Tag: CDC

Cross-border outbreak of E. coli O157:H7 linked to romaine lettuce

The US Food and Drug Administration (FDA), the US Centers for Disease Control and Prevention (CDC), the Public Health Agency of Canada (PHAC), the Canadian Food Inspection Agency (CFIA) and various state and provincial agencies are jointly investigating an outbreak of E. coli O157:H7 illnesses in eleven US states and two Canadian provinces.

The genetic strain of E. coli O157:H7 recovered from patients appears to be the same as the strain implicated in a 2017 outbreak of E. coli O157:H7 illnesses linked to leafy greens in the USA and to romaine lettuce in Canada.

The current outbreak appears to be linked to romaine lettuce, based on epidemiological evidence. FDA is conducting lab tests and traceback investigations to determine the source or sources of the lettuce.

CDC reports 32 cases in 11 states: California (10), Connecticut (1), Illinois (2), Massachusetts (2), Maryland (1), Michigan (7), New Hampshire (2), New Jersey (3), New York (2), Ohio (1), and Wisconsin (1). Thirteen people have been hospitalized.

In Canada, confirmed outbreak cases have been reported in Ontario (3) and Quebec (15). Six people have been hospitalized, one of them suffering from hemolytic uremic syndrome (HUS).

The outbreak began in October in both countries, with the onset of the first case in the US on October 6th; the initial cases in Canada developed the week of October 14th. Additional cases are expected in both countries.

CDC is advising U.S. consumers not eat any romaine lettuce, and retailers and restaurants not serve or sell any, until more is learned about the outbreak. The CDC investigation is ongoing and the agency will issue updates as more information is available.

PHAC recommends that consumers in Ontario and Quebec should avoid eating romaine lettuce and salad mixes containing romaine lettuce until more is known about the outbreak and the cause of contamination.

FDA recommends that consumers not eat romaine lettuce or any mixed salads containing romaine, until more information on the source of the contamination and the status of the outbreak can be determined. Consumers are advised to discard any romaine lettuce or mixed salads containing romaine.

 

Jennie-O ground turkey linked to deadly Salmonella outbreak

Jennie-O Turkey Store Sales, LLC (Jennie-O) is recalling more than 45 tons (approximately 91,388 pounds) of raw ground turkey products that may be contaminated with a multidrug-resistant Salmonella Reading strain.

The Salmonella was recovered from an unopened package of Jennie-O raw ground turkey obtained from the home of an outbreak victim. The strain was a genetic match to the Salmonella Reading strain that has killed one person and sickened at least 164 people in 35 states.

The following recalled products were produced on September 11, 2018 and shipped to retail locations nationwide:

  • 1-lb. packages of “Jennie-O GROUND TURKEY 93% LEAN | 7% FAT” with “Use by” dates of 10/01/2018 and 10/02/2018.
  • 1-lb. packages of “Jennie-O TACO SEASONED GROUND TURKEY” with a “Use by” date of 10/02/2018.
  • 1-lb. packages of “Jennie-O GROUND TURKEY 85% LEAN | 15% FAT” with a “Use by” date of 10/02/2018.
  • 1-lb. packages of “Jennie-O ITALIAN SEASONED GROUND TURKEY” with a “Use by” date of 10/02/2018.

All of the recalled packages bear the establishment number P-190 inside the USDA mark of inspection. 

According to CDC, outbreak victims have reported eating different types and brands of turkey products purchased from many different locations. Three ill people lived in households where raw turkey pet food was fed to pets.

The USDA’s Food Safety and Inspection Service (FSIS) cautions that additional product from other companies may also be recalled.

CDC offers the following advice to consumers and retailers

Always handle raw turkey carefully and cook it thoroughly to prevent food poisoning. This outbreak is a reminder that raw turkey products can have germs that spread around food preparation areas and can make you sick.

CDC is not advising that consumers avoid eating properly cooked turkey products, or that retailers stop selling raw turkey products.

CDC advises consumers to follow these steps to help prevent Salmonella infection from raw turkey:

  • Wash your hands. Salmonella infections can spread from one person to another. Wash hands before and after preparing or eating food, after contact with animals, and after using the restroom or changing diapers.
  • Cook raw turkey thoroughly to kill harmful germs. Turkey breasts, whole turkeys, and ground poultry, including turkey burgers, casseroles, and sausage, should always be cooked to an internal temperature of 165°F to kill harmful germs. Leftovers should be reheated to 165°F. Use a food thermometer to check, and place it in the thickest part of the food.
  • Don’t spread germs from raw turkey around food preparation areas. Washing raw poultry before cooking is not recommended. Germs in raw poultry juices can spread to other areas and foods. Thoroughly wash hands, counters, cutting boards, and utensils with warm, soapy water after they touch raw turkey. Use a separate cutting board for raw turkey and other raw meats if possible.
  • Thaw turkey in the refrigerator, in a sink of cold water that is changed every 30 minutes, or in the microwave. Never thaw your turkey by leaving it out on the counter.
  • CDC does not recommend feeding raw diets to pets. Germs like Salmonella in raw pet food can make your pets sick. Your family also can get sick by handling the raw food or by taking care of your pet.

Consumer fault is a red herring; Salmonella should be an adulterant in poultry

This is part one of a two-part opinion piece by Carl Custer. It first appeared in Food Safety News and is reposted here with permission.

In recent days the CDC and FSIS updated information on a continuing salmonellosis outbreak connected to raw and live turkeys. Since the July 19 announcement of the outbreak, 74 more people from 26 more states have been reported.

That brings the totals, as of Nov. 5, to 164 infected people from 35 states. Sixty-three have been hospitalized and one person has died. Of 135 people with information available, 63 of them, or 47 percent, have been hospitalized. That is a high rate; this is a virulent strain highly pathogenic to humans. 

This outbreak is similar to the 2013-2014 outbreak from Salmonella Heidelberg. CDC reported 634 persons were infected with seven outbreak strains in 29 states and Puerto Rico; 38% of ill persons were hospitalized, and no deaths.

Salmonellosis from virulent strains borne by poultry is a decades old continuing problem. According to the definitions in the meat and poultry inspection acts,1.2. these Salmonella strains pathogenic to humans are adulterants. The cases and outbreaks prove they are ordinarily injurious to public health. FSIS has been reluctant to name them as adulterants, sometimes citing APHA vs Butz.3 However, that court decision was based in part on a letter written by USDA in August 1971. That letter wrongly averred that consumers were knowledgeable and competent. It had no scientific validity and was contrary to a 1970 USDA committee’s finding on a 1969 NAS report “An Evaluation of the Salmonella Problem.”11 and a USDA report evaluating that NAS report.10

Depending on consumers to safely handle raw meat and poultry contaminated with virulent pathogens has failed time and again. The CDC report continues with “Advice to Consumers and Retailers.” This is helpful to CDC, FSIS, and the poultry industry. Decades of educational programs by federal, state and private entities show little progress. A half century of scientific opinion and research demonstrate that most consumers are inept. Here are a few examples:

In 1963 Kampelmacher 4 wrote, “The real problem under discussion is: are poultry products a potential danger to public health, and if so, what objective criteria can be applied in the assessment of this danger? … However, the public is usually badly informed on the possible danger of poultry and poultry products to public health. Educating the public on these matters is a  difficult task. ” “In contrast to red meat, raw poultry is not consumed or prepared in any country. The danger lies in the processing, starting with the producers of poultry products and ending with the consumer.” 

Decades later, Kosa concluded “Based on the survey findings, we conclude that education is needed to improve consumer handling practices for raw poultry to decrease illness attributed to Salmonella and Campylobacter in raw poultry products.”9 

This summer, at the 2018 International Association for Food Protection meeting, Quinlan presented: “Mishandling of Poultry Products by Consumers: Identification of Gaps in Knowledge and Safe-handling Practices of Raw Turkey.” 8 The talk focused on a survey of consumers cooking turkey. Contrary to recommendations, a significant number washed turkeys, cooked with stuffing inside the bird, and held the cooked turkey at room temperature for more than two hours before serving. 

These three examples underline the need for better consumer education and training. There are many other scientific papers on consumer mishandling and – even after more than three decades of USDA’s Hot Line and others’ initiatives. These scientific results give lie to the frequent chant “just cook it” often on the internet. 

The attention given to cooking ignores the greater threat of cross contamination in kitchens. Echoing Kampelmacher, in 2009, Luber, citing 58 papers, wrote, “In conclusion, cross-contamination events from activities such as use of the same cutting board for chicken meat and salad without intermediate cleaning or spreading of pathogens via the kitchen environment seem to be of greater importance than the risk associated with undercooking of poultry meat or eggs.” Her paper currently has 108 citations, eight in 2018 so far. 

Virulent strains of Salmonella pathogenic to humans is an old problem. One solution would be to declare them adulterants and thus provide a regulatory incentive for control.

References

1.21 U.S.C. 453 – Definitions: (g) The term “adulterated” shall apply to any poultry product under one or more of the following circumstances:

(1) if it bears or contains any poisonous or deleterious substance which may render it injurious to health; but in case the substance is not an added substance, such article shall not be considered adulterated under this clause if the quantity of such substance in or on such article does not ordinarily render it injurious to health;

2. 21 USC § 601 – Definitions (m) The term “adulterated” shall apply to any carcass, part thereof, meat or meat food product under one or more of the following circumstances:

(1) if it bears or contains any poisonous or deleterious substance which may render it injurious to health; but in case the substance is not an added substance, such article shall not be considered adulterated under this clause if the quantity of such substance in or on such article does not ordinarily render it injurious to health; 

3. American Public Health Association et al., Appellants, v. Earl Butz, Secretary of Department of Agriculture, et al.. United States Court of Appeals, District of Columbia Circuit. – 511 F.2d 331. Argued Jan. 22, 1974.Decided Dec. 19, 1974.Rehearing En Banc Denied April 9, 1975

4. Kampelmacher, E. H. (1963). Public health and poultry products.  British Veterinary Journal 119, 110.

5. 9 CFR 311 Disposal of Diseased or Otherwise Adulterated Carcasses and Parts. 

6. 9 CFR 315.2  Carcasses and parts passed for cooking; utilization for food purposes after cooking.

7. Luber, Petra. 2009. Cross-contamination versus undercooking of poultry meat or eggs — which risks need to be managed first?.  International Journal of Food Microbiology 134 (2009) 21–28. 

8. Quinlan, Jennifer J. 2018. Mishandling of Poultry Products by Consumers: Identification of Gaps in Knowledge and Safe-handling Practices of Raw Turkey. T6-07 Tuesday, July 10, 2018 10:30 AM – 10:45 AM. International Association for Food Protection. Salt Palace Convention Center – Room 151 D-G

9. Kosa, Katherine M.; Cates, Sheryl C.; Bradley, Samantha; Chambers IV, Edgar; Godwin, Sandria. 2015. Consumer-Reported Handling of Raw Poultry Products at Home: Results from a National Survey. J. Food Prot. 78:180-186. 

10. Microbiological Subgroup of the USDA Food Safety Committee.  1970.  Food Protections by the Department of Agriculture.  A Review of the NAS-NRC Report. “An Evaluation of the Salmonella Problem”

11. National Academy of Sciences/National Research Council/Committee on Salmonella. 1969. An Evaluation of the Salmonella Problem. Prepared by the Salmonella Committee of the National Research Council, Washington, DC.: National Academy of Sciences, Publication No. 1683.