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

Last Friday, U.S. regulatory types announced plans to increase testing of beef trim for E. coli O157:H7 and to strengthen safety protocols for fresh fruits and vegetables. The former got lots of attention, especially with a new Salmonella outbreak that has sickened dozens and is linked to ground beef; the latter, not so much.

Fresh fruits and vegetables are one of, if not the most, significant sources of foodborne illness today in the U.S. – and it’s been that way for over a decade. As consumers increase per capita consumption of fresh vegetables, methods of handling, processing, packaging and distributing produce locally and internationally are receiving more attention in terms of identifying and controlling microbiological, chemical and physical hazards.

That was essentially the prelude for FDA publishing its 1998 Guidance for Industry: Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables. We took those guidelines, as well as others, and created an on-farm food safety program for all 220 growers producing tomatoes and cucumbers under the Ontario Greenhouse Vegetable Growers banner. And set up a credible verification system.

So why did regulators and industry make such a big deal about commodity-specific guidelines for tomatoes, melons and leafy greens that were published in the federal register last Friday – in 2009?

I looked at the 2009 CSGs and the 1998 FDA guidance document – and I can’t see much of a difference in the on-farm stuf. Maybe I’m slow on the uptake; maybe guidelines are meaningless without implementation and verification; maybe growers keep asking for government babysitters so when the next outbreak happens, they can say, but we followed FDA guidelines (good luck with that). One of the notices said the draft guidances were FDA's first step toward setting enforceable standards for produce safety, so maybe it’s some lawmaking thing.

Tom Stenzel, president of the United Fresh Produce Association, said in a statement released July 31,

“Our industry has worked hard since 2004 to develop commodity-specific guidance documents in each of these areas, and now strongly supports FDA taking these efforts to a new level.”

2004? Why not 1998? And do the new and supposedly improved guidelines mean fewer sick people? No. Not unless an individual grower or groups of growers, or associations, take serious steps to implement and verify, something could have been done in 1998 and does not need government oversight. We did it – how hard can it be?

It’s not, and lots of growers do it on a daily basis. So maybe the talk from Washington was rightly shrugged off as no biggie.

But why did Health and Human Services Secretary Kathleen Sebelius, in making the announcement, choose to highlight the “vital role” consumers play in ensuring the safety of the fresh produce they eat and offer a laundry list of questionable food safety advice that would do little to reduce contamination of tomatoes, leafy greens and melons that happened in the field? Especially with all the caveats featured in the introduction to the tomato commodity-specific guide, included below.

This guidance is intended to assist domestic firms and foreign firms exporting tomatoes to the United States (U.S.) by recommending practices to minimize the microbial food safety hazards of their products throughout the entire tomato supply chain. It identifies some, but not all, of the preventive measures that these firms may take to minimize these food safety hazards. This guidance document is not intended to serve as an action plan for any specific operation but should be viewed as a start­ing point. We encourage each firm from the farm level through the retail or foodservice level to assess the recommendations in this guidance and tailor its food safety practices to its particular operations by developing its own food safety program based on an assessment of the potential hazards that may be associated with its operations.

In addition, effective management of food safety requires that responsibility be clearly established among the many parties involved in the production of fresh produce. There may be many different permutations of ownership and business arrangements during the growing, harvesting packing, processing, and distribution of fresh and fresh-cut tomatoes. For this reason, it is important to identify which responsibilities rest with which parties, and to ensure that these responsibilities are clearly defined. For example, growers commonly contract with third parties to harvest their crops. Also, it is important that growers clearly identify which party is responsible for each applicable provision of this guidance, such as providing adequate toilet and handwashing facilities and worker training. Approaches to addressing responsibilities include delegating them to individuals within the firm and formally addressing them in contractual agreements when third parties are involved. Each party should be aware of its responsibilities to ensure microbial food safety hazards for tomatoes are minimized at each stage of the supply chain.

The commodity specific guidelines are available for leafy greens, tomatoes and melons. Guidance, however, does not mean responsibility. That’s up to industry, and it begins on the farm.

 

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When I think Thunder Bay, Ontario in January, I think melons.

Ripe, juicy melons, like cantaloupe.

The Thunder Bay District Health Unit is investigating an increased number of Salmonella cases in Thunder Bay and District. Twenty-three cases of Salmonella have been reported since January of this year. We would normally expect approximately seven (7) cases in this time period.

Some cases have been linked to person-to-person transmission or travel and some are related to a North American outbreak being investigated by the Public Health Agency of Canada (PHAC). Six cases are still under investigation, but like most Salmonella cases, are likely related to unsafe food handling in the home. …

The outbreak under investigation by PHAC may be related to melons. Because melons grow at ground level, their rough and pitted outer skin can trap Salmonella bacteria from the soil. If the outer skin of a melon is contaminated, the fruit inside may be affected when the melon is cut. Follow these tips:

* Buy melons that are not bruised or damaged and store them in the fridge.
* Throw away any melon that is bruised or rotten.
* Wash all melons before cutting.  When cleaning a cantaloupe, brush the whole fruit under running water using a clean produce brush, getting into all the pits on the skin.
* Put cut melon on a clean plate; don’t put the pieces back on the cutting board.
* Don’t reuse any food equipment (e.g. knife, cutting board) used to prepare a melon.
* Wash all equipment with hot water and soap or clean them in the dishwasher.
* Store cut melon in a clean container in the fridge.

How is Salmonella in melons a consumer handling issue? Where is the data that says most Salmonella cases are related to unsafe food handling in the home? And why no notice from PHAC about an outbreak investigation?
 

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On March 22, 2008 the U.S. Food and Drug Administration advised consumers not to eat cantaloupes from a Honduran grower because they may have been contaminated with Salmonella.  The outbreak has so far caused over 50 illnesses in 16 states, and at least nine illnesses in Canada.  Warnings and recalls related to cantaloupes are common. This is largely due to their growing conditions and their porosity.

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

How can consumers enjoy cantaloupe without the burden of becoming sick?  The most important thing to do is to minimize the chances of contaminating the interior of the fruit.  This is done by preventing the rind from contaminating the inside of the cantaloupe, either by direct contact or by cross contamination.  There are different methods used for preparing a cantaloupe, but there is disagreement over which is the most effective technique.

References:

“Reducing Salmonella on cantaloupes and honeydew melons using wash practices applicable to postharvest handling, foodservice, and consumer preparation”. Tracy L. Parnell, Linda J. Harris, Trevor V. Suslow.  University of California.  International Journal of Food Microbiology 99 (2005) 59-70.

“Effect of Sanitizer Treatments on Salmonella Stanley Attached to the Surface of Cantaloupe and Cell Transfer to Fresh-Cut Tissues during Cutting Practices”. Dike O. Ukuku and Gerald M. Sapers.  U.S. Department of Agriculture. Journal of Food Protection, Vol. 64, No. 9, 2001.

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On June 12, 1996, Ontario, Canada's chief medical officer, Dr. Richard Schabas, issued a public health advisory on the presumed link between consumption of California strawberries and an outbreak of diarrheal illness among some 40 people in the Metro Toronto area. The announcement followed a similar statement from the Department of Health and Human Services in Houston, Texas, which was investigating a cluster of 18 cases of cyclospora illness among oil executives.

Turns out it was Guatemalan raspberries, and no one was happy.

Last month, the U.S. Food and Drug Administration and the Canadian Food Inspection Agency warned consumers to stay away from Honduran cantaloupes because of a salmonella outbreak that has sickened at least 50 Americans and nine Canadians.

The president of Honduras is furious. So is the agriculture minister who is demanding millions in reparations, saying the U.S. has not scientifically proven the fruit was infected in Honduras.

But proof is rare.

The initial, and subsequent, links between cyclospora and strawberries or raspberries in 1996 was based on epidemiology, a statistical association between consumption of a particular food and the onset of disease. The Toronto outbreak was first identified because some 35 guests attending a May 11, 1996 wedding reception developed the same severe, intestinal illness, seven to 10 days after the wedding, and subsequently tested positive for cyclospora. Based on interviews with those stricken, health authorities in Toronto and Texas concluded that California strawberries were the most likely source. However, attempts to remember exactly what one ate two weeks earlier is an extremely difficult task; and larger foods, like strawberries, are recalled more frequently than smaller foods, like raspberries.

By July 18, 1996, the CDC declared that raspberries from Guatemala -- which had been sprayed with pesticides mixed with water that could have been contaminated with human sewage containing cyclospora -- were the likely source of the cyclospora outbreak, which ultimately sickened about 1,000 people across North America. Guatemalan health authorities and producers vigorously refuted the charges. The California Strawberry Commission estimated it lost $15 million to $20 million in reduced strawberry sales.

Once epidemiology identifies a probable link between a food and some dangerous bug, health officials have to decide whether it makes sense to warn the public. In retrospect, the decision seems straightforward, but there are several possibilities that must be weighed at the time.

Back in 1996, when the Ontario Ministry of Health decided to warn people that eating imported strawberries might be connected to cyclospora infection, two outcomes were possible: if it turned out that strawberries were implicated, the ministry made a smart decision, warning people against something that could hurt them; if strawberries were not implicated, then the ministry made a bad decision with the result that strawberry growers and sellers lost money and people stopped eating something that was good for them.

If the ministry decided not to warn people, another two outcomes were possible: if strawberries were implicated, then the ministry made a bad decision and people could have acquired a parasitic infection they could have avoided had they been given the information (lawsuits usually follow); if strawberries were definitely not implicated then nothing happens, the industry does not suffer and the ministry does not get in trouble for not telling people.

These scenarios apply to cantaloupes and salmonella, raw milk and E. coli, and any other combination of food and pathogen.

It's often not fair. Any hosehead can come along and say, "Hey, I found a mouse in my beer bottle, give me a free case of beer." Or a syringe in some soda. Or I barfed from eating some food. The best producers or manufacturers can do is diligently manage and mitigate risks and be able to prove such diligence in the court of public opinion.

Douglas Powell is scientific director of the International Food Safety Network at Kansas State University. A video on preparing cantaloupe -- and some nasty comments which highlight the trade and economic issues at stake -- is available here .

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Two items on the growing saga of Salmonella-associated Honduran cantaloupes (linked to 59 illnesses in the US and Canada).  Yesterday the Honduran president was pissed at the US import alert, today there is a quote from the Honduran trade minister Trade Minister Fredys Cerrato:

"The United States has the obligation to compensate Agropecuaria Montelibano for the losses it has suffered after its melon exports were paralyzed"

This was followed by comments from Agropecuaria Montelibano's  GM,  Edilberto Rodriguez who was quoted as saying:

"We have never had any complaints from our clients in the United States or Europe."

The second item comes from Jim Prevor over at the Perishable Pundit who posted a criticism of FDA's handling of the alert, but included a weird document that he received from Agropecuaria Montelibano.  The document appears to be lab results of a sampling of the hands of two employees  on March 10 (well after the outbreak would have started).

I'm just not really sure what these hand sampling results really say since it's not clear when they were sampled (like if it was right after handwashing?) and what the results are supposed to represent (are they saying this indicates that all of our employees have clean hands?).  Weird. Not sure sampling hands is a good strategy in trying to demonstrate a good food safety program.

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