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Journal of Food Safety
1/29
2009
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FDA Recall of Products Containing Peanut Butter:
Salmonella Typhimurium
Updated: January 29, 2009
Peanut
butter facility knowingly released Salmonella-tainted product
Source of Article: http://members.ift.org/IFT/Pubs/Newsletters/weekly/nl_012809.htm
The U.S. Food and Drug Administration
(FDA) along with the Centers for Disease Control and Prevention (CDC)
held a media teleconference on Jan. 27 to update consumers on the Salmonella
typhimurium outbreak in peanut butter products. According to Stephen Sundlof,
Director, Center for Food Safety and Applied Nutrition, FDA, the agency
has concluded its investigation of the Peanut Corporation of America (PCA)
facility in Blakely, Ga. This is the plant that the FDA has determined
to be the source of the current Salmonella outbreak. That inspection was
initiated on Jan. 9, 2009, and the inspection team included FDA investigators,
FDA microbiologists, as well as representatives from Centers for Disease
Control and Prevention (CDC) and the Georgia Department of Agriculture.
At the conclusion of the inspection, a FDA 483, which is a list of deficiencies
observed by the inspection team at the facility, was issued to PCA that
identifies a number of good manufacturing deficiencies associated with
the firm's manufacturing process. Specifically, the team identified approximately
12 instances in 2007 and 2008 where the firm, as part of their own internal
testing program, identified some type of Salmonella and released a product
after it was retested, in some case by a different laboratory. The inspection
also identified a number of deficiencies related to the firm¡¯s cleaning
programs and procedures for their manufacturing equipment as well as failure
to take steps to mitigate Salmonella contamination or crop contamination
in the facility. Finally, the inspection revealed environmental samples
that were collected during the inspection that tested positive for Salmonella.
During the teleconference,
the FDA and CDC reassured the press and public that the FDA, along with
its State counterparts, has visited nearly 1,000 firms who purchased products
originating from PCA to facilitate the recall of products. The FDA continues
to work with CDC, State Officials, and PCA to test additional peanut-containing
products, track additional distribution sources, and review distribution
records. So far there are 501 persons from 43 states and one additional
person in Canada that have been infected with the outbreak strain of Salmonella
typhimurium; of these, 108 or 22% were hospitalized because of the illness
and eight deaths have been reported that may be associated with the outbreak.
According to Robert Tauxe, Deputy Director, Division of Foodborne Bacterial
and Mycotic Diseases, CDC, the outbreak appears to be ongoing and the
numbers of new cases have decreased modestly.
FDA
reports filthy conditions at peanut plant
Source of Article: http://www.newsday.com/
BY DELTHIA RICKS 4:10 PM EST, January 28, 2009
Inspectors investigating the Georgia peanut-processing plant at the center
of the nationwide salmonella outbreak found cockroaches, slimy residue
on a conveyor belt and mold colonizing the plant's ceilings and walls,
a federal report shows.
Blatant violations of food safety practices were evident throughout the
Peanut Corporation for America's Blakely, Ga., plant, which shipped peanut
butter to companies nationwide for ready-to-eat products.
U.S. Food and Drug Administration inspectors, at the plant over the course
of 18 days, noted precautions to "protect food and food contact surfaces
from contamination with microorganisms [could not] be taken because of
deficiencies in plant construction and design."
For example, mops, used for scrubbing floors -- known to have salmonella
in their cracks -- were washed in the same sinks as utensils used for
making peanut butter.
FDA
Form 483 Inspection of Peanut Corporation of America- A Company Out of
Control
Source of Article: http://www.marlerblog.com/
Bottom line is that we are amending the complaint in the first filed civil
case in Federal Court in Georgia to add a claim for Punitive Damages.
Even the "American Peanut Council (APC) expressed its shock and dismay
at findings that report the Peanut Corporation of America (PCA) knowingly
released a product with potential salmonella contamination into the food
supply....The findings of the FDA report can only be seen as a clear and
unconscionable action of one irresponsible manufacturer."
Peanut
Plant Knew of Contamination, Officials Say
Source of Article:
http://www.nytimes.com/2009/01/28/us/29Peanut.htmlhp
By GARDINER HARRIS Published: January 28, 2009
The Georgia peanut plant linked to a nationwide salmonella outbreak that
has killed eight people and sickened more than 500 knew on at least 12
occasions over the past two years that its product was contaminated but
sold it anyway, according to federal officials.
Officials from the Food and Drug Administration and the Centers for Disease
Control and Prevention traced the outbreak to Peanut Corporation of America¡¯s
plant in Blakely, Ga. And on Jan. 9, investigators descended on the plant
for a thorough inspection.
Michael Rogers, director of the division of filed investigations at the
F.D.A., said that the inspectional team found records showing that on
at least 12 occasions between 2007 and 2008, the company¡¯s own tests of
its product ¡°identified some type of salmonella and released a product
after it was retested, in some cases by a different laboratory.¡±
Mr. Rogers said the positive test results should have led the company
to take actions to eliminate the contamination. ¡°It¡¯s significant because,
at the point at which salmonella was identified, it shouldn¡¯t be there,
based on the manufacturing process that¡¯s designed to mitigate salmonella,
actually eliminate it.¡±
The firm took no steps to clean its plant after the test results alerted
the company to the contamination, and the inspection team found problems
with the plant¡¯s routine cleaning procedures as well, Mr. Rogers said.
Retesting contaminated product until it tests clean and then selling that
product is not appropriate, according to agency officials. ¡°This is a
practice that the firm should not have engaged in,¡± Dr. Stephen Sundlof,
director of the agency¡¯s food center said on Tuesday.
Calls to the Peanut Corporation on Wednesday were not immediately returned.
But in a statement to reporters, George Clarke, a spokesman for the company,
said it ¡°has cooperated fully with F.D.A. from Day 1 during the course
of this investigation.¡± He added, ¡°We have shared with them every record
that they have asked for that is in our possession, and we will continue
to do so.¡±
More than 100 children under the age of 5 have been sickened, and illnesses
have been reported in at least 43 states, said Dr. Robert Tauze, deputy
director of the Division of Food Borne Bacteria and Mycotic Diseases at
the disease centers. Figures from the centers indicate that Ohio, California,
Massachusetts, Virginia, Michigan and Minnesota have reported the most
cases.
The company¡¯s peanut products are used primarily at institutions like
schools and nursing homes and as ingredients in commercial snack products.
As of Wednesday, more than 125 products have been recalled.
The plant where the contamination was discovered, located in the southwestern
corner of Georgia, has a history of sanitation lapses. Inspection reports
provided to The New York Times by Georgia officials indicated this week
that the company was cited on numerous occasions in 2006 and 2007 for
having dirty surfaces and dirt buildup throughout its plants. It was found
to be in violation of cleanliness standards in 2008 as well.
Inspections by the State Agriculture Department found areas of rust that
could flake into food, gaps in warehouse doors large enough for rodents
to get through, unmarked spray bottles and containers and numerous violations
of other practices designed to prevent food contamination. The plant was
recently shut down.
A typical entry from an inspection report, dated Aug. 23, 2007, said:
¡°The food-contact surfaces of re-work kettle in the butter room department
were not properly cleaned and sanitized.¡± Another entry noted: ¡°The food-contact
surfaces of the bulk oil roast transfer belt¡± in a particular room ¡°were
not properly cleaned and sanitized. The food-contact surfaces of pan without
wheels in the blanching department were not properly cleaned and sanitized.¡±
A code violation in the same report observed ¡°clean peanut butter buckets
stored uncovered,¡± while another cited a ¡°wiping cloth¡± to ¡°cover crack
on surge bin.¡± Tests on samples gathered on the day of that inspection
were negative for salmonella.
Two inspection reports from 2008 found the plant to be out of compliance
with practices for making sure ¡°food and non-food contact surfaces were
cleanable, properly designed, constructed and used.¡±
The state performs the inspections on behalf of the Food and Drug Administration
as part of a contractual agreement with the federal agency, officials
said.
Anahad O¡¯Connor and Roni Caryn Rabin contributed reporting.
Officials
call for criminal probe into salmonella recall
Source of Article: http://www.usatoday.com/
From staff and wire reports
Senior congressional and state officials called Wednesday for a federal
probe of possible criminal violations at a Georgia peanut processing plant
linked to the nationwide salmonella outbreak.
The government Tuesday accused the peanut butter manufacturer Peanut Corp.
of America (PCA) of shipping products in 2007 and 2008 after internal
tests found bacterial contamination, violating food safety regulations.
The company's actions "can only be described as reprehensible and
criminal," said Rep. Rosa DeLauro, D-Conn., who oversees Food and
Drug Administration funding. "Not only did this company knowingly
sell tainted products, it shopped for a laboratory that would provide
the acceptable results they were seeking. This behavior represents the
worst of our current food safety regulatory system."
In Georgia, the state's top agriculture official joined DeLauro in asking
the Justice Department to determine if the case warrants criminal prosecution.
"They tried to hide it so they could sell it," said Georgia
Agriculture Commissioner Tommy Irvin. "Now they've caused a mammoth
problem that could destroy their company ? and it could destroy the peanut
industry."
There was no immediate response from Peanut Corp., which owns the Blakely,
Ga., processing plant at the center of the investigation. The company
has previously said it fully cooperated with the salmonella investigation.
Irvin, the Georgia agriculture official, said he was outraged by the company's
actions and said a state criminal probe was possible. He would not, however,
specify which Georgia laws the company may have violated for fear it would
help the company start planning its defense.
Meanwhile, state lawmakers were drafting a plan to require food makers
to report the results of internal inspections to state officials, something
the peanut plant in Blakely wasn't required to do.
Peanut butter and peanut paste manufactured by Peanut Corp. has been tied
to the salmonella outbreak that has sickened 501 people in 43 states and
is believed to have contributed to eight deaths.
The FDA said that its inspection of the plant found records of 12 instances
in which plant officials identified salmonella in ingredients or finished
products. The products should not have been shipped, the FDA says. PCA
took no steps to address cleaning after finding the salmonella, says Michael
Rogers, director of the FDA's division of field investigations.
In some instances, the company had the product tested again by a different
laboratory and got a clean test result, FDA officials said in a telephone
conference with reporters.
It's quite possible that a
retest would miss the salmonella, says Michael Doyle, director of the
University of Georgia's Center for Food Safety. The product should have
been destroyed after the first positive test result, he says.
This outbreak is hitting children especially hard, says Robert Tauxe of
the Centers for Disease Control. Half of those stricken are younger than
16, and 21% are under 5, Tauxe says. While PCA's peanut butter was sold
in bulk to institutions, its peanut paste has been used as an ingredient
in snack foods.
The FDA says it has not found the exact outbreak strain in the plant,
but it has been found in tubs of peanut butter made at the plant, considered
the sole source of the contamination.
"It's incredibly negligent," says William Hubbard, a former
FDA associate commissioner. Hubbard questions why the FDA didn't act sooner,
given the sanitation violations found by state inspectors.
Previous inspection reports by the Georgia Department of Agriculture found
deficiencies in how well the plant was cleaned.
In a statement issued Tuesday, PCA said it "has cooperated fully
with FDA from day one during the course of this investigation. We have
shared with them every record that they have asked for that is in our
possession, and we will continue to do so."
| Shipping products known to be contaminated is "a violation of the
law," says the FDA's Stephen Sundlof. "Whether or not there
was any criminal activity involved is a different issue."
Contributing: Elizabeth Weise and Julie Schmit, USA TODAY; Associated
Press
FDA
and CDC Four Types of Salmonella Found at Peanut Corporation of America
Source of Article: http://www.marlerblog.com/
According to AP, FDA and CDC officials say four kinds of salmonella have
been identified in the growing investigation of tainted peanut products.
A congressional official briefed on the investigation said health officials
have identified four types of salmonella as they focus on a Georgia facility.
The official spoke on condition of anonymity because the investigation
is continuing. Salmonella Typhimurium is the strain that caused the illnesses.
Two other strains were found on the floor of the facility and a third
in a container of peanut butter from the plant.
Usually, we get one outbreak strain of bacteria as opposed to four in
any given outbreak. I would expect this to mean the recall may expand
in both in time (going back further into 2008) and scope (amount of product
to be recalled).
And, we complain about Chinese food safety?
Peanut
Plant Was Cited for Violations
Source of Article: http://www.nytimes.com/2009/01/27/health/27peanuts.html?_r=3&ref=health
By RONI CARYN RABIN Published: January 26, 2009
The plant in Georgia that produced peanut butter tainted by salmonella
has a history of sanitation lapses and was cited repeatedly in 2006 and
2007 for having dirty surfaces and grease residue and dirt buildup throughout
the plant, according to health inspection reports.
Inspections of the plant in Blakely, Ga., by the State Agriculture Department
found areas of rust that could flake into food, gaps in warehouse doors
large enough for rodents to get through, unmarked spray bottles and containers
and numerous violations of other practices designed to prevent food contamination.
The plant, owned by the Peanut Corporation of America of Lynchburg, Va.,
has been shut down.
A typical entry from an inspection report, dated Aug. 23, 2007, said:
¡°The food-contact surfaces of re-work kettle in the butter room department
were not properly cleaned and sanitized.¡± Additional entries noted: ¡°The
food-contact surfaces of the bulk oil roast transfer belt¡± in a particular
room ¡°were not properly cleaned and sanitized. The food-contact surfaces
of pan without wheels in the blanching department were not properly cleaned
and sanitized.¡±
A code violation in the same report observed ¡°clean peanut butter buckets
stored uncovered,¡± while another cited a ¡°wiping cloth¡± to ¡°cover crack
on surge bin.¡± Tests on samples gathered on the day of that inspection
were negative for salmonella.
At a later inspection, on Dec. 14, 2007, no violations were noted, but
the report said the plant was ¡°shut down for cleaning.¡±
The inspection reports were provided by Georgia officials in response
to a request made by The New York Times under the state¡¯s open-records
act.
State officials said they could not release two recent inspection reports
from 2008 because of the continuing investigation into the plant. The
state performs the inspections on behalf of the Food and Drug Administration
as part of a contractual agreement with the federal agency, the officials
said.
Representatives of the Peanut Corporation of America did not respond to
requests for comment.
The salmonella outbreak has sickened almost 500 people around the country
and is linked to seven deaths. More than 125 products containing peanut
butter or peanut paste from the Georgia plant have been recalled.
National
salmonella death toll rises to 7
Source of Article: http://www.newsday.com/services
STAFF AND WIRE REPORTS; Staff writer Ridgely Ochs contributed to this
story.
January 24, 2009
A seventh death was linked Friday to a nationwide outbreak of salmonella
associated with tainted peanut butter and paste sourced to the Peanut
Corp. of America's plant in Blakely, Ga., authorities confirmed.
Although their exact causes of death have not been determined, all seven
people have died after being infected with the bacterial strain Salmonella
Typhimurium, the Centers for Disease Control and Prevention said on its
Web site. A spokesman confirmed there have now been three deaths in Minnesota,
two in Virginia and one each in North Carolina and Idaho.
In New York, an Erie County resident has been added to the list of those
infected, bringing to 19 the number known to have been sickened in the
state so far, said Beth Goldberg, a state Department of Health spokeswoman.
All the New York cases occurred between Sept. 28 and Dec. 25, 2008, she
said, with the ages of those afflicted ranging from 2 to 68. Three of
those cases have been on Long Island.
There have been 493 cases reported in 43 states and one Canadian province
of people sickened, though authorities stress the numbers sickened are
likely far in excess of that as many cases go unreported. Known patients
ranged in age from 1 to 98, and 22 percent of the those have been hospitalized.
The most recent known onset of reported illness was Jan. 8.
Another 10 firms Friday recalled products that use PCA peanut butter or
paste - bringing to roughly 360 the number of products affected - as it
emerged that the plant at the center of the probe laid off most of its
roughly 50 workers.
PCA president Stewart Parnell confirmed the layoffs Friday through a public
relations firm and it was unclear when the plant would be running again
and whether the workers will be brought back. Recalled products range
from snack bars to ice cream to even pet food.
While PCA is a relatively small
supplier on the national scene, its peanut products are supplied in bulk
direct to private food labels and manufacturers, as well as institutions
such as nursing homes and schools. Health officials are focusing on 30
companies out of a total of 85 that received peanut products from the
Georgia plant.
The outbreak has triggered a congressional inquiry and renewed calls for
reform of food safety laws.
Peanut butter
food poisoning cases top 500
Source of Article: http://www.msnbc.msn.com/id/28864316/
List of recalled cookies, cakes and other treats continues to expand
msnbc.com staff and news service reports
updated 6:39 p.m. PT, Mon., Jan. 26, 2009
Confirmed cases of salmonella infection linked to tainted peanut butter
continue to grow, rising to 501 in 43 states, according to latest figures
from federal health officials.
New cases were reported as of late Sunday by states involved in the outbreak,
including Arizona, Iowa, New Jersey, New York and Oregon. One ill person
has been reported from Canada.
The mounting numbers of foodborne illness have been accompanied by a deluge
of recalled cakes, crackers, cookies, ice cream, energy bars and more
from dozens of manufacturers and retailers who bought peanut butter and
peanut paste products from a Blakely, Ga., commercial processing facility.
Even companies not linked to the tainted products made at the Peanut Corp.
of America plant have pulled peanut butter foods to assuage worried consumers.
On Monday, Starbucks Corp. announced it removed all peanut butter treats
from stores in the U.S. and Canada.
To help consumers, the Food and Drug Administration has set up a searchable
list of recalled peanut products on its Web site. No major brands of peanut
butter sold in jars have been implicated.
Peanut butter is not normally thought of as a high-risk product for salmonella
infection. The bacteria, a frequent source of food poisoning, are supposed
to be killed off in the roasting process. Officials say the bacteria remain
dormant in the peanut butter until eaten, when they start growing and
cause infection.
Originally the problem appeared limited to peanut butter shipped in big
tubs to institutional customers such as nursing homes. But then peanut
paste was implicated. Made from ground roasted peanuts, it is used as
an ingredient in dozens of other products sold directly to consumers.
Investigators from the federal Centers for Disease Control and Prevention
are continuing to look for a precise source of the contamination, a spokeswoman
said.
For first
time, trace amount of mercury found in corn syrup
(Minneapolis Star Tribune, MN) By MATT McKINNEY
A test of popular processed foods from some of the biggest names in the
industry found trace amounts of mercury, according to the Institute for
Agriculture and Trade Policy, a nonprofit group based in Minneapolis.
The amounts of mercury found was far less than that commonly seen in most
fish and seafood, but turned up in many foods not previously known to
be sources of mercury, including many preferred by children, the group
said. It includes Nutri-Grain Strawberry Cereal Bars, Quaker Oatmeal to
go bars, Hershey's Chocolate Syrup, Yoplait Strawberry yogurt, Market
Pantry Grape Jelly and Coca-Cola, it said.
"This seems like an avoidable source of mercury that we didn't know
was out there," said David Wallinga, one of the study's co-authors.
The study concluded that the mercury came from food plants that use caustic
soda laced with mercury to produce high fructose corn syrup for major
food companies. The researchers cautioned that their study was limited.
It tested 55 consumer items, finding mercury in one third of the samples
ranging from 30 to 350 parts per trillion. A part per trillion is the
rough equivalent of a drop of water in 20 Olympic-sized swimming pools.
Several companies named in the IATP report defended their products Monday,
pointing to the very low levels of mercury detected. "You would have
to eat more than 100 pounds of ketchup each day to even come close to
reaching the EPA's safe exposure level," said ConAgra spokeswoman
Stephanie Childs.
A spokesman for General Mills challenged the science behind the report,
saying it didn't identify which form of mercury was detected and that
parts per trillion of mercury can be found in water, soil and plant and
animal tissue. "To suggest a safety concern on the basis of this
study is irresponsible," said Tom Forsythe, a spokesman.
A group representing the high fructose corn syrup industry said food plants
no longer use the mercury-containing ingredients that caused contamination
in the past, adding that four-year-old samples were cited in an academic
paper that was released in tandem with the IATP report.
"This study appears to be based on outdated information of dubious
significance," said Audrae Erickson, president of the Corn Refiners
Association.
The IATP, however, said four plants in Georgia, Tennessee, Ohio and West
Virginia still use the "mercury-cell" technology that leads
to contamination. A fifth plant in Wisconsin has begun converting its
plant to use mercury-free agents.
The report was published Monday in the peer-reviewed journal Environmental
Health. Lead author Renee Dufault, a former Food and Drug Administration
scientist, said she presented findings about mercury in processed food
to the FDA after preliminary testing in 2005.
"Environmental mercury exposure via food, water and air is a threat
to sensitive populations -- those who may not be able to effectively metabolize
mercury (autistic children and the elderly). Sensitive populations may
be bioaccumulating mercury and this leads to neurological effects,"
she said in an email.
An FDA spokesman said the agency was overwhelmed with the peanut butter
salmonella scare and could not respond immediately to this issue.
The mercury findings, while potentially alarming, should be viewed in
context, said Michael Jacobson, executive director of the Center for Science
in the Public Interest. The report found 300 parts per trillion of mercury
in Jack Daniel's Barbecue Sauce, but that's still 30 to 3,000 times less
than the amount of mercury found in fish and seafood."I suspect people
eat more fish than barbecue sauce," he said.
The type of mercury commonly found in fish and seafood is methyl mercury,
and its effects are known to be toxic, but the type of mercury found in
the packaged foods is not yet known, the report's authors said.
Heavy metal contamination in the food chain of industrialized nations
is not uncommon. A 2004 study by the World Health Organization found an
average adult consumes 100 micrograms of mercury per week in Portugal,
and more than 50 micrograms per week in Italy, Germany and France. 1-26-09
Consumer Alert: Keeping Food Safe During An Emergency
D.C. Department
of Health Confirms: Norovirus Back at CUA
Source of Article: http://blogs.cuatower.com/2009/01/26/norovirus/
Norovirus, which spread across campus in December 2006, is back according to an e-mail from the CUA Office of Public Affairs.
Today, D.C.¡¯s Department of Health told Catholic University¡¯s Student Health Services that initial tests confirmed the illnesses were caused by the virus. The first student was treated on the evening of Jan. 21, and 23 students have reported symptoms including nausea, vomiting and diarrhea. The University has focused additional cleaning efforts on buildings frequented by students, and Dining Services has implemented a series of precautionary measures, according to the e-mail.
¡°While all the known instances of the illness have occurred among the student population, all members of the campus community are asked to be attentive to this outbreak and to follow recommendations for containing it,¡± said the e-mail. ¡°In particular, we would like to remind all students to be vigilant about hand washing, to not share eating utensils, and to refrain from group activities, if they are ill.¡±
In Dec. 2006, 130 Catholic University students fell ill during exam week because of the virus. The District of Columbia¡¯s Department of Health (DOH) found no specific cause or source of the Norovirus outbreak, but found that the risk factors for becoming ill included living in the dorms, eating in the student cafeteria and using the on-campus computer labs.
Two separate food inspectors
with the DOH found several critical violations on Dec. 12, 2006, which
required correction within five days. Such violations included improper
glove and hair restraint, poor hand-washing, unclean food utensils and
equipment, and the presence of fruit flies.
While the food preparation area violations were ¡°not egregious,¡± the University
fixed them and in addition, has spent thousands of dollars on new equipment
and training for custodial staff.
On Dec. 13, 2006, four food samples were taken from the cafeteria: the
jerk chicken, Caribbean chicken, rice and beans and sausage. Bacteria
cultures of these samples tested negative for growth. At the recommendation
of the DOH, the University instituted a mass cleaning of the campus using
dilute bleach on Dec. 14, 2006.
The DOH recommended increasing the availability of alcohol-based hand cleaning gels in the cafeteria. The University was working on placing the dispensers in computer labs and other common areas and encouraging students to wash their hands frequently.
The Jan. 26, 2009 e-mail from Victor Nakas:
The District of Columbia Department of Health informed Catholic University Student Health Services this afternoon that initial test results indicate that the recent gastrointestinal illness being experienced by some CUA students is caused by norovirus. Since the first student was treated late in the evening on Jan. 21, 23 students have reported symptoms including nausea, vomiting, and diarrhea.
While all the known instances of the illness have occurred among the student population, all members of the campus community are asked to be attentive to this outbreak and to follow recommendations for containing it that are outlined in the Web sites indicated at the end of this message. In particular, we would like to remind all students to be vigilant about hand washing, to not share eating utensils, and to refrain from group activities, if they are ill.
Since last Thursday, Jan. 22, the university¡¯s Custodial and Special Event Services staff have focused additional cleaning and sanitization efforts on targeted buildings frequented by students. CUA¡¯s Dining Services has also implemented a series of precautionary sanitization measures.
Students who develop symptoms
are advised to follow the suggestions on the Student Health Services Web
site at http://health.cua.edu/selfhelp/Nausea.cfm or call Student Health
Services at 202-319-5744 to make an appointment. If you are experiencing
extreme dizziness, lightheadedness, increased abdominal pain, or blood
in the vomit or stool, you may need to be seen in the emergency room.
Please call Student Health Services between 9 a.m. and 5 p.m. before heading
to the emergency room. When Student Health Services is closed, an on-call
physician is available for consultation by calling 202-269-7000. Calling
the after-hour physician is always recommended before heading directly
to the emergency room. The operator will take your information and have
the doctor call you.
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