Beach Beat: Romaine producers urge blanket recall in light of new outbreak

This opinion piece by Coral Beach first appeared on Food Safety News and is reposted here with permission.

ALERT: Federal officials in the U.S. and Canada have announced a new E. coli outbreak linked to romaine lettuce and recommend that consumers, retailers and foodservice operators not eat, sell or serve any romaine. As of Nov. 20, a total of 50 people across 11 U.S. states and two Canadian provinces had been confirmed with the outbreak strain of E. coli O157:H7. 


Leafy greens growers, facing terrible news yesterday about another E. coli outbreak linked to romaine lettuce, did the right thing. They called for an immediate, voluntary industry-wide recall of all brands and forms of romaine.

That’s exactly what the U.S. Food and Drug Administration suggested industry do when it posted a notice Tuesday announcing the new outbreak. Officials from industry and government say they haven’t been able to identify any specific growers or other entities in the supply chain as the source of the E. coli O157:H7.

“At this stage in the investigation, the most efficient way to ensure that contaminated romaine is off the market would be for industry to voluntarily withdraw product from the market, and to withhold distribution of romaine until public health authorities can ensure the outbreak is over and/or until FDA can identify a specific source of contamination,” according to the FDA’s notice. 

“Until then, the FDA advises that consumers should not eat and discard romaine, or any mixed salads containing romaine, until more information on the source of the contamination and the status of the outbreak can be determined.”

It’s encouraging to see the largest and most influential fresh produce and leafy greens organizations act quickly. Their plea for a voluntary industry-wide recall is what the public, legislators, and consumer advocates wanted them to do this past spring when health officials announced an E. coli outbreak linked to romaine. Ultimately 210 people across 36 states were confirmed infected in that outbreak. Five of the patients died.   

We don’t yet know how long officials have been investigating the current outbreak — which they say involves a different strain of E. coli O157:H7 than this spring’s outbreak — or when they informed the leafy greens industry of the romaine connection. But, the fact that industry leaders are telling romaine growers and processors to take the economic hit right now and pull back their products is good news. 

Of course, one could argue that it’s a smart business strategy at this point for the leafy greens industry to do what many people perceive as the right thing. Consumer’s trust, and more importantly their romaine purchases, dropped significantly earlier this year because the romaine industry failed to act in the public’s best interest. Growers and processors kept doing what they do even after everyone knew the implicated romaine was coming from the Yuma, AZ, area.

So, today I tip my hat to the following groups: Arizona Leafy Greens Marketing Agreement; California Leafy Greens Marketing Agreement (LGMA); Produce Marketing Association; United Fresh Produce Association; Western Growers; Yuma Safe Produce Council; and Yuma Fresh Vegetable Association. Their joint statement Tuesday afternoon did not mince words.

“In light of today’s announcement by government health agencies in the U.S. and Canada of an E. coli outbreak linked to romaine, a group of produce industry associations is relying on producers and retail/restaurant customers to support the government health agency advisories and is urging an industry-wide voluntary withdrawal of all romaine currently in marketing channels and held in inventory,” according to the statement posted on the California LGMA website.

“… We believe a withdrawal of romaine lettuce is the fastest way to clear up the supply chain of any romaine that could be responsible for illnesses and to make a hard, convincing and clean break from harvesting and shipping romaine lettuce until this outbreak is declared over or the source of the implicated produce can be identified. Additionally, we are calling on handlers to clean and sanitize any equipment that may have been used in recent weeks to prevent cross-contamination of product during future harvest, processing and distribution activities.

“… In order to be sure that any romaine lettuce that may have been responsible for illnesses is completely gone, we are urging full compliance with the government’s request for a voluntary withdrawal of all romaine.”

The industry groups did not shy away from encouraging consumers to throw out any romaine they have on hand. The produce community also urged the public, retailers and foodservice operators to thoroughly clean and sanitize any surfaces, containers, utensils or appliances that had come into contact with romaine. 

That’s standard advice during foodborne illness outbreaks and food recalls. But, such advice makes it perfectly clear that there was danger associated with the implicated food, and that’s something food businesses usually soft pedal. Kudos to the fresh produce folks for telling the public up front that there are important steps to take to prevent additional infections.

Few specifics available yet, but industry is looking for them
Government and industry officials said the outbreak earlier this year involved romaine grown around the Yuma, AZ, area. That determination was initially based on the timing — Yuma growers harvest from late fall through mid-spring, wrapping up between mid-March and the end of April. At that same time growers in Southern California are beginning their harvest, with Northern growing areas in the state following.

“Northern California is essentially done,” Scott Horsfall of the California LGMA told Food Safety News. “The desert region, which includes California’s Imperial Valley as well as Arizona and Northern Mexico, is where most romaine is coming from now. … but the transition from north to south is well underway.”

The FDA included this Google Earth view in its memorandum on the environmental assessment related to the E. coli outbreak. It shows a section of the Wellton canal that is adjacent to a 100,000-head feedlot. Portions of this image (in gray) were redacted by the government. However, the FDA report says the image shows the locations of the feedlot, sites where E. coli-positive water samples were collected, unlined sections of the irrigation canal, and a retention pond at the feedlot. The water in the canal flows from west to east.

Horsfall, who is CEO of the California organization, and other leaders in the industry who include Teressa Lopez from the Arizona LGMA, have been working with a task force of academic researchers, the FDA, USDA, CDC, and state health and agriculture departments since spring. The group’s efforts led to changes in growing and harvesting practices that were in place for the Yuma planting season this fall and are in place for California growers in 2019. The new practices weren’t adopted by the LGMA in time for the Northern California season this year.

One of the changes is an increase in the width of buffer zones between feedlots and leafy greens growing fields from 400 feet to 1,600 feet. The Yuma fields are adjacent to and near McElhaney Feedyard, which has a capacity of more than 100,000 head. 

That setback change was spurred by previous research and the fact that the most likely scenario developed by outbreak investigators and scientists is that dust or runoff from the feedlot contaminated water in an open canal that produce growers use for irrigation.

It their statement Tuesday, the produce industry groups said the task force work will continue.

“A group of food safety experts from the produce industry is coming together as quickly as possible to closely examine information that may help pinpoint the specific source of the outbreak utilizing the extensive traceback information maintained by leafy greens producers,” according to the statement from the product groups.

“The goal of this effort is to learn any information about the geographic region or specific farms that may be tied to this outbreak. Government agencies have indicated the E. coli isolate involved in this outbreak has been closely related by Whole Genome Sequencing data to two past outbreaks linked to leafy greens in 2016 and 2017.”

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.

 

Outbreaks in Quebec, Twin Cities Traced to Chinese Raspberries

Frozen raspberries imported from China were the source of 615 confirmed cases of norovirus in Quebec between March and July of this year, and of 15 cases in Minnesota in August of 2016.

The Quebec outbreak included clients and staff at seven seniors’ residences, two daycare centers and one hotel in four separate administrative regions of the province, according to a spokesperson for Quebec’s Ministry of Health and Social Services (MSSS).

Confirmed cases were documented in Mauricie at 6 seniors’ residences, in Laurentides at a conference at a hotel, in Chaudieres-Appalaches at a daycare center, and in Capitale-Nationale at a daycare center and a seniors’ residence.

Of the 615 outbreak victims, 141 were employees of at least two of the seniors’ residences. Four were employees at one of the affected daycare centers. Citing privacy concerns, MSSS declined to provide any further details on the victims by gender, age or geographic location. However, extrapolation of data provided by the provincial health agency suggests about 250 of the outbreak victims were seniors, and 33 were children.

The Minnesota outbreak was linked to ice cream manufactured by Sebastian Joe’s, a Minneapolis-based company, according to a spokesperson from the Minnesota Department of Health (MNDOH). The company supplied the ice cream to multiple venues within the Minneapolis-St. Paul area.

Norovirus illnesses were linked to consumption of raspberry chocolate chip flavor ice cream consumed at two Sebastian Joe’s venues, one private gathering, and one area restaurant. Of the 15 confirmed cases, 10 were female. One person was hospitalized.

The ice cream contained frozen raspberries imported from China. Analyses conducted by the Food and Drug Administration confirmed the presence of norovirus matching the case specimens in samples of the raspberries.

The Twin Cities and Quebec outbreaks occurred more than six months apart and appear to have been independent of each other, though frozen raspberries from China were implicated in both. Taian Runko, the company identified by the FDA during its analytical sampling, was not involved in the Quebec outbreak, according to the CFIA.

Product recalls lacked transparency
The Canadian Food Inspection Agency (CFIA) issued 14 recall notices, from June 20 through Aug. 21 this year. The agency disseminated 11 of the recalls only to businesses in the food industry, with no public warning released. Recall notices dated Aug. 11, 16 and 21 were released to the public, and alluded to the existence of “…reported illnesses associated with the consumption…” of the recalled products.

From June 23 through Aug. 14, Quebec’s Ministry of Agriculture, Fisheries and Food (MAPAQ) issued a series of six public alerts and product recalls, which included numerous bakery products manufactured with the individually quick frozen (IQF) raspberries. Each of the MAPAQ alerts warned of “many” illnesses associated with the consumption of products containing the IQF raspberries.

The U.S. Food and Drug Administration carried out analytical sampling and laboratory analysis when advised of the Minnesota outbreak, according to an agency spokesperson. As a result of the FDA investigation, the agency added IQF raspberries from Taian Runko Industry International Trade Co. Ltd. to the Import Alert 99-35 “Detention Without Physical Examination” list (Red List) on May 2 this year. Sebastian Joe’s initiated a product withdrawal as a result of the 2016 Minnesota outbreak.

Canadian health agency never issued alert
The Public Health Agency of Canada (PHAC) never issued a public health alert in conjunction with the IQF-raspberry norovirus outbreak. A spokesperson for PHAC explained the agency’s silence was because of the outbreak having been confined to a single province.

In Quebec, the provincial health department responsible for investigating the 5-month outbreak did not issue any news releases or public health alerts either. According to a MSSS spokesperson, food recalls are the responsibility of MAPAQ and CFIA. The spokesperson added that MSSS worked in collaboration with MAPAQ and other federal authorities on the investigation.

The first public notice of the Quebec outbreak was contained in a public warning and recall notice issued by MAPAQ on June 23. The CFIA did not include a similar warning with its recall notices until Aug. 11.

No public health alerts were posted on the Minnesota Department of Health website regarding the norovirus illnesses or ice cream recall in that state.

What consumers should know about norovirus
Norovirus is the leading cause of outbreaks from contaminated food in the United States, according to the Centers for Disease Control and Prevention. It accounts for approximately about half of all foodborne illnesses in the country every year.

Symptoms of norovirus infection include nausea, vomiting, diarrhea and stomach pain. The symptoms usually develop within 12 to 24 hours after exposure to the virus and last one to three days days.

Although extremely unpleasant, most cases of Norovirus are self-limiting, and do not present a long-term health risk, according to the CDC. Nevertheless, seniors and young children are at heightened risk of severe dehydration if infected with the virus.

Most cases of norovirus illness in the population at large are shrugged off as so-called stomach flu. Victims are usually not seen by doctors, and the infections go unreported.

A national survey carried out in the United Kingdom in 2011 determined that only one in every 23 people with norovirus consulted a physician. Overall, for every 288 cases of norovirus occurring in the general population, only one was reported to national surveillance authorities.

Timeline for Quebec, Minnesota outbreaks
August 4-14, 2016: Norovirus illnesses associated with consumption of raspberry chocolate chip ice cream at four Minneapolis-St. Paul area venues.

March-May 2017: Three separate outbreak clusters involving six seniors’ residences, all of which were serviced by a single central kitchen.

May 2, 2017: Individually quick frozen (IQF) Red Raspberries from Taian Runko Industry International Trade Co. Ltd. in Taian, Shandong China, is added to the Red List of Import Alert 99-35, citing norovirus GII contamination.

May 31, 2017: CFIA is notified by Quebec authorities that norovirus outbreak clusters appear to be linked to raspberries, and initiates a food safety investigation.

June 2017: Two additional outbreak clusters occur, one at a daycare center and the other at a hotel.

June 20, 2017: CFIA issues first product recall notice for IQF raspberries imported from China.

June 23, 2017: MAPAQ issues first consumer alert and recall notice for IQF raspberries and some products containing the raspberries, reporting for the first time the existence of “many” illnesses associated with consumption of IQF raspberries.

July 2017: Two additional outbreak clusters are reported, one at a daycare center and the other at a seniors’ residence.

This story first appeared in Food Safety News and is reproduced here with permission.