working for the federal government.

I have no intention of getting wound up in the pros, cons or otherwise of chemical use. But what has been absent in the public discussion of various risks is the voice of the government regulator, which can lead to the creation of an information vacuum, which can lead to all kinds of erroneous information amplified through various social media. It’s a well-documented phenomena, and I co-authored a 1997 book about it, Mad Cows and Mother’s Milk.

So it was an unexpected surprise when Richard Aucoin, acting executive director of Health Canada’s Pest Management Regulatory Agency, penned a lucid, articulate, and well-thought out letter which appeared in the Ottawa Citizen.

“Health Canada's priorities are the health and safety of Canadians and their food supply, and this primary mandate is applied when approving pesticides for use in Canada.

Under the Pest Control Products Act, if a pesticide (herbicide, insecticide, fungicide) meets our stringent health and environmental safety standards and proves value in its application, it must be approved for use. Only those products that meet Canada's strict health and safety standards are registered for sale and use in Canada.

When determining if a pesticide can be used in Canada, Health Canada conducts extensive health and environmental scientific reviews.

Testing methods must have adhered to accepted international standards. The evaluation takes into account the available scientific information on potential health and environmental effects from publicly available studies including epidemiological and incident reports both nationally and internationally.

Health Canada employs over 300 qualified scientists dedicated to the evaluation of pesticides, many of whom have doctorates and masters credentials in the fields of human health sciences, environmental and agricultural sciences. This team carefully scrutinizes the scientific information available on all of the components of a product, including both the active and non-active ingredients.

In addition, before Health Canada makes a final decision on whether to allow the use of a pesticide, the Canadian public is invited to submit comments and questions.

All chemical substances have inherent risks, which is why Health Canada has a dedicated regulatory program in place to review pesticides.

Given the rigour of the evaluation process, we are confident that the pesticides approved for use in Canada, including lawn and garden products, can be used safely under the prescribed circumstances indicated on the label.

Canadians should use pesticides judiciously, carefully follow label directions, and take measures to become better informed about their safe and effective use.
Any questions about pesticides can be addressed to Health Canada's Pesticide Information Services at 1-800-267-6315.”

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Since April, 552 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 32 states and the District of Columbia. These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization. The marked increase in reported ill persons since the last update is not thought to be due to a large number of new infections. The number of reported ill persons increased mainly because some states improved surveillance for Salmonella in response to this outbreak and because laboratory identification of many previously submitted strains was completed. In particular, the number of ill persons reported from Texas markedly increased, and two new states, New Jersey and Rhode Island, reported ill persons.

FDA recommends that U.S. retail outlets, restaurants, and food service operators offer only fresh and fresh cut red plum, red Roma, and round red tomatoes and food products made from these tomatoes from specific sources listed at: http://www.fda.gov/oc/opacom/hottopics/tomatoes.html#retailers*. Cherry tomatoes, grape tomatoes, and tomatoes sold with the vine still attached from any source may be offered.

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Michelle Mazur has been working with me for several months. She's starting vet school in the fall and came up with the cryptosporidium-in-pools infosheet.

Michelle just returned from two weeks in Japan. I asked her to take some pictures of Japanese hand washing facilities and the like. In her own words,

"I'm a bit embarrassed at how many pictures I took during the trip.  At first my group members made fun of me taking photos of bathrooms, but by the end of the trip they would walk out of the bathroom saying "Cool, Michelle, you've got to go in and take a picture of that awesome bathroom!"
 
Michelle's photo odyessy is available at:
http://www.flickr.com/photos/27779935@N05/sets/72157605689172182/

Her commentary is quite funny.

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I'm gonna drop the Food Safety Network name.

Just doesn't seem to fit anymore.

Too many hacks and posers.

I started sending out news shortly after I began my PhD in 1993. Jack-in-the-Box had just happened, Al Gore hadn't invented the Internet yet, but I was plugged in through the various twists and turns of life, and started sharing stories -- in real time --  with my science-geek colleagues.

They seemed to like it, and research confirmed it was useful.

In 1993, food safety types were conditioned to reading about outbreak investigations when CDC's MMWR arrived in the mail six months later. That's still way faster than the Canadian government types write up any outbreak investigation.

I originally called the news distribution the Food Safety Network cause network was sorta new. Sure, it seems dated now, but at the time, we rocked. Now, it just rolls.

The whole idea of calling my lab the Food Safety Network rests with Lester Crawford. I wanted to create a group modeling Georgetown University's Center for Food and Nutrition Policy (which has since moved). Lester spent a couple of days in Guelph, and told me, whatever you do, make it bigger than yourself. No one cares about Doug Powell's lab. So give it a name. And bring in others.

So I did.

Unfortunately, due largely to my unfailing optimism, others went for the short game. In the spirit of open and honest collaboration, the University of Guelph went and trademarked Food Safety Network in Canada the day I resigned -- and didn't bother to tell anybody. Then they scooped up whatever money was left to cover the deficit in their paper clip fund.

The actions of so many have been small and petty. But there have always been a few that make it worthwhile.

Katija Blaine and Ben Chapman have both been with me in various capacities since 1999. Still are. We've traveled the various minefields of genetically engineered sweet corn and on-farm food safety programs for fresh produce, and now we're all having babies.

Katija was first up on Saturday, delivering Cormac (right). Congrats to Katija and Jeff.

Ben and Dani and due in Sept.

And me -- forever trying to hang out with the cool kids -- me and Amy are due the end of November.

Got no time for posers.

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Mayra Rivarola is a new student in my lab and pulled together a decent piece on tomatoes and salmonella. And provided some excellent tomato photos.

Karen Wisser of Eastside & Westside markets in Manhatan, Kansas, knows fresh produce. Wisser says buying produce from her markets is much safer than buying produce from larger retailers because she can identify their supplier easily and go back directly to the source in case of an outbreak of foodborne illness.

"If we don’t like what we’re getting, we can stop buying from them, we know what consumers want,” said Wisser.

Bryant Ambelang, chief marketing officer of Desert Glory, one of North America’s largest grower of greenhouse tomatoes, says that food safety is a top priority which is why the company invests in greenhouse operations, private wells, continual testing procedures and 100% product traceability.

The latest outbreak of salmonella associated with fresh tomatoes, with 277 sick people now identified in 28 states, including Kansas, raises questions about the safety of fresh produce and the food supply in general.

The U.S. Food and Drug Administration is advising consumers to stay away from red plum, red roma and round red tomatoes unless they come from areas that have been given the all-clear by the FDA. The list is available at www.fda.gov/oc/opacom/hottopics/tomatoes.html#retailers. The FDA website also states that homegrown tomatoes are safe to consume.

But, should consumers blindly assume that a tomato, because it was bought from the farmer next door, is free of salmonella or other dangerous bugs?

To protect the produce, it is essential that safety guidelines are followed, beginning on the farm.

Fresh fruits and vegetables can be contaminated through different venues including: contact with untreated manure, contaminated water, workers with poor hygiene habits or infected with contagious diseases, unclean containers, tools, storage or transportation facilities.

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I started worked with Ontario Greenhouse Vegetable Growers in 1998. The general manager at the time, Denton Hoffman, saw the U.S. export market growing rapidly, and told me of his recurring nightmare … one he wanted to prevent.

"The phone rings and it's a retailer on the U.S. east coast. He says he's got a customer who says she got sick from eating my Ontario greenhouse tomatoes. What do I say?"

That was the challenge Denton laid out for my group in 1998. Using a risk analysis approach, we assessed the risks for all 220 or so Ontario greenhouse producers, developed management schemes, and communicated what we were doing to buyers, consumers, whoever.

We learned lots of things about building trust with individual growers (which means visiting their farms, not plopping them in a classroom and trying to make them HACCP experts), coming up with practical, farm-based solutions, and being on call 24/7 for when those phone calls come in (that's me and Amber Leudtke, back in about 2001, in a greenhouse, above right).

But I could never get the group to take the final step and really promote their food safety program. I suggested putting a url on the stickers at retail that would link to a series of videos showing whoever wanted to see them the food safety practices undertaken by the growers.

During the latest Salmonella-in-tomatoes outbreak, a rep for Nature Sweet, a grower in San Antonio e-mailed me and said, what should we do? This grower does great things for food safety. So I told her.

The rep wrote me back last week and said,

"I spoke with you last week briefly about the tomato outbreak.  You made the suggestion about putting our company's safety practices on blogs, YouTube, etc.  Well, we took your advice and have created a video that is up on YouTube.  Here is the link to the video if you're interested to view it, http://www.youtube.com/naturesweettomatoes."

The video is also below. Sure, I'd rather see a farmer than the marketing dude, and the intro will have to be redone for future use, but the rest is great.

And they spelled it out in a press release:

Our greenhouse growing practices are the foundation of our food safety program:

• The water supply used in our greenhouses is self-contained, filtered, and secure. Water from each well and each greenhouse farm is continuously monitored and tested for purity by our staff and by third party experts.
 
• We use only natural fertilizers.

• Our tomatoes are picked under sanitary conditions.

• Food safety begins with the seed. Our tomato seeds are always naturally selected, disinfected and germinated under sanitary conditions.

• Within each greenhouse, we control and monitor all intakes – water, nutrients, and pest control.

In addition to our greenhouse practices, we also employ the following food safety initiatives:

• Regulate all aspects of tomato production and processing, as well as employ the best agricultural practices.

• Monitor all of our systems continuously to ensure that our produce exceeds the highest food safety standards and FDA guidelines. In addition to our adherence to HACCP-based safety practices, we follow rigorous training, growing, packing, and shipping standards.

• Use a food safety coding system that provides us with traceability of every case and pallet of tomatoes to the greenhouse in which they are grown. In addition, each individual selling unit has a comprehensive food safety tracking code.

• Test, monitor, and audit our products, our water, our processes, and our procedures regularly with staff and third-party experts.

I can quibble about details. But it's a great start, and, like transparency in risk assessments, now that it's out there, it can be improved. It's a lot better than just telling consumers to wash their tomatoes or it's local so it's safe.

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Three-year-old Brianna Kriefall and her family ate at a Sizzler restaurant in South Milwaukee in July 2000. Brianna died a week later after battling E. coli-related hemolytic uremic syndrome.

Brianna, along with most of the other 140 people who were sickened in the outbreak, consumed watermelon that had been cross-contaminated with raw meat.

Genetic testing showed the microbes that made the restaurant patrons sick matched microbes contained in an unopened package of meat.

The national Sizzler chain, its local franchise and an insurance company are suing Excel Corp., the subsidiary of Cargill Inc. that produced the meat.

On Friday Brianna's family reached a $13.5 million settlement with the company's meat supplier and others.

The Kriefalls' case had been dismissed in 2004 by a different Milwaukee County Circuit judge after Excel lawyers argued the company was exempt from state lawsuits because it had followed federal regulations in handling the beef sold to Sizzler.

An appeals court reversed the dismissal, saying the legal action fit within the federal goal of making food safer for consumers. The U.S. Supreme Court declined Excel's appeal.

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Yesterday Doug appeared on NPR Science Friday. The topic was the recent outbreak of Salmonella that has now officially sickened 228 persons in 23 states.
A podcast of the episode is now available online, and can be heard at this location.

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The number of people sick from salmonella-tainted tomatoes jumped to 228 in 23 states Thursday as the government learned of five dozen previously unknown cases and said it is possible the food poisoning contributed to a cancer patient's death.

Twenty-five people have been hospitalized as a result of the U.S. outbreak, which has been linked to raw plum, Roma and round tomatoes.

The Food and Drug Administration has not pinpointed the source of the outbreak. With the latest known illness striking on June 1, officials also are not sure if all the tainted tomatoes are off the market.

The FDA's food safety chief, Dr. David Acheson, said,

"As long as we are continuing to see new cases come on board, it is a concern that there are still contaminated tomatoes out there."

The FDA is directing consumers to its Web site — http://www.fda.gov — for updated lists of the safe regions.

Also safe are grape tomatoes, cherry tomatoes and tomatoes sold with the vine still attached. That is not because there is anything biologically safer about those with a vine but because the sick have assured investigators that is not the kind of tomato they ate.

What if you did not go to the store armed with a list, or the store or restaurant manager cannot assure that any plum, Roma or round tomatoes came from safe regions?

"If you don't know, don't take the risk," Acheson said.

Cooking also kills salmonella, but the FDA is not formally advising people to cook suspect tomatoes for fear they will not get them heated thoroughly.

(The possibility also exists for cross-contamination during preparation -- dp).

Meanwhile, export-quality tomatoes labeled "Ready to Eat" in English flooded Mexico City markets on Thursday after a salmonella scare in the U.S. stopped them from crossing the border.

Associated Press reports that most consumers do not even know about the U.S. salmonella scare. And those who do, rarely care. Mexicans are accustomed to washing all produce because the vegetables sold on the national market are not held to the same standards as those certified for export.

Sergio Martinez, a 40-year-old bricklayer, said, "What the U.S. doesn't want is what we see here. They always send the best stuff over there, from avocados to tequila. What ends up here is second-rate. Almost all vegetables are contaminated with something because they water them with sewer water and put on a lot of chemicals."

Agriculture Secretary Alberto Cardenas told Televisa network Thursday, "The Mexican tomato is safer and cleaner than ever."

Even U.S. officials agree that certified Mexican exporters are among the safest in the world. Their fields are irrigated with fresh water, and their packing plants are staffed by workers covered head-to-toe in sterile clothing. Inspectors monitor the process at every step.

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During the 728 or so interviews I've done on tomatoes and Salmonella in the past week, a radio reporter in Calgary asked me, as did several other Canadian outlets,

"What is the Canadian Food Inspection Agency doing?"

"Nothing."

CFIA can speak for itself.

When asked if Canadians were safe from this outbreak, I said, maybe, depends on first figuring out where the contaminated tomatoes were grown, then depends on what was coming into Canada at that point in time.

That uncertainty would help explain why Canadian fast-food outlets pulled fresh tomatoes from their offerings -- at least until the source could be verified.

But, I added, even if someone did get sick, it would be difficult to notice because Canadian health surveillance sucks.

Apparently the Canadian Medical Association agrees, calling the system,

"a national embarrassment."

Dr. Kumanan Wilson writes in the Canadian Medical Association Journal that the Auditor General of Canada has warned 3 times, most recently in May, 2008, that Canada's failure to develop surveillance systems puts Canadians at risk.

In an accompanying editorial, Dr. Amir Attaran  of the University of Ottawa, writing on behalf of CMAJ's editorial team, calls upon the federal government to "legislate a way past the jurisdictional schisms" and make information regarding health epidemics readily available. Currently, "12 of 13 provinces are under no obligation to share information with the federal government or the rest of Canada during an outbreak," writes Dr. Attaran. "We at CMAJ believe this is a national embarrassment."

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Rebekah Denn of Seattlepi.com, a barfblog.com fan (see below), writes,

With a tomato-related salmonella outbreak in 16 states, the Neighborhood Farmers Market Association got this interesting question:

"Are tomatoes from the University District farmer's market safe to eat, given the FDA's recent warning about tomatoes & salmonella?"

The F.D.A. has linked the nasty illness to raw red plum, red Roma and round red tomatoes. The feds say it's OK to eat those varieties if they're sourced from regions that are not associated with the outbreak, clearing tomatoes from places like California and Canada. Washington did not make the all-clear-as-far-as-we-know list.

The market association is checking in with its greenhouse growers on the topic, and sent out this reply to the query:

"Yes, our local farm tomatoes are definitely safe. The outbreak is likely due to the wide use of some kind of composting medium on big factory farms that was contaminated - but none of our market farmers are connected in any way to those kinds of operations. In fact, the tomatoes at the markets right now are all hothouse tomatoes, which makes them even safer, as they are grown in wood bark. Also, our farmers are mostly growing heirloom varieties, both in their hothouses and in their fields.

The FDA Web site also notes that homegrown tomatoes are safe. Our market farmers are essentially growing homegrown tomatoes: they are not huge operations but rather smaller family farms, using safe, healthy and sustainable growing methods. These farmers live on their farms, pick the harvest themselves and eat the food they grow as well as selling it to local markets."

I checked in with Doug Powell, associate professor and scientific director of the International Food Safety Network at Kansas State University -- but to me better known for "BarfBlog," an acerbic and opinionated and evidence-based blog on food safety.

His take on the farmer's market go-ahead? Not so fast. He wrote:

"Whether your produce comes from around the corner or around the globe, contamination must be prevented beginning on the farm. Ask your tomato supplier:

-- What do you do for food safety?
-- Do you or your suppliers test wash water for bacteria? Irrigation
water?
-- What soil amendments are being used?
-- Do you or your suppliers train your staff on handwashing?"

But wait! Aren't the farmer's markets at least safe from the current salmonella outbreak, I asked, if the farmers are truly growing different varieties than the ones identified with the problem?

Powell said yes, although there's no basis (yet, I say) for the speculation that big factory farms caused the problem. In general, though, when it comes to food safety, "there is no evidence that sustainable and local is safer."

But wouldn't outbreaks from small local farms at least be easier to contain and easier to track?

Maybe, Powell wrote, but it's a tough comparison to make. "We have no sense how often they happen because they are small and don't get picked up."

So, talk to the people who grow your produce. Ask them questions. The advantage of the farmer's markets is, at least at the markets you actually get that chance.

Barfblog: the acerbic and opinionated and evidence-based blog on food safety. I like that.

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"For lunch today I was forced to order a BLB sandwich, which is bacon, lettuce, and more bacon. I'm thinking of ditching the lettuce too, just to be safe."

Bada-bing.

Check out the clip below.

During last night's monologue on Jimmy Kimmel Live! Jimmy talks tomatoes, with an awesome public service announcement from the Broccoli Council at the end.

I'm all for marketing microbial food safety at retail.

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I just wrapped up a food safety talk at the World Congress for Processing Tomatoes. Delegates from 34 countries have converged in Toronto for meetings, mirth and merriment. The Salmonella in fresh tomatoes outbreak was up for discussion, but these are the processing folks -- it's all cooked.

This picture (right) was taken by in Cincinnati, Ohio, and posted on The Consumerist. Just weird.

And The Packer says today in an editorial that the source, not criticism, should be the top priority in outbreak.

Too vague. Too slow. Too aggressive.

All of the above criticisms may apply to the handling of the recent linkage of Salmonella Saintpaul to tomatoes by the Food and Drug Administration and various federal and state agencies.

Unfortunately, the criticisms are easy to level, but not so easy to apply in reality.
The FDA was too specific in warning consumers in Texas and New Mexico to avoid round red and roma tomatoes. Shouldn’t consumers in other states receive the warning? On the other hand, the warning was too vague. Many cocktail-style tomatoes are round and red. Many greenhouse tomatoes are round and red yet not sold on the vine, but the FDA was saying it was OK for consumers to eat tomatoes on the vine from greenhouses.

The New Mexico Department of Health was perhaps too aggressive June 4 in naming Mexico as the likely source of the product. At that time, the FDA stated it was impossible to say whether the tomatoes were domestic or imported.

And because the foodborne illnesses occurred over so long a stretch, the tomatoes very likely did not come from one single grower. There is a possibility they were contaminated somewhere along the supply chain.

Yet, despite the rush to a conclusion, there is legitimate criticism that parties have acted too slowly. This situation affects the entire tomato category. By extension, it affects products that are used with tomatoes, such as fresh basil and some salad items. A lot of people will lose a lot of money over this.
In outbreaks that decimate a category, it’s absolutely imperative to say the right thing at the right time.

There needs to be better coordination between state and national organizations. The overseeing parties must work closely with both the growing community and retailers to ensure that public comments do not unintentionally mislead consumers or create false perceptions.

The utmost importance is finding the source. Until then, all handlers are presumed guilty and suffer the consequences of lower sales.

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The Los Angeles Times reports that fast-food chains Taco Bell Corp. and Chipotle Mexican Grill Inc. have, in addition to McDonald's and others, stopped serving certain tomatoes. Same with supermarket chains Ralphs, Vons and Albertsons, which stopped selling red plum, red Roma or round red tomatoes cited by the FDA.

Elizabeth Weise of USA Today reported this morning that simply washing tomatoes can help, but it won't necessarily remove the salmonella bacteria, because when tomatoes are picked on very hot days and put into cold water to chill, salmonella on their surface can be drawn up into the fruit.

David Acheson, director of the FDA's Food Safety and Security Staff, said that doesn't mean the public should stop washing produce, adding, "If there is surface contamination, washing is going to help remove it."

Below is a  photo from the Tampa Tribune of a Burger King at Kennedy and West Shore boulevards, indicateing it's not serving tomatoes.

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Doug and I are attending TrainCan's Food Safety Forum in Toronto today.  The topic of the conference is all around food safety culture and changing behaviour -- which fits really well with the iFSN infosheets.

In a response to an outbreak of Salmonella linked to certain types of raw tomatoes in the U.S., food service and grocery firms across North America have withdrawn tomatoes from their sites and meals.  The outbreak provided us with the focus of this week's infosheet, which can be found here.

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The U.S. Food and Drug Administration is expanding its warning to consumers nationwide that a salmonellosis outbreak has been linked to consumption of certain raw red plum, red Roma, and red round tomatoes, and products containing these raw, red tomatoes.

FDA recommends that consumers not eat raw red Roma, raw red plum, raw red round tomatoes, or products that contain these types of raw red tomatoes unless the tomatoes are from the sources listed below.

If unsure of where tomatoes are grown or harvested, consumers are encouraged to contact the store where the tomato purchase was made. Consumers should continue to eat cherry tomatoes, grape tomatoes, and tomatoes sold with the vine still attached, or tomatoes grown at home.

On June 5, using traceback and other distribution pattern information, FDA published a list of states, territories, and countries where tomatoes are grown and harvested which have not been associated with this outbreak. This updated list includes: Arkansas, California, Georgia, North Carolina, South Carolina, Tennessee, Texas, Belgium, Canada, Dominican Republic, Guatemala, Israel, Netherlands, and Puerto Rico. The list is available at www.fda.gov/oc/opacom/hottopics/tomatoes.html#retailers. This list will be updated as more information becomes available.

FDA recommends that retailers, restaurateurs, and food service operators not offer for sale and service raw red Roma, raw red plum, and raw red round tomatoes unless they are from the sources listed above. Cherry tomatoes, grape tomatoes, and tomatoes sold with the vine still attached, may continue to be offered from any source.

Since mid April, there have been 145 reported cases of salmonellosis caused by Salmonella Saintpaul nationwide, including at least 23 hospitalizations. States reporting illnesses linked to the outbreak include: Arizona, California, Colorado, Connecticut, Idaho, Illinois, Indiana, Kansas, New Mexico, Oklahoma, Oregon, Texas, Utah, Virginia, Washington, and Wisconsin. Salmonella Saintpaul is an uncommon type of Salmonella.

As I've said, food safety for fresh produce begins on the farm and goes right through to the fork.

Fresh fruits and vegetables are the most significant sources of
foodborne illness today in the United States, and because fresh produce is
not cooked, anything that comes into contact is a possible source of contamination.

Wash water, irrigation water, manure in soil, even contact with animals or humans, can introduce dangerous microorganisms onto fresh produce. There is evidence that bacteria like Salmonella and E. coli can enter fruit like tomatoes and cantaloupes, and leafy greens such as spinach and lettuce, making removal extremely difficult.

The farm is the first line of defense.  Whether your produce comes from around the corner or around the globe, contamination must be prevented on the farm.

A brief review of pathogens in produce is available at:
http://tinyurl.com/6ypdad

A table of tomato-related North American outbreaks is available at:
http://tinyurl.com/6oqv67

A table of known outbreaks of verotoxigenic E. coli -- including but not
limited to E. coli O157:H7 -- associated with fresh spinach and lettuce
is available at: http://tinyurl.com/586azl

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The Dallas Morning News reports that Texas and New Mexico now claim 104 of the 138 cases of Salmonella Saintpaul related to tomatoes in 11 U.S. States. At least 19 people from the two states have been hospitalized. No deaths have been reported.

The U.S. Food and Drug Administration said that tomatoes grown in Texas, California, Georgia, North Carolina and South Carolina appear to be blameless. Those imported from Belgium, Canada, Dominican Republic, Guatemala, Israel, the Netherlands and Puerto Rico also did not appear to be the source.

The FDA said preliminary investigations suggest that raw red plum, red Roma or round red tomatoes are the source of the problem.

Meanwhile, the Washington Health Department said an E. coli outbreak that sickened at least nine people in Pierce and Thurston counties is apparently over and that there have been no new cases since May 29.

A spokesman, Donn Moyer, said the infection apparently came from romaine lettuce that was served at schools or restaurants. Moyer says health officials haven't been able to identify the source for sure, although the Food and Drug Administration is still investigating.

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A total of 11 states, which now include Wisconsin, Virginia and Kansas, have confirmed 112 cases of Salmonella Saintpaul and of those cases, 83 were reported in Texas and New Mexico.

The U.S. Food and Drug Administration said preliminary investigations suggest that raw red plum, red Roma or round red tomatoes are to blame.

The agency advised residents of Texas and New Mexico to only eat tomatoes that haven’t been connected to the outbreak, including homegrown, cherry and grape tomatoes as well as those sold attached to the vine.

They also reminded consumers that fresh salsa, guacamole, pico de gallo and other products may contain raw tomatoes.

Albertsons has joined Kroger and Central Market in pulling tomatoes from its shelves.

New Mexico Environment Secretary Ron Curry said Thursday in a statement,

"The department's food program bureau is contacting distributors of tomatoes to ensure they notify food establishments to stop serving tomatoes suspected in making people sick."

KRIS 6 News in Corpus Christi, Texas, conducted a random phone survey Wednesday afternoon, and found tomatoes are temporarily not on the menu at Subway, La Playa, Olive Garden, Water Street Restaurants, and Schlotzky's.

However, tomatoes are still being served at TGI Friday's, Fuddrucker's, Katz 21, Nolan's Poorboys, McDonald's, Mimi's by the Sea, Whataburger, and Wallbangers.

Reuters reported that even pork bellies are feeling the pressure, as prices fell $4 to $15 per hundredweight in the cash markets on Thursday. The bacon for BLT sandwiches is sliced from pork bellies.

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The AFP is reporting today that “real” camembert makers can rejoice. In addition to reducing the geographic boundaries of the camembert region, now the only camembert makers that will be recognized with the prestigious AOC (appellation d’origine contrôlée) label will:

-    use only raw milk;
-    have at least half of the cows providing the milk from Normandy origin; and,
-    ensure that their cows graze on Normandy pastures for at least 6 months of the year and fed hay the remainder of the time.

The grazing restrictions are new to the AOC conditions. I find them particularly surprising as research has shown that grass-fed or not, all cows can carry E. coli O157:H7.

The “real camembert” supporters apparently found the decision to be “undeniable progress.” Lactalis and Isigny-Sainte-Mère, two large companies that previously produced more than 80% of AOC Camembert, decided last year to begin heat-treating their milk as a safety measure.

Francophiles, can read today's original story for themselves. The French clearly articulate that the raw milk camembert has a velvety taste compared to the pasteurized version, but that the traditional methods are more onerous because they require various testing measures to avoid pathogens such as listeria. According to my favorite food safety advisor, you cannot test your way to safe food. The new and improved camembert will have enhanced risks.

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Farmers Guardian is reporting that UK government veterinarians, in the interest of an open and frank discussion, have been told to sit quietly and not express their views on whether badgers should be culled to control bovine TB -- unless their opinion agrees with whatever the government decides to do.

In a circular email, seen by Farmers Guardian, the Defra agency has told all its staff that a major announcement from Defra on TB policy, including the decision on badger culling, is expected ‘within the next few weeks’.

The message, sent by Animal Health field services director Andy Foxcroft, says it is ‘essential that all members of Animal Health are seen to support Government policy’ whatever decision is made, stating, “I appreciate that this maybe challenging, given the strong views some of our customers groups hold about the issues. However, I know that you will appreciate that it is critical. Therefore, all Animal Health staff who come into contact with customers, either by telephone or in person, will be expected to not express any disagreement with the Defra position on TB strategy at any stage."

A former state vet, who  asked to remain anonymous, said old colleagues were ‘surprised’ by the email that smacked of ‘paranoia.’

An Animal Health spokeswoman said the agency had "taken the opportunity to remind our staff of the need to support" Defra policy, whatever decision is made in order ‘to ensure there is no confusion."

"Farmers need one clear message on the position on bTB."

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An investigation commissioned by the Chartered Institute for Environmental Health (CIEH) Wales found that one in five samples of ice tested from hotels and pubs in Cardiff and the Vale of Glamorgan were contaminated with fecal matter -- probably because staff are not washing their hands before serving customers ice in their drinks.

Julie Barratt, director of the CIEH in Wales, said,

“The results of the survey give us cause for concern. Although realistically there is little likelihood of food poisoning from the levels of bacteria that were found, the presence of fecal bacteria shows that the people handing the ice have very poor standards of personal hygiene. While the ice may pose little risk the same may not be true for other foodstuffs that they may also handle. Food business operators and food handlers need to recognise that ice is a food product and treat it in the same way as all other foods prepared for sale to the public.”

The Chartered Institute for Environment Health in Wales has put together these tips for when asking for ice in a drink:

• if the ice is in a bucket on the bar where anyone can lean over it or cough or sneeze on it, don’t have it;

• if the bar tender takes the ice out of the bucket with their hands, don’t have it;

• if the bar tender pushes a glass down into the ice and their hands come into contact with it, don’t have it;

• if the scoop or tongs for handling the ice are not stored properly, don’t have the ice – you wouldn’t chose to have meat cut with a dirty knife;

• if you can see the ice machine, and it looks grubby, don’t have the ice that comes from it; and,

• if the ice bucket looks dirty, don’t have the ice that comes out of it.

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The U.S. Centers for Disease Control has just issued a statement about the ongoing outbreak of Salmonella St. Paul

"An epidemiologic investigation conducted by the New Mexico and Texas Departments of Health and the Indian Health Service using interviews comparing foods eaten by ill and well persons has identified consumption of raw tomatoes as the likely source of the illnesses in New Mexico and Texas. The specific type and source of tomatoes are under investigation; however, preliminary data suggest that large tomatoes, including Roma and red round are the source.

Since late April, 40 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in Texas (21 persons) and New Mexico (19 persons). The New Mexico Department of Health is investigating 17 additional Salmonella Saintpaul illnesses. These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization. Among the 38 persons who have been interviewed, illnesses began between April 23 and May 27, 2008. Patients range in age from 3 to 82 years; 48% are female. At least 17 persons were hospitalized. No deaths have been reported."

Advice to consumers
In New Mexico and Texas, until the source of the implicated tomatoes is determined,

    persons with increased risk of severe infection, including infants, elderly persons, and those with     impaired immune systems, should not eat raw Roma or red round tomatoes other than those sold     attached to the vine or grown at home, and
    persons who want to reduce their risk of Salmonella infection can avoid consuming raw Roma or     red round tomatoes other than those sold attached to the vine or grown at home.

 • Avoid purchasing bruised or damaged tomatoes and discard any that appear spoiled.
• Thoroughly wash all tomatoes under running water.
• Refrigerate within 2 hours or discard cut, peeled, or cooked tomatoes.
• Keep tomatoes that will be consumed raw separate from raw meats, raw seafood, and raw produce items.
• Wash cutting boards, dishes, utensils, and counter tops with hot water and soap when switching between types of food products.
You can check the CDC and FDA websites for updates on this investigation and changes in recommendations.

A table of tomato-related North American outbreaks is available at
http://www.foodsafety.ksu.edu/en/article-details.php?a=3&c=32&sc=419&id=953.

Tomatoes are one type of fresh produce where it appears pathogens like Salmonella can be internalized, which means washing is of little use. The problems need to be prevented on the farm. Regulators and the industry in the past have released food safety guidelines for tomatoes, but there is a lack of verification; it is unclear if all growers are actually following the guidelines.

Guidelines are a first step, but more creative ways are required to compel everyone, from the person harvesting to the person distributing, to take food safety seriously, even in the absence of an outbreak.

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The practice of people eating insects, that is.

The New Zealand Herald reports that scientists at the National Autonomous University of Mexico have catalogued 1,700 different species and found that bugs are eaten in at least 113 countries worldwide.

David George Gordon, a Seattle-based naturalist and author, said,

"Insects are the most valuable, underused and delicious animals in the world,"  and the West "is one the few cultures" that doesn't eat them. "Maybe we are the weirdos."

A plate of maguey worms - larvae of a giant butterfly - sell for NZ$31.50 in smart Mexican restaurants (right).

Sago grubs wrapped in banana leaves are a delicacy in Papua New Guinea.

Large leafcutter ants are popular in Colombia.

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The Canadian Food Inspection Agency (CFIA) is warning the public not to consume the KingFisher brand cantaloupes described below because these cantaloupes may be contaminated with Salmonella. 

The affected cantaloupes, produce of the United States, were distributed under KingFisher brand name in cartons containing 6 or 9 cantaloupes.  The individual cantaloupes may have a sticker with the following information:

KingFisher Brand
Produce of USA
UPC : 0 33383 11600 6
#4050
Fisher Ranch Corp., Blythe, CA, 92225

These cantaloupes were distributed in Ontario and sold from May 16 up to and including June 2, 2008.

Consumers who have purchased whole cantaloupes or in-store products containing pieces of fresh cantaloupes and are not sure of the brand should inquire at the place of purchase to verify if the stores have received the affected product.

There have been no reported illnesses associated with the consumption of these cantaloupes.

A table of U.S. outbreaks related to the consumption of cantaloupe is available at: http://www.foodsafety.ksu.edu/articles/1183/cantaloupe_outbreaks_.pdf. We also have preparation tips at http://barfblog.foodsafety.ksu.edu/2008/04/articles/salmonella/safely-preparing-cantaloupe/.

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I'm an advocate for asking questions.

Where was that fresh produce grown? What temperature is medium-rare? Did the cook wash his hands after going to the bathroom?

I also recognize that most people -- including me -- feel socially awkward asking such questions.

So, would you ask your doctor if he has washed his hands?

That's what Carmela Fragomeni of The Hamilton Spectator in Canada asked this morning.

Hamilton resident Maria Pimentel says,

"I'm not comfortable to ask him because maybe he'd get upset."

Linda VanRysell believes doctors would always automatically be washing their hands before examining a patient, stating,

"I assume they're professional."


Dr. David Higgins, chief of staff at St. Joe's in Hamilton, said if he were to fail to wash his hands, he hopes patients would called him on it, adding,

"I should thank the person for doing it. That's the ideal culture."

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Information about risk -- specifically the microbiological risks in food and water -- needs to be rapid, reliable, relevant and repeated. Often those with the most information and the most credibility in an outbreak situation are the local medical officers of health, or some other government-type.

And they often don't say much.

But there are examples of officials doing their jobs and being accountable to the public they serve. In the aftermath of the first case of homegrown bovine spongiform encephalopathy in Canada in May, 2003, Brian Evans, the chief veterinarian for the government of Canada, did an excellent job of explaining here's what we know, here's what we don't know, here's what we're doing to find out more, and whatever we find out, you'll hear it from me first.

Two public health officials have stepped out in the past two days and offered their analysis on a couple of persistent health risks: raw milk and parasites in swimming pools.

Yesterday, Dr. Stephen Ostroff, director, Bureau of Epidemiology, Pennsylvania Department of Health, wrote in the Lebanon Daily News that,

"In light of recent discussions pertaining to raw-milk health issues, the Pennsylvania Department of Health continues to advise consumers that raw milk is an inherently unsafe product regardless of how it is produced. While the permitting process unquestionably enhances the safety margin of raw milk, and we strongly endorse this program, it is not a substitute for milk pasteurization.…

Last year, an outbreak of salmonellosis due to consumption of raw milk sold in south-central Pennsylvania produced 29 illnesses. Sadly, many of the victims were children who had no choice in the kind of milk their parents purchased for them. Indeed, the department is currently investigating another raw-milk-associated outbreak of campylobacter infections. So far, more than 54 illnesses have been reported.

While standard hygiene and production practices can reduce the risk from consuming raw milk, they simply cannot eliminate it. In a 2006 survey of Pennsylvania dairy farms, pathogens were found in 13 percent of bulk tank raw-milk samples. Therefore, the department believes it is necessary to warn consumers about the risks associated with raw milk and to urge persons with immune disorders, pregnant women and young children to avoid consuming this product in the interest of protecting the public’s health."

Today, David N. Sundwall, executive director of the Utah Department of Health, wrote in The Salt Lake Tribune that,

"The UDOH, along with our partners at Utah's local health departments, carefully considered whether to restrict young children from pools. Young children are more likely to become ill from crypto and more likely to leave poop in the pool. While it might seem like common sense to ban them, we cannot say that they caused the outbreak or that banning them would prevent another one.
Children have been swimming in public pools in Utah in past years when outbreaks didn't occur. To our knowledge, no state bans children from public pools. Older children and adults, who have control of their bowels when healthy, are also susceptible to "leaking" if they swim with diarrhea.

We chose to continue to allow children to swim with swim diapers and waterproof swim pants. We believe this will help prevent contamination of the pool, but it isn't foolproof.

Parents of young children need to act responsibly and with common sense. They need to monitor their children and give them frequent potty breaks. Most important, they need to keep them out of the pools when they are ill with diarrhea and for two weeks afterward.

The UDOH takes seriously its responsibility to protect people from health threats like cryptosporidium. After last summer's outbreak, we considered multiple measures to help prevent a recurrence this summer. Preventing crypto transmission will require a combination of changes at pools and changes in behavior."

Both Ostroff and Sundwall are too be commended. You may not agree with what they say, but at least you know why they came to the positions they advocate. Public health types, please speak out.

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