Recalled salad mix blamed for Listeria monocytogenes outbreak

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The US Food and Drug Administration (FDA), together with state and local partners and the CDC, is investigating an outbreak of ten Listeria monocytogenes illnesses in eight states.

The onset dates for illnesses linked to the outbreak strain range from July 26, 2016 to October 19, 2021.

The outbreak strain is a genetic match for the Listeria monocytogenes recovered from Fresh Express Sweet Hearts salad mix by the Michigan Department of Agriculture and Rural Development (MDARM) during the course of a routine sampling program.

The MDARM issued a Consumer Advisory on December 17, 2021.

In response to the Listeria monocytogenes finding and the outbreak investigation, Fresh Express, Inc. has recalled certain varieties of its branded and private label salad products produced at the company’s Streamwood, Illinois facility.

Fresh Express, Inc. is a division of Chiquita Brands.

Affected brands include: Fresh Express, Giant Eagle, Little Salad Bar, Market District, Marketside, O Organics, Signature Farms, Simply Nature Organic, Weis Fresh From the Field, and Wellsley Farms Organic.

The recall includes all Use-By Dates of fresh salad items with product codes Z324 through Z350. Please refer to the Fresh Express recall notice for a complete list of affected products.

The recalled products were distributed in Connecticut, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, North Dakota, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, and Wisconsin.

Some of the recalled products were also exported to Canada. Please refer to the CFIA recall notice for a complete list of affected products, which were sold in Manitoba and Ontario and also may have been distributed in other provinces and territories. 

A Repeat Offender

Fresh Express, which has suspended production at its Streamwood facility, has been the source of more than one previous foodborne disease outbreak.

In 2018, more than 500 customers of MacDonald’s in fifteen states were infected with Cyclospora after consuming a packaged romaine lettuce/carrot mix supplied to the restaurant chain by Fresh Express. 

In December 2019, Fresh Express Sunflower Crisp Chopped Salad Kits were identified as the source of an outbreak of E. coli O157:H7 illnesses in the United States and Canada.

And on October 20, 2020, the FDA issued a Warning Letter to the company as a result of the agency’s investigation into the source of yet another multistate outbreak of cyclosporiasis that was traced back to bagged salad mixes produced at the Streamwood production plant.

On November 10, 2021, the FDA issued a Close-out Letter acknowledging the company’s corrective actions to the violations listed in the October 2020 Warning Letter.

What Retailers Need to Know

  • Stop serving or selling recalled produce, whether it is fresh or frozen. Produce stored at cold temperatures can be contaminated. Listeria monocytogenes can grow even at refrigerated temperatures.
  • Keep recalled produce away from other foods and from any equipment, utensils, and linens, among other things.
  • Determine if cross-contamination with other foods may have happened.
  • Determine the source of the produce, or the supplier if the source of the fresh/frozen produce is unknown.
  • Follow the instructions from the source or supplier on how to return or dispose of the recalled produce.
  • Your employees should wash their hands thoroughly after handling recalled produce.
  • Wash any clothing and linens that have may be contaminated.

What Consumers Need to Know

  • Mild symptoms may include a fever, muscle aches, nausea, vomiting, and diarrhea. If the more severe form of listeriosis develops, symptoms may include headache, stiff neck, confusion, loss of balance, and convulsions. 
  • People infected with L. monocytogenes may start to see symptoms in a few hours or as long as two to three days after eating contaminated food. More severe forms of listeriosis may take anywhere from three days to three months to develop.
  • Consult your health care provider if you suspect that you or a family member has developed symptoms that resemble a L. monocytogenes infection.
  • Discard any of the recalled products or return them to the retailer for a refund.
  • Wash and sanitize any surfaces in your refrigerator or your kitchen that may have come into contact with one of the recalled products.
  • Canadian consumers should be on the alert for any recall notices issued by the Canadian Food Inspection Agency. In the meantime, do not purchase, serve or eat any of the products listed on the US recall notice.

For more information, members of the public can contact the Fresh Express Consumer Response Center toll-free line at: 800-242-5472

Massive onion recall sparked by Salmonella outbreak

ProSource Produce LLC of Hailey, Idaho is recalling whole raw onions imported from Mexico due to potential Salmonella contamination.

The recall comes after the US Food and Drug Administration (FDA) identified ProSource as a source of onions linked to a large multi-state outbreak of Salmonella Oranienburg illnesses that has sickened 652 people so far, sending 129 of them to hospital.

To date, no onions marketed through ProSource have tested positive for Salmonella, according to the company.

The Recall

The recall encompasses red, yellow, and white whole raw onions shipped to the United States from Chihuahua, Mexico, between July 1, 2021, and August 31, 2021, and includes the following brand names:

  • Big Bull
  • Peak Fresh Produce
  • Sierra Madre
  • Markon First Crop.
  • Markon Essentials
  • Rio Blue
  • ProSource
  • Rio Valley
  • Sysco Imperial

The onions were distributed to wholesalers, broadline foodservice customers, and retail stores in 50 lb., 25 lb., 10 lb., 5 lb., 3 lb., and 2 lb. mesh sacks; and 50 lb., 40 lb., 25 lb., 10 lb., and 5 lb. cartons in:

  • Alabama
  • Arkansas
  • Arizona
  • California
  • Colorado
  • Connecticut
  • Florida
  • Georgia
  • Iowa
  • Idaho
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Massachusetts
  • Maryland
  • Michigan
  • Minnisota
  • Missouri
  • Mississippi
  • North Carolina
  • Nebraska
  • New Jersey
  • New Mexico
  • New York
  • Ohio
  • Oklahoma
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • Tennessee
  • Texas
  • Virginia
  • Wisconsin

Some of the recalled product also was shipped to Ontario and Québec, Canada.

The Outbreak

The US Centers for Disease Control and Prevention (CDC) first identified an outbreak of 20 confirmed cases of Salmonella Oranienburg illnesses on September 2, 2021. By September 15th, the date of CDC’s initial outbreak investigation announcement, the number of cases had risen to 127 people from twenty-five states.

On September 24th, the CDC reported having found the outbreak strain in a sample taken from a takeout condiment cup containing cilantro and lime. The outbreak victim who supplied the condiment cup reported that it also had contained onions, but none were left in the cup at the time of sampling.

As of October 18th, the CDC had amassed reports of 652 confirmed outbreak cases from 37 US states. Thirty-one percent (31%) of the outbreak victims required hospitalization.

Salmonella Oranienburg illnesses caused by the outbreak strain have been reported by the following states:

  • Alabama (3)
  • Arkansas (12)
  • California (9)
  • Colorado (1)
  • Connecticut (4)
  • Florida (5)
  • Georgia (2)
  • Illinois (37)
  • Indiana (1)
  • Iowa (3)
  • Kansas (14)
  • Kentucky (9)
  • Louisiana (5)
  • Maryland (48)
  • Massachusetts (12)
  • Michigan (9)
  • Minnesota (23)
  • Mississippi (2)
  • Missouri (21)
  • Nebraska (8)
  • New Jersey (5)
  • New Mexico (8)
  • New York (12)
  • North Carolina (14)
  • North Dakota (4)
  • Ohio (7)
  • Oklahoma (98)
  • Oregon (2)
  • Pennsylvania (7)
  • South Carolina (3)
  • South Dakota (8)
  • Tennessee (10)
  • Texas (158)
  • Utah (3)
  • Virginia (59)
  • West Virginia (1)
  • Wisconsin (25)

Déjà Vu

In the summer of 2020, the CDC and the Public Health Agency of Canada (PHAC) identifed a cross-border outbreak of Salmonella Newport infections that sickened more than 1100 people in 48 US states and 515 in seven Canadian provinces.

The source of the 2020 outbreak was traced to onions supplied by Thomson International Inc. of Bakersfield, California. Although, the outbreak strain was never recovered from Thomson’s onions, the FDA found eleven different Salmonella serotypes from various environmental samples.

What You Need To Know

Illness subclusters investigated in this outbreak are currently associated with restaurants and food service locations.

The investigation is ongoing to determine the source of contamination and if additional products or firms are linked to illness.

The FDA is working to determine if these onions were available to consumers through grocery stores.

Meanwhile, the CDC advises businesses and individuals to take the following precautions:

  • Businesses should not sell or serve fresh whole red, white, or yellow onions that were imported from Chihuahua, Mexico and distributed by ProSource Inc.
  • Do not buy or eat any whole fresh red, white, or yellow onions if they were imported from Chihuahua, Mexico and distributed by ProSource Inc.
  • Throw away any whole red, white, or yellow onions you have at home that do not have a sticker or packaging.
  • Call your healthcare provider right away if you have any of these severe Salmonella symptoms:
    • Diarrhea and a fever higher than 102°F
    • Diarrhea for more than 3 days that is not improving
    • Bloody diarrhea
    • So much vomiting that you cannot keep liquids down
    • Signs of dehydration, such as:
      • Not peeing much
      • Dry mouth and throat
      • Feeling dizzy when standing up
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Here’s how to report your USA food problem directly to USDA or FDA

FOOD SAFETY EDUCATION MONTH

Anytime you think you are seriously ill, seek medical attention. And if you think food caused your illness, make sure it gets reported. Most foodborne illnesses are “reportable,” which means your doctor lets the local health department know about them.

That’s how you might become a “confirmed case” in a multistate outbreak.  It’s your confirmed test result that gets reported to the health department,  your name is kept private.

But if you do not want to pursue action through a medical route, you can report your bad food experience directly to federal regulators. The USDA’s Food Safety and Inspection Service and the U.S. Food and Drug Administration both welcome consumer reports about contaminated or adulterated food.

But how?

Both FSIS and FDA explain how on their websites. As September’s food safety month comes to a close shortly, Food Safety News is passing this information along with some explanation to help consumers get to the right agency.  The FSIS and FDA are responsible for protecting different segments of the food supply. If you have experienced a problem with a food product, be sure to contact the appropriate public health organization.

To reach them by phone:

  • USDA’s Food Safety and Inspection Service (FSIS) — Call the toll-free USDA Meat and Poultry Hotline at 888-674-6854 or report the complaint online.
  • Food and Drug Administration (FDA) — Call 888-723-3366 (10 a.m. to 4 p.m. EDT.  Closed Thursdays 12:30 p.m. – 1:30 p.m. EDT.

It’s important before you call FSIS or FDA that you understand how federal regulatory responsibilities are divided among the various agencies. The FDA, which has the most authority in these areas, offers this outline of how it breaks down.

In general, FDA regulates foods and other products as follows:

  • dietary supplements
  • bottled water
  • food additives
  • infant formulas
  • other food (although the U.S. Department of Agriculture plays a lead role in regulating aspects of some meat, poultry, and egg products)

FDA also regulates drugs, including:

  • prescription drugs (both brand-name and generic)
  • non-prescription (over-the-counter) drugs

Biologics, including:

  • vaccines for humans
  • blood and blood products
  • cellular and gene therapy products
  • tissue and tissue products
  • allergenic

Medical devices, including:

  • simple items like tongue depressors and bedpans
  • complex technologies such as heart pacemakers
  • dental devices
  • surgical implants and prosthetics

Electronic products that give off radiation, including:

  • microwave ovens
  • X-ray equipment
  • laser products
  • ultrasonic therapy equipment
  • mercury vapor lamps
  • sunlamps

Cosmetics, including:

  • color additives found in makeup and other personal care products
  • skin moisturizers and cleansers
  • nail polish and perfume

Veterinary products, including:

  • livestock feeds
  • pet foods
  • veterinary drugs and devices

Tobacco products, including:

  • cigarettes
  • cigarette tobacco
  • roll-your-own tobacco
  • smokeless tobacco

By subject and topic, FDA also has “functions related” to these federal agencies:

  • Advertising — The Federal Trade Commission is a federal agency that regulates many types of advertising. The FTC protects consumers by stopping unfair, deceptive, or fraudulent practices in the marketplace. Consumers may write to FTC at 6th St. and Pennsylvania Ave., N.W., Washington, DC 20580; telephone 202-326-2222.
  • Alcohol — The Department of the Treasury’s Alcohol and Tobacco Tax and Trade Bureau (TTB) regulates aspects of alcohol production, importation, wholesale distribution, labeling, and advertising. Consumers may write to TTB at 1310 G St. N.W., Box 12, Washington, DC 20005; telephone 202-453-2000 or see the TTB Contact page.
  • Consumer Products The Consumer Product Safety Commission (CPSC) works to ensure the safety of consumer products such as toys, cribs, power tools, cigarette lighters, household chemicals, and other products that pose a fire, electrical, chemical, or mechanical hazard. Consumers may send written inquiries to CPSC, Washington, DC 20207. CPSC operates a toll-free hotline at 800-638-2772 or TTY at 800-638-8270 for consumers to report unsafe products or to obtain information regarding products and recalls.
  • Drugs of abuse — The Department of Justice’s Drug Enforcement Administration (DEA) works to enforce the controlled substances laws and regulations of the United States, including as they pertain to the manufacture, distribution, and dispensing of legally produced controlled substances. Inquiries regarding DEA activities may be sent to the Drug Enforcement Administration, Office of Diversion Control 8701 Morrissette Drive Springfield, VA 22152; telephone 202-307-1000.
  • Pesticides — The Environmental Protection Agency (EPA) regulates many aspects of pesticides. EPA sets limits on how much of a pesticide may be used on food during growing and processing, and how much can remain on the food you buy. Public inquiries regarding EPA should be mailed to U.S. Environmental Protection Agency, Office of Pesticide Programs Public Docket (7506C), 3404, 401M St., Washington, DC 20460; telephone 202-260-2080.
  • Vaccines for animal diseases  The U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS), Center for Veterinary Biologics, regulates aspects of veterinary vaccines and other types of veterinary biologics. Public inquiries regarding APHIS’s Center for Veterinary Biologics should be mailed to Center for Veterinary Biologics, 1920 Dayton Ave, P.O. Box 844, Ames, Iowa, 50010; telephone 515-337-6100 or see the APHIS Contact page.
  • Water The Environmental Protection Agency (EPA) regulates certain aspects of drinking water. EPA develops national standards for drinking water from municipal water supplies (tap water) to limit the levels of impurities.

USDA’s Food Safety and Inspection Service regulates the following:

FSIS regulates aspects of the safety and labeling of traditional (non-game) meats, poultry, certain egg products and catfish. For a USDA investigation of any problem with these products, please be ready to provide:

  • The original container or packaging
  • Any foreign object that you might have discovered in the product
  • Any uneaten portion of the food (refrigerate or freeze it)

Here’s the information the FSIS Hotline needs from you:

  1. Name, address, and phone number;
  2. Brand name, product name, and manufacturer of the product
  3. The size and package type
  4. Can or package codes (not UPC bar codes) and dates
  5. Establishment number (EST) usually found in the circle or shield near the “USDA passed and inspected” phrase;
  6. Name and location of the store, as well as the date that you purchased the product.
  7. You can complain to the store or the product’s manufacturer if you don’t choose to make a formal complaint to the USDA.
  8. If an injury or illness allegedly results from the use of a meat or poultry product, you will also need to tell the hotline staff about the type, symptoms, time of occurrence, and name of the attending health professional (if applicable).

FDA’s Center for Food Safety and Applied Nutrition, known as CFSAN, provides services to consumers, domestic and foreign industry and other outside groups regarding field programs; agency administrative tasks; scientific analysis and support; and policy, planning, and handling of critical issues related to food, dietary supplements, and cosmetics.

How to Report a Problem with Food to FDA

  • For all questions or problems related to meat and poultry, please contact USDA.
  • If you are a consumer, health professional, or member of the food industry who wants to voluntarily report a complaint or adverse event (illness or serious allergic reaction) related to a food product, you have three choices:
  • If you are a member of the food industry who needs to submit a Reportable Food Registry report when there is a reasonable probability that an article on food will cause serious adverse health consequences or death to humans or animals, please visit the Reportable Food Registry page.

How to report seafood-related toxins and Scombrotoxin fish poisoning illnesses

To help FDA effectively investigate, remove unsafe seafood products from the market, and develop new prevention strategies, the FDA relies on illness reporting from public health officials and healthcare providers. While most foodborne outbreaks are tracked through the FDA’s Coordinated Outbreak Response and Evaluation (CORE) network, seafood-related illnesses caused by natural toxins have a unique reporting mechanism.

To contact FDA by mail: 

U.S. Food and Drug Administration
Center for Food Safety and Applied Nutrition
Outreach and Information Center
5001 Campus Drive, HFS-009
College Park, MD 20740-3835

FDA asks that products not be mailed to this address.

This article by Dan Flynn first appeared on Food Safety News and is reposted here with permission.