Missouri health types have been notified of a suspected foodborne illness in the St. Louis metro area with 14 cases in the past 24 hours.

The Missouri Department of Health and Senior Services is assisting local health officials in the investigation, that includes testing for E. coli at the State Public Health Laboratory in Jefferson City, which has notified the Centers for Disease Control and Prevention in Atlanta.

Details are trickling out about the death of Jasper County, Missouri, resident from E. coli last week.

The Joplin Globe reports this morning that a food or a beverage served at a Thanksgiving dinner is the apparent source of an E. coli outbreak that killed a 51-year-old Carthage woman and sickened several other people.

Tony Moehr, director of the Jasper County Health Department, said,

“We have two confirmed cases of E. coli O157:H7 in Jasper County. One of the cases resulted in a death.”

Moehr said a third confirmed case of the bacterial infection has been reported in Dade County and involves someone who attended the Thanksgiving dinner.

“It appears the cases are related to a family gathering for Thanksgiving on Nov. 27,” he said. “We have identified seven or eight additional illnesses related to that gathering, but we don’t have the test results back for them. These cases occurred around the same period of time but were not as severe.”

It is believed that 11 of the 24 people who attended the event became ill.

The department, Moehr said, did not issue a press release about the E. coli death because the incident was associated with a family gathering and did not pose a threat to the public.

Continuing the weird-things-people-do-with-food theme, doctors are warning people not to eat raw crayfish.

Physicians at Washington University School of Medicine in St. Louis have diagnosed a rare parasitic infection in six people who had consumed raw crayfish from streams and rivers in Missouri. The cases occurred over the past three years, but three have been diagnosed since last September; the latest in April. Before these six, only seven such cases had ever been reported in North America, where the parasite, Paragonimus kellicotti, is common in crayfish.

"The infection, called paragonimiasis, is very rare, so it's extremely unusual to see this many cases in one medical center in a relatively short period of time," says Washington University infectious diseases specialist Gary Weil, MD, professor of medicine and of molecular microbiology, who treated some of the patients. "We are almost certain there are other people out there with the infection who haven't been diagnosed. That's why we want to get the word out."

Paragonimiasis causes fever, cough, chest pain, shortness of breath and extreme fatigue. The infection is generally not fatal, and it is easily treated if properly diagnosed. But the illness is so unusual that most doctors are not aware of it.

The half-inch, oval-shaped parasitic worms at the root of the infection primarily travel from the intestine to the lungs. They also can migrate to the brain, causing severe headaches or vision problems, or under the skin, appearing as small, moving nodules.

The recent infections, which occurred in patients ages 10-32, have prompted the Missouri Department of Health & Senior Services to issue a health advisory alerting doctors across the state. The department also printed posters warning people not to eat raw crayfish and placed them in campgrounds and canoe rental businesses near popular Missouri streams. Thoroughly cooking crayfish kills the parasite and does not pose a health risk.

Paragonimiasis is far more common in East Asia, where many thousands of cases are diagnosed annually in people who consume raw or undercooked crab that contain Paragonimus westermani, a cousin to the parasite in North American crayfish.

The crayfish is the State Invertebrate of Missouri. I’m not making this up.

My friend Jorge Hernandez and I both spoke at the Missouri Milk, Food and Environmental Health Association annual meeting in Columbia, Missouri on April 2, 2010.

We never plan these things because we’re both busy – Jorge in his crisp, tailored suit, talking about all the meals U.S. Foodservice serves in a day, me looking ever more rumpled and frumpy as I evolve into the professor’s outfit of patches on the elbows of the corduroy suit jacket in my future. But our talks were surprisingly complimentary. Jorge (right, not exactly as shown) with his self-deprecating Mexican jokes, me just looking weird.

Jorge took a similar message to the Conference for Food Protection meeting in Rhode Island this week, calling for the creation of integrated food safety cultures within the farm-to-fork food safety system.

“The best way to ensure the right food safety and HACCP behaviors from employees, suppliers, and customers is to make sure there are clear benefits and rewards for excellence,” said Hernandez, U.S. Foodservice’s senior vice president, food safety and quality assurance. “A culture of continuous improvement must be developed at all levels of the food chain.”

Jorge gets it, which is good considering the number of safe meals US Foodservice provides on a daily basis. He also likes to say, trust, but verify, which is appropriately apt when dealing with food safety.

I’m not sure John Coyne, vice-president of legal and corporate affairs for Unilever Canada gets it. He told a recent symposium,

"We are not just in the protection business, we are in the anticipation business. … (The) 2008 listeria event shook our entire industry; going forward, if we fail to anticipate food safety risks, it will be at our peril” and he encouraged companies to adopt a "culture of courage" when it comes to food safety.

The 22 people who died in the Canadian listeria outbreak were not an event: they were a preventable tragedy. Have the courage to call it accurately, Coyne. When I was in Missouri earlier this month I asked the audience of sanitarians, didn’t the nursing homes where all these Canadians died have dieticians and how brilliant was it to be giving immuno-compromised elderly folks cold-cuts that were a known listeria risk? A woman interjected and stated,

“I’m a dietician.”

“OK”

“We got one hour of food safety training.”

“Is that god or bad?”

“It’s awful.”