What's it worth to barf? Not much in Canada
Chapman and I have thrown around the idea that one of the reasons Canadians seem complacent about foodborne illness – despite several high-profile devastating outbreaks – is the availability of public health care. If someone loses a kidney because of E. coli O157:H7 or a liver because of hepatitis A, the cost is borne by the system. In the U.S. those without health care coverage would be out $100,000 – at a minimum. So Canadian lawsuits are kept to a minimum, media coverage remains stagnant, and everyone goes back to sleep.
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As Jim Romahn wrote in Dec. after a $27 million settlement for victims in the Maple Leaf listeria outbreak that killed 20 and sickened hundreds was announced, CEO Michael H. McCain is a wily strategist.
For $27 million, tops, he has bought freedom from a court case that could have proven highly embarrassing to Maple Leaf. The ongoing coverage could well have become the final nail in consumer confidence in Maple Leaf products. The lawyers were sure to ask who knew what and when. They were sure to ask about the degree of plant contamination as the company continued to ship products, failing to first hold them for testing and clearance.
What does that $27 million buy?
• Someone who was ill for up to 48 hours would receive $750
• Up to a week receives $3,000
•Up to two weeks receives $5,500
• Up to a month receives $8,000
• If listeriosis led to a secondary infection that didn't cause ongoing symptoms, such as meningitis or pneumonia, the settlement is $35,000
• If listeriosis caused sustained or permanent symptoms, the settlement is $75,000 plus $750 for each day of hospitalization
• If secondary complications affected the nervous system and caused “serious and permanent impairment of physical and/or mental function,” payment is $125,000 plus $750 for each day of hospitalization. A family member who was affected psychologically could receive $10,000.
• A death would lead to a $120,000 payment to the victim's estate. A spouse would be eligible for an additional $35,000, while children could receive $30,000, parents could receive $20,000 and siblings or grandchildren could receive $5,000. Funeral expenses up to $13,500 would also be covered.
• Anyone who “sustained psychological injuries or trauma for up to 60 days” after eating tainted meat, without any injuries, could receive up to $4,000.
• Anyone who was at particular risk, such as pregnant women and the elderly, but did not become ill could receive up to $6,000 for psychological trauma that lasted up to 60 days.
• If psychological symptoms lasted more than 60 days, compensation is set at $13,500.
• Those in the vulnerable group who experienced psychological symptoms for more than 60 days could receive $17,500.
Should deli meats carry warning labels?
Warning labels are a lousy risk management strategy, but the outbreak of listeria in Canada which has killed at least 12 and sickened dozens has had lots of lousy aspects. So why not?
A story that is running across Canada this morning says,
With pregnant women and the elderly especially at risk from Listeria, the Canadian Food Inspection Agency needs to step up efforts to alert people to the hazard — perhaps going so far as to put warning labels on deli products — said University of Guelph adjunct professor Doug Powell.
What? Guess that was some stretch at Canadian content. I’m an associate professor of food safety at Kansas State University. If I’m adjunct at Guelph, I want access to all the money that was provided to deliver news and is instead being used as some sort of room renovation fund by a department chair I never met.
The opinion piece that ran in the Toronto Star this morning was more accurate.
Michael McCain delivered a powerful and compelling apology over the weekend as authorities confirmed Maple Leaf deli meats were the likely source of food-borne illness that has killed at least six and sickened dozens.
Outbreaks of food and water-borne illness are far too common. The World Health Organization estimates that up to 30 per cent of people in so-called developed countries will suffer each and every year. That's a lot of sick people.
But the current listeria outbreak turns statistics into stories, and challenges a company like Maple Leaf, with world-class aspirations, to do better.
The first case of listeriosis apparently surfaced in late June. Why it took the various health authorities so long to make a link remains to be uncovered.
For now, the Canadian Food Inspection Agency, Health Canada and others are providing little in the way of details regarding who knew what when.
The authorities are, however, proving unjustifiably adept at praising themselves for the speed with which they responded to the outbreak.
Two months after the first case is not an early-warning system. The political barbs that have been tossed around – which provide no insight on managing listeria – are simply embarrassing given the loss of life and illness.
McCain and Maple Leaf are better than this, and can be better:
• Issue pictures of the recalled products:
Telling people to look for products that contain the stamp "Establishment (EST) 97B" puts too much of a burden on people who just wanted to go shopping, not do homework. The U.S. Food and Drug Administration realized this, and last year started including pictures on their recall notices for products deemed to be high health risks.
Pictures aren't superficial, they are good communication. It's difficult for even PhD-types to wade through nine pages of recalled products, and pictures can make the connection for those who don't always know what brands they buy.
• Warn pregnant women and others at risk from listeria in deli meats:
My wife is six months pregnant and she hasn't had deli meats or smoked salmon or other refrigerated, ready-to-eat foods for six months.
That's because, as Michael McCain says, the bacterium listeria is fairly much everywhere, difficult to control, and grows in the refrigerator. It also causes stillbirths in pregnant women, who are about 20 times more likely to contract the bug than other adults.
The banter in Canada about government or industry taking the lead on food inspection, whether food should be produced in large or small places, is misguided at best and more likely, political opportunism.
Long before the current outbreak, the advice from the Canadian government about listeria was mushy:
"Although the risk of listeriosis associated with foods from deli counters, such as sliced packaged meat and poultry products, is relatively low, pregnant women and immunosuppressed persons may choose to avoid these foods."
The advice from the U.S. Centers for Disease Control is clear: Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated.
It has been documented that many pregnant women are not aware of the risks associated with consuming refrigerated, ready-to-eat foods like cold cuts.
Don't expect the bureaucrats in the Canadian government to do anything. If Michael McCain and Maple Leaf are truly concerned with public health, they could at a minimum put warning labels on their products. Maybe near the "(EST) 97B."
• Make your listeria data public:
Maple Leaf Foods spokesperson Linda Smith told CTV Newsnet Friday, officials at the plant are "... constantly looking for it (listeria), constantly swabbing and looking for it."
Smith said the equipment at the plant is sanitized every day and officials take about 3,000 swabs per year. The plant also has a microbiologist on site.
"This plant has an excellent food safety record, excellent inspection record, excellent external auditors. We'll never know exactly how it got here."
But you do have 3,000 samples per year. If Maple Leaf really wants to restore public confidence, release the listeria data. How many positives does the Toronto plant see in a year? Were there positives leading up to the initial Aug. 17 recall? If there were no positives, why not? What is the protocol when a positive is discovered?
Consumers can handle more, not less information about the food they eat.
Maple Leaf Foods has the unfortunate opportunity to set new standards for consumer confidence.
Douglas Powell of Brantford is an associate professor of food safety at Kansas State University.
Michael McCain of Maple Leaf: Should pregnant women eat deli meats?
There’s been an outbreak of babies amongst the food safety stalwarts in my lab. Katija delivered in June, Ben’s gonna be a daddy next month, and me, trying to keep up with the cool kids, at the end of November.
Michael McCain, the president and CEO of Maple Leaf Foods, seems sincere enough. He said yesterday that listeria is "pervasive" adding that,
"It (Listeria) is virtually impossible to eradicate in its entirety. It exists in plants, in supermarkets, potentially in your kitchen.”
That’s true. And deli meats and other refrigerated ready-to-eat foods like smoked salmon are particularly good sources of listeria.
Back in May, U.K. environmental health officers from 42 local authorities purchased 1,127 samples of sliced-at-the-counter cooked meats from food retailers including butchers, delicatessens, market stalls and supermarkets.
Laboratory tests found that 15 per cent of the samples were contaminated with low numbers of listeria on the day of purchase, while 7.3 per cent were contaminated with Listeria monocytogenes, the more serious form of listeria.
Although these were within European Food Safety Standards, when the contaminated samples were tested again after storage for 48 hours in a refrigerator, the L. monocytogenes in some of the contaminated samples had multiplied to unsafe levels.
In July, 2008, health types in Ireland warned pregnant women to avoid ready-to-eat, refrigerated and processed foods, such as soft cheeses, cold cuts of meat, pates and smoked fish after an increase in pregnancy-related listeriosis.
A Dec. 2007 review of listeria in pregnancy states,
“One of the most important changes during pregnancy is the down-regulation of the cellular immune system. Because the fetus is genetically different from the mother, the body treats it as a graft. To prevent the maternal immune system from rejecting the fetus, cell-mediated immunity must therefore be suppressed during pregnancy. This is favored by high levels of progesterone. However, reduced cell-mediated immune function leads to increased susceptibility of the woman and her fetus to infections by intracellular pathogens such as Listeria monocytogenes. That is why pregnant women are 20 times more at risk of contracting listeriosis than are other healthy adults. Pregnant women account for 30% of all cases of listeriosis and 60% of cases among persons 10 to 40 years of age.
“Typically, systemic infection occurs most frequently after ingestion of food contaminated with L monocytogenes. The bacteria cross the mucosal barrier of the intestine, probably aided by active endocytosis of organisms by epithelial cells. Once in the bloodstream, bacteria spread to different sites, but they have a particular affinity for the central nervous system or placenta. While circulating, the bacteria are internalized by macrophages and other plasma cells and are thereafter spread cell-to-cell through phagocytosis. As a result, antibodies, complement, and neutrophils become unable to protect the host.”
And that’s why 6-months pregnant Amy hasn’t touched a deli product in over six months. But most women don’t know this. Neither do a lot of doctors or health professionals. During one of our prenatal visits, I asked the aid if there were any foods pregnant Amy should be avoiding.
She said, “no, not really.”
I specifically asked about deli meats.
She said, “Get the deli meat from the counter cause it’s fresher than the pre-packaged stuff.”
She didn’t know about listeria. Most people don’t. Researchers reported in the Australian and New Zealand Journal of Health that in a survey of 586 women attending antenatal clinics in one private and two major public hospitals in New South Wales between April and November 2006, more than half received no information on preventing Listeria.
So, Michael McCain, I know what I’d tell my wife or any other pregnant woman. What would you tell a pregnant woman about deli meats? Would you be willing to put a health advisory on the back of the package?
Deli meats sliced at the deli counter should be consumed within 2 days
I often find myself loitering around the deli counter, watching people order pound after pound of sliced roast beef or shaved turkey breast.
At one point a few years ago, I began chatting with one of the customers and politely commented that was a lot of deli meat she was ordering (really, there was a polite context).She replied it was sandwiches for the kids for the next two weeks.
Uugh.
Yesterday, the Liverpool Daily Post reported U.K. environmental health officers from 42 local authorities purchased 1,127 samples of sliced-at-the-counter cooked meats from food retailers including butchers, delicatessens, market stalls and supermarkets.
Laboratory tests found that 15 per cent of the samples were contaminated with low numbers of listeria on the day of purchase, while 7.3 per cent were contaminated with Listeria monocytogenes, the more serious form of listeria.
Although these were within European Food Safety Standards, when the contaminated samples were tested again after storage for 48 hours in a refrigerator, the L. monocytogenes in some of the contaminated samples had multiplied to unsafe levels.
The tests were carried out at a fridge temperature of six degrees centigrade. However, many domestic fridges are warmer than this, allowing L. monocytogenes to grow faster.
Hugh Lamont, communications manager for the Health Protection Agency North West, said
“We are anxious to ensure that we do not create a scare around freshly sliced cooked meats. We are not saying that people should not buy or eat them, but rather that they should follow ‘use by’ advice where it is given – and consume the products within 48 hours where it is not. We are also reminding food retailers of the advice they should give to customers.”
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The U.S. Centers for Disease Control recommendations for persons at high risk from listeria, such as pregnant women and persons with weakened immune systems, includes:-Do not eat hot dogs, luncheon meats, or deli meats, unless they are reheated until steaming hot
-Avoid getting fluid from hot dog packages on other foods, utensils, and food preparation surfaces, and wash hands after handling hot dogs, luncheon meats, and deli meats
-Do not eat soft cheeses such as feta, Brie, and Camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and Panela, unless they have labels that clearly state they are made from pastuerized milk
-Do not eat refrigerated pâtés or meat spreads. Canned or shelf-stable pâtés and meat spreads may be eaten
-Do not eat refrigerated smoked seafood, unless it is contained in a cooked dish, such as a casserole. Refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna or mackerel, is most often labeled as "nova-style," "lox," "kippered," "smoked," or "jerky." The fish is found in the refrigerator section or sold at deli counters of grocery stores and delicatessens. Canned or shelf-stable smoked seafood may be eaten.
The USDA risk assessment for listeria is ready-to-eat foods is available at
http://www.fsis.usda.gov/OPPDE/rdad/FRPubs/97-013F/ListeriaReport.pdf
and one from the World Health Organization is at
http://www.who.int/foodsafety/publications/micro/mra_listeria/en/index.html
