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

Butte County Health Officer Dr. Mark Lundberg said Thursday that the number of cases of E. coli amongst the 300 or so who attended a barbecue fundraiser Sept. 6 in Forest Ranch to benefit the volunteer fire department has grown to 13.

Action News reports,

One of the infected is a 6-year-old girl named Olivia.  She and her family have been sick for several days.  They learned of the E.coli outbreak on Action News at Eleven Wednesday night.  Thursday afternoon, Olivia was airlifted to U.C. Davis Medical Center in Sacramento where she will be cared for in the pediatric intensive care unit.  Her family says she was diagnosed with kidney decline, which could lead to kidney failure.

Olivia's mother, Kimberli Titus says she, her daughter and her mother have made three trips to the emergency room this week.  They have been extremely sick, and until seeing the story on Action News, they couldn't figure out what was wrong.  "She's weaker, and weaker every day and she can't even lift her head.  And she does not feel well."

The food for the BBQ was purchased from Cash-N-Carry in Chico. 

Health officials are still trying to determine what food made people sick. Among items on the menu at the barbecue were chicken, potato salad, beans, hot dogs, veggie burgers, chips and tri-tip, he said. People who became ill are being asked what they ate at the fundraiser.
 

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The U.S. Centers for Disease Control and Prevention report in the current issue of Morbidity and Mortality Weekly Report on Escherichia coli O157:H7 infections in children associated with raw milk and raw colostrum from cows -- California, 2006. Some highlights below:

On September 18, 2006, the California Department of Public Health (CDPH) was notified of two children hospitalized with hemolytic uremic syndrome (HUS). One of the patients had culture-confirmed Escherichia coli O157:H7 infection, and both patients had consumed raw (unpasteurized) cow milk in the week before illness onset. Four additional cases of E. coli O157:H7 infection in children who had consumed raw cow milk or raw cow colostrum produced by the same dairy were identified during the following 3 weeks. In California, intrastate sale of raw milk and raw colostrum is legal and regulated. This report summarizes the investigation of these cases by CDPH, the California Department of Food and Agriculture (CDFA), and four local health departments and subsequent actions to prevent illnesses. As a result of this and other outbreaks, California enacted legislation (AB 1735), which took effect January 1, 2008, setting a limit of 10 coliforms/mL for raw milk sold to consumers. Raw milk in several forms, including colostrum, remains a vehicle of serious enteric infections, even if the sale of raw milk is regulated.

Six cases were identified; four persons had culture-confirmed infections, one had a culture-confirmed infection and HUS, and one had HUS only. The median age of patients was 8 years (range: 6--18 years), and four of the patients (67%) were boys. The six cases identified during this investigation were geographically dispersed throughout California. All six patients reported bloody diarrhea; three (50%) were hospitalized. Illness onset occurred during September 6--24, 2006. Isolates from the five patients with culture-confirmed infections had indistinguishable pulsed-field gel electrophoresis (PFGE) patterns. The PFGE pattern was new to the PulseNet (the National Molecular Subtyping Network for Foodborne Disease) database and differed markedly from the pattern of the E. coli O157:H7 strain associated with a concurrent multistate outbreak linked to spinach consumption (1). Four of the five E. coli O157:H7 isolates were subtyped by multiple-locus variable-number tandem repeat analysis (MLVA) according to a protocol used by CDPH laboratory and were found to have closely related MLVA patterns (2).

Five of six patients reported they had consumed brand A raw dairy products in the week before their illness onset; the sixth patient denied drinking brand A raw milk, although his family routinely purchased it. Among the five patients who consumed brand A dairy products, two consumed raw whole milk, two consumed raw skim milk, and one consumed raw chocolate-flavored colostrum. Four of the five patients routinely drank raw milk from dairy A. One patient was exposed to brand A dairy product only once; he was served raw chocolate colostrum as a snack when visiting a friend. No other food item was commonly consumed by all six patients. No other illness was reported among household members who consumed brand A dairy products.

Using purchase information supplied by the patients' families, investigators determined that the patients consumed raw milk from lots produced at dairy A during September 3--13, 2006. Milk samples from these production dates were not available for testing. Fifty-six product samples from several lots with code dates of September 17, 2006, or later were retrieved from retails stores and dairy A and were tested for aerobic microflora, total coliform, fecal coliform, and E. coli O157:H7. The outbreak strain of E. coli O157:H7 was not found in any product samples. However, standard aerobic plate counts and coliform counts of collected samples with code dates of September 17 through October 9, 2006, were indicative of contamination. Colostrum samples had high standard plate counts and total coliform counts, and fecal coliform counts of 210--46,000 MPN/g. California standards limit standard plate counts for raw and pasteurized milk to 15,000 CFU/mL and total coliform counts for pasteurized milk to 10 coliform bacteria/mL. At the time of this outbreak, California did not have a coliform standard for milk sold raw to consumers. California also classifies colostrum as a dietary supplement, for which it has no microbiologic standards, rather than a milk product.

Raw milk from dairy A was the likely vehicle of transmission, but the exact mode of milk contamination in this outbreak was not determined.

Asymptomatic cows can harbor pathogens and cause human illness by shedding pathogens in untreated milk or milk products. These findings suggest that if raw milk had been subject to the same coliform standard as pasteurized milk in California, milk from dairy A might have been excluded from sale and this outbreak might have been averted.

From 1998 to May 2005, raw milk or raw milk products have been implicated in 45 foodborne illness outbreaks in the United States, accounting for more than 1,000 cases of illness (CDC, unpublished data, 2007). Because illnesses associated with raw milk continue to occur, additional efforts are needed to educate consumers and dairy farmers about illnesses associated with raw milk and raw colostrum. To reduce the risk for E. coli O157 and other infections, consumers should not drink raw milk or raw milk products.

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San Mateo County Director of Environmental Health Dean Peterson said that laboratory tests revealed Thursday that 62 of about 200 people attending a Redwood City-San Mateo County Chamber of Commerce event at Hotel Sofitel on Jan. 24 were infected with norovirus.

The Examiner reports that health officials had pinpointed either the salmon or chicken, which was served as the evening’s main courses, and that nobody who chose the vegetarian entrée fell sick. Contaminated workers could have been the source.

Inspectors found evidence that the Sofitel’s staff was re-using dirty towels to wipe down tables, food being kept too hot or too cold and a dishwasher who was touching clean dishes directly after touching dirty dishes. Hotel management immediately corrected the violations.

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After two salmonella outbreaks in 2001 and 2004 were traced to almonds from California farms, the Almond Board of California, the marketing agency for California's largest tree crop, decided to push for a regulation requiring nearly all almonds grown in the United States to go through a pasteurization process before they are passed on to consumers.

The new regulation applies to growers who sell more than 100 pounds per day to an entity, typically retailers and restaurants. Generally, farmer's markets and roadside stands will remain unaffected.

That exception is not enogh for some folks.  Vinicio Penate says that eating a raw almond is like eating the almond tree, stating,,

"All that strength, all that force, all that information, all the genetics. They're all there. They're just untouched."

Jean Chevalier of Taber Ranch in Yolo, whose almonds will now be pasteurized, called the regulation ridiculous, adding,

"I eat 'em raw right out of the field. I still have both legs and I'm not sick."

Judith Redmond, owner of Full Belly Farms in Capay Valley, who has grown organic almonds since 1985, said,

"The mode of industrial agriculture is that instead of addressing the cause, they deal with the problems.''

Apparently the cause is being a farm larger than an acre. And while we're all delighted to know that Chevalier still has both legs, those who have barfed on almonds in the past may prefer the pasteurization approach.

Almond board spokeswoman Marsha Venable said,

 "As an industry, we have our consumer's health and safety in mind."

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The Monterey County Herald is reporting tonight that two of the three lettuces in a Dole bagged salad mix recalled this week were grown in the Salinas Valley. If confirmed, it means that whatever shreds of credibility the California Leafy Greens Marketing Agreement had will vanish.

As it should.

Top-down approaches rarely work and require a lot of muscle to succeed -- and that isn't going to happen in the reality of competing government resources.

Politicos like Senator Tom Harkin or Congresswoman Rosa L. DeLauro (Conn.-3), and lobhyists like the Center for Science in the Public Interest can chatter all they want inside the Beltway but that isn't going to matter much in America's salad bowl. Especially on the farms, where E. coli O157:H7 contamination invariably begins.

Any hope that the safety of leafy greens will improve after 29 outbreaks over the past 15 years has nothing to do with calls for government inspections, new technology, or even pledges by growers to be extra super special careful. It can be found in the final report on the fall 2006 outbreak of E. coli O157:H7 in spinach (http://www.DHS.ca.gov), which sickened 205 and killed three

The first line of defense is the farm, not the consumer. Since 1998, American consumers have been told to FightBac, that is to fight the dangerous bacteria and virus and parasites found in a variety of foods, by cooking, cleaning, chilling and separating their food. Solid advice, but limited.

(Coincidentally, the FightBac folks were today congratulating themselves back in the Beltway on their consumer messaging -- yet, produce peanut butter and pet food are not consumer issues, just like the lettuce today.)

Fresh fruits and vegetables are good for us; we should eat more. Yet fresh fruits and vegetables are one of, if not the most significant source of foodborne illness today in North America. Because fresh produce is just that - fresh, and not cooked -- anything that comes into contact is a possible source of contamination. Every mouthful of fresh produce is an act of faith -- especially faith in the growers -- because once that E. coli O157:H7 or Salmonella gets on, or inside, spinach, lettuce, tomatoes, sprouts or melons, it is exceedingly difficult to remove.

In 2004, Salmonella-contaminated Roma tomatoes used in prepared sandwiches sold at Sheetz convenience stores throughout Pennsylvania sickened over 400 consumers. The FightBac folks told the public that, "In all cases, the first line of defense to reduce risk of contracting foodborne illness is to cook, clean, chill and separate."

Consumers were being told that when they stop by a convenience store and grab a ready-made sandwich, they should take it apart, grab the tomato slice, wash it, and reassemble the sandwich.
 
Which would have done nothing to remove the Salmonella inside the tomatoes. The fall 2006 outbreaks finally focused the buying public on the farm. Top-down approaches like audits and marketing agreements may appease worried buyers but do little to foster a culture on each and every farm that values microbiologically safe food.

The recommended best practices for growing safe produce need to be practiced every day on every farm. That was a key message out of the California report. New manuals, guidelines and plans are not required; what is essential is that farmers and their staff follow the already established good agricultural practices on a daily basis. Yes more research is important, yes there are new technologies to be utilized, but given that produce is being pooled from multiple growers at the packing shed, how can consumers be assured that every grower is doing what they say they are doing? Calls for mandatory government inspection is akin to mandatory restaurant inspection -- it sets a bare minimum standard, is a snapshot in time, and has little to do with future outbreaks of food poisoning.

Rules and regulations look pretty on paper. But they are not comforting to those 76 million Americans who get sick from the food and water they consume each and every year. Instead, every grower, packer, distributor, retailer and consumer needs to adopt a culture that actually values safe food.

Top down approaches to food safety are cumbersome and ineffective.

The first company that can assure consumers they aren't eating poop on spinach, lettuce, tomatoes and any other fresh produce, will make millions and capture markets.

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