The risk may be small, but the failures are tragic.

Governments routinely warn that immunocompromised people, including expectant mothers and the elderly, should refrain from certain ready-to-eat refrigerated foods like deli meats and smoked salmon because of the risk of listeriosis.

Elizabeth Weise writes in today’s USA Today that the U.S. Centers for Disease Control and Prevention has been saying for at least 11 years now that people over 50 and especially those over 65 should avoid hot dogs, lunch meats, cold cuts and other deli meats unless they are reheated to 165 degrees — "steaming hot" in CDC's words.

The government also says you shouldn't keep an open package of sliced deli meat more than five days, all to reduce the risk of infection from a bacteria called listeria. But some question whether the country's been paying attention.

Barbara Resnick, incoming president of the American Geriatrics Society and a professor of nursing at the University of Maryland, knows of no one over that age who heats deli meats to that level and says she's never seen a case of listeriosis in a patient.

Neil Gaffney, spokesman for the U.S. Department of Agriculture's Food Safety Inspection Service said, "When it comes to food safety, we're serious: People at risk for listeriosis should not eat hot dogs, luncheon meats or deli meats unless they are reheated until steaming hot. Thoroughly reheating food can help kill any bacteria that might be present. If you cannot reheat these foods, do not eat them."

Mike Doyle, a professor of food microbiology at the University of Georgia said about 85% of listeriosis cases are linked to cold cuts or deli meats, and that today almost all packaged lunch meats contain either added sodium lactate, an acid formed by fermentation, or potassium lactate, fermented from sugar, as antimicrobials. That's what he looks for when he buys cold cuts.

And based on FSIS risk-assessment data, meats sliced at the store pose a greater risk than meats pre-sliced at federally inspected establishments

Listeria and cold cuts were ranked just last week as the third worst combination of a food and a pathogen in terms of the burden they place on public health, costing $1.1 billion a year in medical costs and lost work days, according to a study by the University of Florida's Emerging Pathogen Institute.

Douglas Powell a professor of food safety at Kansas State University, said, "And you can't see, taste or smell that it's there.”

CDC also says don't keep opened packages of lunch meat, or meat sliced at the local deli, for longer than three to five days. That's another one no one pays attention to, says Kansas' Powell.

"Anecdotally, lots of people keep cold cuts in their refrigerator far longer than they should. People keep them for one to two weeks. That's the key message. If you get it from the deli counter, four days max."

What wasn’t included in the story is evidence of listeria-related tragedies in other countries – countries that may not have approved those listeria-restraining additives.

Twenty-three elderly people died in Canada in 2008 after eating listeria-laden cold-cuts from Maple Leaf Foods. Later that year, listeria in soft cheese in Quebec led to 38 hospitalizations, of which 13 were pregnant and gave birth prematurely. Two adults died and there were 13 perinatal deaths.

The New South Wales Food Authority said last month the Authority provides information on listeria to pregnant women to allow them to make an informed food choice regarding the risk and how to minimize it. It is not to say that every piece of deli meat has Listeria on it, but some foods have a higher potential rate of contamination than others, and it is better to avoid them.

The risk of acquiring listeriosis is low. However the consequences for a pregnant woman contracting listeriosis are dire.

While the Authority may be accused of ‘being over the top’, we may also be accused of neglecting pregnant women if we did not provide this information so pregnant women could make informed choices in what they eat.

Over the last 5 years in Australia there have been between 4 and 14 cases of listeriosis diagnosed in pregnant women or their babies each year. These infections have resulted in the deaths of 8 fetuses or newborn babies.

Chapman is here in Manhattan (Kansas) for a couple days, delivering a seminar later today, hanging out at the Missouri-Kansas State football game tomorrow, and primarily helping plot our research and extension activities for the next few years.

We’ve both sired offspring in the past year-and-a-bit, so the issue of listeria and pregnant women has been a recurring theme – on barfblog.com, in research proposals, and in our microbiological nerd discussions.

Researchers from the University of Georgia reported in the journal, Risk Analysis, this month, that pregnant women may get ill from Listeria at lower doses than previously thought.

The risk of fetal or infant mortality among pregnant women who consume food containing 1 million cells of the food-borne pathogen Listeria monocytogenes in soft cheeses and other food is estimated at about 50 percent, suggesting five stillbirths potentially could occur when 10 pregnant women are exposed to that amount.

A previous risk assessment estimated more than 10 trillion cells would result in stillbirths to 50 percent of pregnant women exposed, researchers said.

"We're not saying there's a new epidemic here, we're suggesting we've come up with a more accurate method of measuring the risk and how this deadly bacteria impacts humans, especially the most medically vulnerable among us," study co-author Mary Alice Smith of the University of Georgia said in a statement.

When estimates are extrapolated from data in tests on laboratory animals, the results showed "Listeriosis is likely occurring from exposure to lower doses than previously estimated," Smith said.

That’s a convoluted way of saying Listeria happens, and it’s probably more deadly than anyone thought for developing babies. Given the ridiculously low levels of awareness amongst physicians, health professionals and expectant mothers, new messages using a variety of media are needed so parents-to-be are at least aware of the risks of certain refrigerated, ready-to-eat foods.

The Centers for Disease Control and Prevention (CDC) has estimated approximately 2,500 cases of Listeriosis occur annually in the United States, with about 500 cases resulting in death. In 2000, Listeria exposure resulted in a higher rate of hospitalization than any other food-borne pathogen and more than one-third of reported deaths from food pathogens, the CDC says.
 

“Hot water for handwashing has not been proved to remove germs better than cold water.”

That’s the conclusion of The Claim column in tomorrow’s N.Y. Times science section.

We’ve been saying for a couple of years that water temperature is not a critical factor -- water hot enough to kill dangerous bacteria and viruses would scald hands -- so use whatever is comfortable. Warmer water may be better at removing oils and stuff, but not the things that make people sick.

The Times story says,

In its medical literature, the Food and Drug Administration states that hot water comfortable enough for washing hands is not hot enough to kill bacteria, but is more effective than cold water because it removes oils from the hand that can harbor bacteria.

But in a 2005 report in the Journal of Occupational and Environmental Medicine, scientists with the Joint Bank Group/Fund Health Services Department pointed out that in studies in which subjects had their hands contaminated, and then were instructed to wash and rinse with soap for 25 seconds using water with temperatures ranging from 40 degrees Fahrenheit to 120 degrees, the various temperatures had “no effect on transient or resident bacterial reduction.”

They found no evidence that hot water had any benefit, and noted that it might increase the “irritant capacity” of some soaps, causing contact dermatitis.

“Temperature of water used for hand washing should not be guided by antibacterial effects but comfort,” they wrote, “which is in the tepid to warm temperature range. The usage of tepid water instead of hot water also has economic benefits.”
 

While the websphere, blogsphere and twittersphere were ejaculating electrons about the potential passage of new food safety legislation by the U.S. House– it passed -- I was hanging out with some food safety dudes at Publix supermarkets HQ in Lakeland, Florida.

And I saw far more in Lakeland that would impact daily food safety than anything the politicians, bureaucrats, hangers-on and chatting classes could ever come up with.

When it comes to the safety of the food supply, I generally ignore the chatter from Washington, as well as the wasted Internet commentaries and conspiracy theories. If a proposal does emerge, such as the creation of a single food inspection agency, or the bill that passed the House today – and just the House -- I ask, Will it actually make food safer? Will fewer people get sick?

As the General Accounting Office pointed out in a report a year ago,

“The burden for food safety in most of the selected countries lies primarily with food producers, rather than with inspectors, although inspectors play an active role in overseeing compliance. This principle applies to both domestic and imported products.”

Publix, with over 1,000 supermarkets, its own processing plants, and thousands of food products moving through its shelves, can’t afford the luxury of chatter.

After my visit, I went to the local Publix in St. Pete Beach to check out what the food safety type said – sure, the boss knows food safety, but do the front-line staff?

I ordered some shaved smoked turkey breast from the deli, and the sealable bag the meat was delivered in contained the following:

“Publix Deli
The Publix Deli is committed to the highest quality fresh cold cuts & cheeses
Therefore we recommend all cold cuts are best if used within three days of purchase
And all cheese items are best if used within four days of purchase”

(The picture isn’t very good. Note to Publix: The label warning about shelf-life is a great idea, but can’t read it if the price sticker gets slapped over some of the text.)

This is the first time I’ve seen a retailer provide information to consumers on the accurate shelf-life of sliced deli meats. It didn’t require Congressional hearings; it didn’t require some hopelessly-flawed consumer education campaign; it required a food safety type to say, this is important, let’s do it.

I also went looking for some bread for turkey sandwiches tomorrow as we move down to Sarasota, and then Venice Beach. I asked an employee in the bakery for some whole wheat rolls, and she pointed out what was available, said packages of six were pre-packaged, but she could get me whatever number I wanted. I asked for four. There was no bin for me to stick my who-knows-where-they-have-been hands in to and retrieve a few rolls. The bins were turned so that only staff had access. The employee said it had been that way since she started three years ago, and that “there’s just too much stuff going around” to let consumers stick their hands into bun bins (most commonly found item in communal bun bins? False fingernails).

It’s nice that food safety is once again a Presidential priority and that politicians are trying to set a tone. But chatting doesn’t mean fewer sick people – actions do.