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Summary of Food Safety Modernization Act (Senate debate pending)
Posted on April 12, 2010 by Drew Falkenstein
Not exactly fresh out of committee, but out of committee nonetheless, senate bill 510 (a/k/a the Food Safety Modernization Act) makes its way to the senate floor soon, possibly this week. The full senate debate and subsequent vote is certainly timely, as just today Michael Moss was awarded the Pulitzer Prize for his story on Stephanie Smiths E. coli O157:H7 illness and Linda Rivera's long-awaited emergence from a Nevada hospital where she has spent almost a year after also being infected by E. coli O157:H7. Stephanie was sickened by a hamburger made by Cargill, and Linda by contaminated cookie dough made by Nestle.
The Food Safety Modernization Act is truly an important piece of legislation, in that it affects every citizen of this country, and even some abroad, on a daily basis. The bill substantially modifies the Federal Food Drug and Cosmetics Act, and generally gives the Food and Drug Administration better authority and ability to monitor the safety of our food supply, and take quicker and more effective action for food companies that don't adequately protect against foodpoisoning risks.
Among other, more specific, things, the Food Safety Modernization Act:
Amends the Federal Food, Drug, and Cosmetic Act (FFDCA) to expand the authority of the Secretary of Health and Human Services (the Secretary) to regulate food, including by authorizing the Secretary to suspend the registration of a food facility.
Requires each food facility to evaluate hazards and implement preventive controls.
Directs the Secretary to assess and collect fees related to: (1) food facility reinspection; (2) food recalls; and (3) the voluntary qualified importer program.
Requires the Secretary and the Secretary of Agriculture to prepare the National Agriculture and Food Defense Strategy.
Requires the Secretary to: (1) identify preventive programs and practices to promote the safety and security of food; (2) promulgate regulations on sanitary food transportation practices; (3) develop a policy to manage the risk of food allergy and anaphylaxis in schools and early childhood education programs; (4) allocate inspection resources based on the risk profile of food facilities or food; (5) recognize bodies that accredit food testing laboratories; and (6) improve the capacity of the Secretary to track and trace raw agricultural commodities.
Requires the Secretary, acting through the Director of the Centers for Disease Control and Prevention (CDC), to enhance foodborne illness surveillance systems.
Authorizes the Secretary to order an immediate cessation of distribution, or a recall, of food. Requires the Administrator of the Environmental Protection Agency (EPA) to assist state, local, and tribal governments in preparing for, assessing, decontaminating, and recovering from an agriculture or food emergency.
Provides for: (1) foreign supplier verification activities; (2) a voluntary qualified importer program; and (3) the inspection of foreign facilities registered to import food.

Canada: Link made between listeriosis cases and deli meat
By Sarah Schmidt, Canwest News ServiceMarch 12, 2010
Ontario's chief medical officer confirmed Friday a "genetic fingerprint" between two recent listeriosis cases and contaminated deli meat produced at a federally regulated meat plant -- the first such match since Canada was rocked in the summer of 2008 with a deadly outbreak.
Arlene King said public health officials in Ontario have linked two cases of listeriosis to a genetic match from Siena-brand prosciutto cotto cooked ham, recalled Thursday, which covers products with best before dates of March 8 and 22 from delis and grocery stores in three provinces.
"Both individuals reported eating food products from the company. They were hospitalized but they are now recovering at home," said King.
The genetic fingerprint is also a match to a Siena-brand mild cacciatore salami, said King, who also revealed the number of Ontarians who have fallen ill from listeriosis this year is higher than normal.
Usually, there are about 40 cases annually. To date, there have already been 14 cases reported, she said. Ten of the 12 other cases do not appear to be related, while lab results for the other two are still pending.
"At this point in time, we do not know what the source of infection is in the majority of these individuals, and we may never know," she said. "Whether or not all of those, or any of those . . . are linked to any kind of common source is unknown at this point."
In the meantime, King warned people not to consume the two products, manufactured by the Toronto-based Siena Foods Ltd. "They both have the exact same genetic fingerprints as two listeriosis cases in Ontario," she said.
The salami, recalled jointly last December by the Canadian Food Inspection Agency and Siena Foods, was distributed in Ontario and Quebec and may have been distributed nationally. The prosciutto was distributed in Ontario, Quebec and Alberta, according to CFIA, which alerted consumers to the contaminated meat late Thursday.
The Public Health Agency of Canada could not immediately say whether any listeriosis cases in other jurisdictions are under investigation for a link to Siena meats. Alberta's Ministry of Health on Friday said there are no known cases in that province, but public health officials are aware of the situation and will continue to monitor it.
The Ontario match is the first since the massive Maple Leaf recall in 2008. Twenty-two people -- most of them elderly Canadians living in provincial long-term care facilities or hospitals -- died after consuming deli meats contaminated with listeria produced at a government-inspected Maple Leaf plant in Toronto.
Siena Foods did not return phone calls made by Canwest News Service Friday.
This most recent announcement follows an effort by the PHAC and CFIA to rehabilitate their images in the wake of the 2008 listeriosis outbreak.
CFIA said Friday there was "increased regulatory scrutiny" at the Siena plant in Toronto as a result of the salami recall on Dec. 21, 2009. This included a hold-and-test policy, instituted after the Maple Leaf outbreak, where officials hold and test certain finished products before allowing them to be distributed to the marketplace.
In this instance, certain Siena products were held and tested until the policy was lifted in February.
The Siena prosciutto would have been sold to consumers after Jan. 11, 2010.

Small Farms Balk at Food-Safety Bill
WASHINGTON?Congress's food-safety fight is nearing an end but small farmers still have a bone to pick with the legislation.
The Senate version of a food-safety bill has attracted broad bipartisan support and is expected to pass easily soon after Congress returns from recess next week. Iowa Democratic Sen. Tom Harkin, a co-sponsor, predicted it would be "on the president's desk by May." But small farmers worry the measure's fees and inspection requirements would be ruinously expensive and are pushing for exemptions.
"I know people who have been small farmers for 25 to 30 years who are looking to get out of the business because food safety is becoming so alarmist," said Mary Alionis, whose eight-acre Whistling Duck Farm in Grants Pass, Ore., sells produce to farmers markets and restaurants.
According to the Centers for Disease Control and Prevention, there are an estimated 76 million U.S. cases of food-borne illness annually, resulting in 325,000 hospitalizations and 5,000 deaths.
A report by the inspector general of the Department of Health and Human Services issued Wednesday said the Food and Drug Administration inspected fewer than one-quarter of U.S. food-production facilities annually and failed to take regulatory action against more than half of those that violated standards in fiscal year 2007.
Mr. Harkin, chairman of the Health, Education, Labor and Pensions Committee, which unanimously approved the Senate's version of the bill in November, said the FDA "needs additional resources to keep the food on our tables safe."
A salmonella outbreak involving peanut products last year seemed to put food-safety legislation on a fast track. But after the House passed a version of the bill in July, the companion measure got hung up in Senate jurisdictional disputes, then was shunted aside by health-care overhaul legislation.
Both House and Senate versions of the bill would require more FDA inspections of farms, food production and processing facilities, give the agency enhanced authority to order recalls, and force better recordkeeping as food moves from farms to store shelves. The aim is to prevent widespread outbreaks of food-borne illnesses and give the FDA more resources to trace those that occur to their source.
Big food companies generally support the bill, judging the added expenses it would bring to be small compared with the potential financial damage of a vast product recall. But smaller producers say the bill's stepped-up inspection requirements and provisions allowing the FDA to issue preventive recalls would put too big a financial burden on them.
"Small farm groups seriously have problems with this bill," said Deborah Stockton, executive director of the National Independent Consumers and Farmers Association, a coalition of small farmers. "We are not afraid to stand up to it."
Ms. Alionis of Whistling Duck Farm estimated that costs associated with the food-safety legislation could slice 5% off her $200,000 annual profit.
John Ikerd, emeritus professor of agricultural economics at the University of Missouri, Columbia, said the bill's impact on smaller producers "could be a blow to the whole local food movement." He said food-safety requirements should be tailored to reflect the volume of food produced.
That doesn't sit well with some big producers. "Our view is that everyone should have to meet guidelines of food safety no matter where they are and what they grow," said Scott Faber, vice president for federal affairs of the Grocery Manufacturers Association, which represents big producers including General Mills Inc. and Coca-Cola Co.
Rep. Rosa DeLauro (D., Conn.), a longtime advocate of tougher food-safety laws, said the legislation already addresses smaller producers' concerns. For instance, farms selling products directly to consumers from a fruit stand or farmers market would be exempt from some fees and requirements. "We've made all kinds of accommodations to small farmers so that they are not put at risk," she said.

PA Dairy's Raw Milk Permit Suspended
by Suzanne Schreck | Apr 09, 2010

The Pennsylvania Department of Agriculture announced Thursday that it had suspended the permit allowing Pasture Maid Creamery in New Castle, PA, to sell raw milk for human consumption. The move came Monday after testing revealed Campylobacter in the creamery's raw milk.
Campylobacter is found in a wide variety of healthy domestic and wild animals including cattle, sheep, goats, pigs, chickens, ducks, geese, wild birds, dogs, cats, rodents, and marine mammals. The bacteria usually live in the intestines as part of the animal's normal flora, and is shed in feces. Most Campylobacter species do not cause any signs of illness in the animal host.
Ingestion of Campylobacter bacteria by humans causes diarrhea, nausea, vomiting, abdominal pain, headache, and muscle pain. Symptoms typically appear two to five days after exposure. Most cases are mild, do not require hospitalization, and are self-limited; however, Campylobacter jejuni infection, or campylobacteriosis, can be severe and life-threatening.
Campylobacteriosis may cause appendicitis or infect other organs. It can also enter the blood stream. Guillain-Barre syndrome is a severe complication of campylobacteriosis that can lead to paralysis. An estimated one in 1,000 cases of Campylobacter infection results in death.
According to the Pennsylvania Department of Health, at least six people became ill with campylobacteriosis after consuming raw milk from Pasture Maid Creamery in February.
Freezing raw milk will not kill Campylobacter; anyone who has purchased raw milk from Pasture Maid Creamery is urged to discard the milk. Anyone ill with symptoms of campylobacteriosis should contact their health care provider and report their illness to the Pennsylvania Department of Health.

Implementing a Hand Washing Plan
by O. Peter Snyder, Jr., Ph.D. | Apr 09, 2010

Hand washing is a significant food safety risk. If not done properly, many people can be exposed to bacterial, viral, and parasitic pathogens that can cause illness. Of the estimated 76 million foodborne illnesses annually, an estimated 70 percent are caused by improper hand and fingertip washing. The following presentation will discuss the food and non-food sources of pathogens and types of bacteria on found on hands and fingertips, with attention given to Staphylococcus aureus. It will discuss the ineffectiveness of germicidal soaps and alcohol rubs as a replacement for hand washing and the use of a fingertip rinse in the kitchen when hand washing is not a convenient option.
The tested hand / fingertip wash procedure featured in this presentation is two-fold: 1) the double wash when a food handler comes into the kitchen from an outside location such as the toilet and 2) the single wash, which can be used in the kitchen. The procedure is analyzed in terms of the input (level of hazard on fingertips prior to washing), the increase of the hazard, if any, during the process minus the necessary reduction in order to achieve a Food Safety Objective. A detailed description and pictorial flow of the hand wash procedure are presented. The double wash makes use of the nail brush on fingertips and soap and flowing water, which removes pathogens by friction and dilution, followed by a regular wash with soap and flowing water and paper towel dry. The single wash is simply the second part of the double wash.
There is discussion of the misconception of glove use and when gloves can be effectively used.
Hand and fingertip washing should be a part of a food manager's Active Managerial Control plan. How to implement a hand wash plan is presented.
View Handwashing Slideshow:

Food safety proctor accused of letting students cheat
By Lisa Jennings
ORLANDO, Fla. (April 12, 2010) The food safety credentials of 27 foodservice workers in central Florida were revoked recently because of alleged improprieties by the proctor who administered their exams.
The foodservice workers are not accused of wrongdoing, but will be required to retake the test to become certified, the National Registry of Food Safety Professionals said last week.
The incident is the latest example of the National Registry¡¯s attempt to crack down on what some say is a growing number of people attempting to cheat the system under growing pressure to improve food-safety standards.
Under the laws of 20 states, restaurant operators must have at least one employee who has passed an accredited food-safety certification exam. Another 36 states have at least one jurisdiction with similar requirements. The National Registry is one of three groups accredited to develop the food-safety certification exams as well as to approve and oversee the proctors who administer the test.
The proctor under investigation is an employee of a central Florida county school system, who taught a food-safety certification class on the side.
According to the allegations, most of the students in the food-safety class took the test in class, as is required. But for students who missed the test date, the proctor allegedly e-mailed the live test to them. They returned answers, which the proctor filled onto the test form.
The improper practice, which may have gone on for several years, not only allowed students to cheat, it also compromised the safety of the exam questions, said Larry Lynch, president and chief executive of the National Registry.
As a result, the organization has had to spend about $100,000 replacing the exam questions because they were potentially widely exposed. Lynch said the students believed they were taking the test legitimately.
¡°This alleged breach has significantly inconvenienced many innocent people and created an unnecessary financial burden for a number of food establishments and other businesses," Lynch said. ¡°But what we all should have is zero tolerance for any conduct that jeopardizes public health in any way, shape or form.¡±
Last year, a similar incident in California resulted in the invalidation of more than 730 certificates held by foodservice workers there.
That incident, which involved improprieties by three exam givers, caused San Francisco public health officials to call for stricter oversight of the food-safety certification process, which many say is key to preventing foodborne illness.
¡°This is happening with greater frequency,¡± Lynch said. ¡°As the certification becomes more highly regarded, it becomes more popular for people to attempt to game the system.¡±

Food (Safety) Fight
By: Richard Raymond

Too many times in this blog's string of responses I keep reading "just cook it", as if that were the answer to the problem of food borne illnesses.
Handling and cooking raw meat and poultry correctly would go a long way in reducing incidences of food borne illnesses, but in this day and age of more people dining out, more meals being prepared by schools and other organizations, a more diverse population of the US with language, cultural, educational and economic barriers to the receiving of and following safe food handling messages, "just cook it" just does not show an understanding of the problem we face.
The USDA's Food Safety and Inspection Service (FSIS), fortunately, does understand the need to educate consumers and the difficulty in reaching out to people in a fashion that will get the desired response. That desired response is a body of consumers empowered with the knowledge to safely handle food in its preparation stages, thus providing the best line of defense against illnesses.
FSIS just conducted a Food Safety Education Conference at Atlanta, Georgia, March 23-26, 2010. Interest was so high that with over 700 registrants, registration was closed long before the conference even convened. Four years ago a similar conference by FSIS had over 600 persons attend. That conference, in Denver, focused on how to reach at risk audiences on food safety education. This most recent conference title was "Advancements in Food Safety Education: Trends, Tools and Technologies" and it is evident that the goal for this conference was to explore more effective ways to reach every consumer, every retailer and every out of home provider of food to the general public. The agenda can be seen at
Social media tools such as Face Book, You Tube, LinkedIn and Twitter were discussed and used to follow the conference proceedings. Consumer behavior patterns and social marketing were explored, as was how to make recall information more pertinent to consumers. The need to engage with the medical community and food workers are not new subjects, but the "how to BETTER engage" was an important agenda item. How to make instructions on frozen and microwaveable products more meaningful and understandable was debated. Lastly, how to expand partnerships and increase collaboration was considered.
"Just cook it" is a lousy defense of an industry, and a worse statement to make when something goes wrong in the production system and causes illnesses. A gathering such as the one FSIS just hosted with support and collaboration from many other organizations, too numerous to mention here, is the kind of proactive steps we need to help reduce food borne illnesses. I can't wait to read the transcripts once they are posted?I hope the "just cook it" crowd will also read them and learn.

'Growing concern' over marketing tainted beef
By Peter Eisler, USA TODAY

WASHINGTON ? Beef containing harmful pesticides, veterinary antibiotics and heavy metals is being sold to the public because federal agencies have failed to set limits for the contaminants or adequately test for them, a federal audit finds.
A program set up to test beef for chemical residues "is not accomplishing its mission of monitoring the food supply for ¡¦ dangerous substances, which has resulted in meat with these substances being distributed in commerce," says the audit by the U.S. Department of Agriculture's Office of Inspector General.
The health effects on people who eat such meat are a "growing concern," the audit adds.
The testing program for cattle is run by the USDA's Food Safety and Inspection Service (FSIS), which also tests meat for such pathogens as salmonella and certain dangerous strains of E. coli. But the residue program relies on assistance from the Environmental Protection Agency, which sets tolerance levels for human exposure to pesticides and other pollutants, and the Food and Drug Administration, which does the same for antibiotics and other medicines.
Limits have not been set by the EPA and FDA "for many potentially harmful substances, which can impair FSIS' enforcement activities," the audit found.
The FSIS said in a written statement that the agency has agreed with the inspector general on "corrective actions" and will work with the FDA and EPA "to prevent residues or contaminants from entering into commerce."
Even when the inspection service does identify a lot of beef with high levels of pesticide or antibiotics, it often is powerless to stop the distribution of that meat because there is no legal limit for those contaminants.
In 2008, for example, Mexican authorities rejected a U.S. beef shipment because its copper levels exceeded Mexican standards, the audit says. But because there is no U.S. limit, the FSIS had no grounds for blocking the beef's producer from reselling the rejected meat in the United States.
"It's unacceptable. These are substances that can have a real impact on public health," says Tony Corbo, a lobbyist for Food and Water Watch, a public interest group. "This administration is making a big deal about promoting exports, and you have Mexico rejecting our beef because of excessive residue levels. It's pretty embarrassing."
Some contamination is inadvertent, such as pesticide residues in cows that drink water fouled by crop runoff. Other contaminants, such as antibiotics, often are linked to the use of those chemicals in farming. For example, the audit says, veal calves often have higher levels of antibiotic residue because ranchers feed them milk from cows treated with the drugs. Overuse of the antibiotics help create antibiotic-resistant strains of diseases.
"Beef farmers and ranchers pride themselves on producing a safe and wholesome product, and anything less is unacceptable," says Meghan Pusey, a spokeswoman for the National Cattlemen's Beef Association. "We remain committed to working with industry and government partners to eliminate rare safety incidences from a meat supply that is extraordinarily safe by any nation's standards."
Others say legislative action is needed, especially to curb problems with antibiotic residues.
The audit "shows clearly the need for quick action by Congress to place some reasonable limits on the use of antibiotics in farm animals," says Rep. Louise Slaughter, D-N.Y., who has more than 100 co-sponsors on her bill to ban seven types of antibiotics from being used indiscriminately in animal feed. "If we don't remedy this problem, who knows what kind of havoc these residues will have on our bodies."

Audit Finds Tainted Meat Reaching Consumers
by Helena Bottemiller | Apr 14, 2010

Veterinary drugs, pesticides, and heavy metals are making it onto our plates via meat, according to a federal audit released this week.
The U.S. Department of Agriculture (USDA) Office of the Inspector General (OIG) report concludes that the agencies responsible for monitoring harmful residues are "not accomplishing" their mission.
"Together, [USDA's Food Safety Inspection Service], FDA, and EPA have not established thresholds for many dangerous substances (e.g., copper or dioxin), which has resulted in meat with these substances being distributed in commerce," says the audit, which identifies lack of agency commitment and poor interagency coordination as key issues.
The OIG also found that FSIS does not attempt to recall meat, even when its tests have confirmed the "excessive presence of veterinary drugs."
"Not only does overuse of antibiotics help create antibiotic-resistant strains of diseases, but the residues of certain drugs and heavy metals can have potentially adverse health consequences if they are consumed in meat," OIG reported. The audit offers the following table, which lists five drugs and substances found in meat and their potential health effects (click to enlarge):
Harmful residues can find their way into meat in a variety of ways. If drugs are used on a sick animal and adequate time does not elapse between when the drugs are withdrawn and the time of slaughter, the drugs may be found in the animal's meat. If there are pesticides in the feed, pesticide residues can likewise continue on through the food chain.
The report explains the findings are particularly troubling because dangerous residues cannot be cooked out. "While cooking meat properly can destroy [pathogens] before they are consumed, no amount of cooking will destroy residues. In some cases, heat may actually break residues down into components that are more harmful to consumers. Since consumers have no easy way of protecting themselves against the residues of harmful substances in their food, it is important that the national residue program's controls be as robust as possible to prevent meat contaminated with harmful substances from reaching the kitchen table."
"The implications of this audit are huge," said Congresswoman Louise Slaughter (D-CA), the only microbiologist serving in Congress, who has become a champion for curbing the routine, or subtherapeutic, use of antibiotics in agriculture.
"Americans expect our government to protect the public health," she said. "Overuse of antibiotics on farms leads directly to antibiotic-resistant pathogens. In addition, antibiotic and other residues in meat can cause potentially severe health consequences. I am pleased to see that the OIG is taking this issue seriously, and I expect that the Department of Agriculture, the Food and Drug Administration, and the Environmental Protection Agency will take swift and aggressive action to improve oversight of meat safety."
"It's unacceptable. These are substances that can have a real impact on public health," Tony Corbo, a lobbyist for Food and Water Watch, told USA TODAY Tuesday. "This administration is making a big deal about promoting exports, and you have Mexico rejecting our beef because of excessive residue levels. It's pretty embarrassing."
The OIG report says FSIS, EPA, and FDA need to expand the number of substances tested for, improve the methodology for sampling hazardous residues, determine more efficient ways of approving newer methods of testing for drug residues, and collaborate to set tolerances for additional residues.
FSIS did not dispute any of the OIG's findings or recommendations.
The entire report is available here:

Washington D.C. consumer protection: FDA fails to check food makers for years

2010-04-14 13:06:32 (GMT) ( - Justice News Flash, Personal Injury)
Legal news for consumer protection attorneys. The FDA leaves many food manufacturing plants unchecked for years.
Consumer protection attorneys- The FDA has failed to conduct inspections at many food-manufacturing plants, raising the risk of food borne illness occurrences.
Washington, D.C.?Over the last four years, the U.S. food supply has been inundated with outbreaks of food-borne illnesses in an abundance of foods, which may be attributed to the dwindling Food and Drug Administration¡¯s (FDA) review of food manufacturing plants. Government investigators stated that many facilities have gone over five years without being checked by federal inspectors, as reported by MSNBC.
With the drop of inspections of our nations food supplying plants, the likelihood of an outbreak of food borne diseases are rising, thus putting the pubic at risk. A report by the Department of Health and Human Services¡¯ inspector general is making people think twice about the safety of our food. Since 2006, high-profiled outbreaks involving foods like lettuce, peppers, peanuts and spinach has plagued the news. The diseases have caused the U.S. to spend $152 billion in health-related expenses every year.
The report found that food safety violations were not always properly addressed by the FDA. ¡°FDA can assign a facility with the most serious food safety or regulatory infractions an official action indicated (OAI) classification, which warrants agency action to ensure the violation is fixed. But FDA took no regulatory action against 25 percent of facilities it assigned an OAI classification in fiscal 2007. Additionally, 36 percent of facilities with an OAI classification did not receive any follow up from FDA to ensure the violations were corrected.¡± according to the report.
The report indicates that a dwindling FDA workforce and resources are responsible to the lax inspections. The U.S. Centers for Disease Control and Prevention (CDC) estimates that 76 million people across the U.S. get sick every year with food borne illnesses, which 5,000 resulting in deaths.

Peanut Allergy Misdiagnosed in 2 out of 3 Cases
A new generation of sophisticated allergy tests reveals that peanut allergy is often misdiagnosed. Two out of three diagnosed patients would be able to eat peanut without any problems at all. This according to a Swedish study conducted by Karolinska Institutet in collaboration with Phadia.
PORTAGE, Mich.--(BUSINESS WIRE)--Allergy to peanuts is one of the most common and feared food allergies. Due to its infamously severe reactions, peanut allergy has always been associated with a deep anxiety, especially in parents of peanut allergic children. Now, a recent study makes it possible to give a majority of these parents some reassuring news.
¡°However, using these new ImmunoCAP¢ç tests, we were able to distinguish what peanut protein each patient was actually allergic to. This made it possible for us to see which one of them were allergic to the ¡®birch pollen similar¡¯ Ara h 8, and find the cross reaction.¡±
¡°Many people are being told that they are allergic to peanut, that they must avoid them and all foods that might contain them at all cost, are actually not allergic to the nut at all,¡± says Swedish scientist, Professor Magnus Wickman at Sachs¡¯ Children¡¯s Hospital and Karolinska Institutet, Stockholm, Sweden. ¡°In fact, our findings show that two out of three that are considered allergic to peanut only experience mild symptoms, if any symptoms at all. The reason is that these patients are not allergic to peanut, but to birch pollen.¡±
¡°There are several different proteins in peanut that can give rise to allergic reactions. One of them, Ara h 8, is very similar to one of the proteins responsible for birch pollen allergy,¡± adds Dr. Wickman. ¡°What we are seeing in these patients is a mild birch pollen like reaction as a result of peanut consumption, what we call a ¡®cross-reaction.¡¯ Unfortunately, a routine allergy test, either in the skin or the blood, cannot tell the difference and pinpoints the patient as allergic to both peanut and birch pollen.¡±
The problem is in the limitations of today¡¯s routine allergy tests. Normally, either a skin prick test is performed by introducing a small amount of the suspected allergen into the skin, or a basic blood test for antibodies to the allergen extract is carried out. While these tests have great utility, the problem is that neither of them can determine exactly which specific protein(s) in the extract is giving rise to the allergic reaction. To do this requires a closer look at allergy on the molecular level, at exactly which protein is causing the reaction, by testing each component separately. This is a rapidly growing area in allergy diagnostics called molecular allergology, or molecular allergy.
¡°Normal tests based on natural extracts from peanut or birch can only tell that the body is reacting to something in this complex mixture. Molecular allergy can precisely identify the protein that is giving rise to the reaction, making it possible to investigate the cause of allergy, discover false allergies, and find unexpected cross-reactions,¡± says Dr. Wickman.
This is the aim of the BAMSE project, a 10-year study of over 4,000 children born between 1994 and 1996, from which this latest finding is released. The study is conducted by Karolinska Institutet in cooperation with Phadia who developed this new type of ImmunoCAP¢ç Allergen Component tests.
¡°At first, as many as 7.5 percent of the children seemed allergic to peanut at age 8, based on routine tests,¡± says Dr. Wickman. ¡°However, using these new ImmunoCAP¢ç tests, we were able to distinguish what peanut protein each patient was actually allergic to. This made it possible for us to see which one of them were allergic to the ¡®birch pollen similar¡¯ Ara h 8, and find the cross reaction.¡±
¡°Clearly, these children should have been diagnosed with birch pollen allergy and not with a potentially life-threatening peanut allergy,¡± says Magnus Wickman. ¡°In light of these new findings and the new available allergy tests, my advice to parents of peanut allergic children is to contact their physician and ask for additional laboratory testing using allergen component testing.¡±
ImmunoCAP¢ç Allergen Component tests are widely used and widely available in Europe, but in the United States are available to allergy specialists only through the Phadia Immunology Reference Laboratory ( as a Laboratory Developed Test while Phadia works with the U.S. Food and Drug Administration to move towards clearance for ImmunoCAP Allergen Components. With Allergen Components, allergists can test patients for reactions to specific protein components of allergens.
Allergists who wish to order ImmunoCAP Allergen Component profiles, obtain supplies for shipping, or ask questions about the program can call PiRL Customer Service at 1-800-346-4346.
About Phadia:
Phadia is the global leader in allergy, asthma and autoimmunity diagnostics. 8 out of 10 allergy blood tests worldwide are ImmunoCAP¢ç tests from Phadia. The latest addition to the ImmunoCAP¢ç family; ImmunoCAP¢ç Allergen Components were used by researchers at Karolinska Institutet for this study.
Reference: J. Allergy

CDC Reports Decline in Foodborne Illness
Posted on April 15, 2010 by David Babcock
How about a little good news for a change? The CDC announced today, in the Morbidity and Mortality Weekly Report (MMWR), the results of a study indicating a decline in the incidence of a number of high-profile foodborne pathogens:
In comparison with the first 3 years of surveillance (1996--1998), sustained declines in the reported incidence of infections caused by Campylobacter, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC) O157, Shigella, and Yersinia were observed.
On the other hand, incidence of Vibrio infection continued to rise. In addition, vulnerable populations, in particular the young and those of advanced age, continued to suffer disproportionate effects of foodborne illness: "For most infections, reported incidence was highest among children aged <4 years; the percentage of persons hospitalized and the case fatality rate (CFR) were highest among persons aged ¡Ã50 years."
The CDC also provided incidence rates, per 100,000 population for several pathogens, for 2009, encompassing a total of 17,468 culture confirmed illnesses in the tracked pathogens:

Salmonella (7,039; 15.19).
Campylobacter (6,033; 13.02).
Shigella (1,849; 3.99).
Cryptosporidium (1,325; 2.86).
STEC O157 (459; 0.99).
STEC non-O157 (264; 0.57).
Vibrio (160; 0.35).
Listeria (158; 0.34).
Yersinia (150; 0.32).
Cyclospora (31; 0.07)

Farmers Gain in Senate Food Safety Battle
by Helena Bottemiller | Apr 15, 2010

An update on the pending food safety bill, with an outline of key amendments and discussion on the proposed exemption for small farms
Several amendments aimed at lessening the impact on small farms will be adopted in the final version of the food safety bill headed for the Senate floor next week, a key sustainable agriculture group announced yesterday.
The National Sustainable Agriculture Coalition (NSAC) reported that "several very important breakthroughs on important improvements" for its constituents will be included in the manager's amendment, a package of changes agreed upon by both sides before floor debate.
The group has been working closely with Senate staff to address widespread concern in the small, organic, sustainable agriculture communities about the impact the pending FDA Food Safety Modernization Act (S. 510) would have on the growing local food movement.
With key changes in the works, the group may be able to get behind the legislation, NSAC spokeswoman Aimee Witteman told Food Safety News. "Assuming there are no new surprises in the bill and once information is shared about the outcome of the negotiations over Senator Brown's traceback provision [see below], we can support the bill as amended," said Witteman in an email yesterday.
According to NSAC, the support for changes has "picked up speed in the past week" with a floor vote imminent. The group reported that the following changes have been agreed to (it's important to note, the final language has not been worked out):
-The amendment sponsored by Senator Bernie Sanders (D-VT) pertaining to farms that engage in value-added processing or that co-mingle product from several farms will be included in the final bill. It will provide the Food and Drug Administration (FDA) with the authority to either exempt farms engaged in low or no risk processing or co-mingling activities from new regulatory requirements or to modify particular regulatory requirements for such farming operations. Included within the purview of the amendment are exemptions or flexibilities with respect to requirements within S. 510 for food safety preventative control plans, and FDA on-farm inspections.
-The amendments sponsored by Senator Michael Bennet (D-CO) will also be included in the final bill. These amendments, intended to reduce unnecessary paperwork and excess regulation, pertain to both the preventative control plan and the produce standards sections of the bill. FDA will be instructed to provide flexibility for small processors including on-farm processing, minimize the burden of compliance with regulations, and minimize the number of different standards that apply to separate foods. FDA will also be prohibited from requiring farms and other food facilities to hire consultants to write food safety plans or to identify, implement, certify, or audit those plans. With respect to produce standards, FDA will also be given the discretion to develop rules for categories of foods or for mixtures of foods rather than necessarily needing to have a separate rule for each specific commodity or to regulate specific crops if the real food safety issue involved mixtures only.
-The amendment sponsored by Senator Debbie Stabenow (D-MI) to provide for a USDA-delivered competitive grants program for food safety training for farmers, small processors and wholesalers will also be part of the final bill. The training projects will prioritize small and mid-scale farms, beginning and socially disadvantaged farmers, and small food processors and wholesalers. In order to comport with the FDA-specific nature of the overall bill, the farmer training grant program will be provided via a memorandum of understanding between FDA and USDA, but will then be administered by USDA's National Institute for Food and Agriculture. As is the case for all of the provisions in S. 510, funding for the bill and for this competitive grants program will happen through the annual agriculture appropriations bill process.
-The effort championed by Senator Barbara Boxer (D-CA) to strip the bill of wildlife-threatening enforcement against "animal encroachment" of farms will also be in the manager's package. It will require FDA to apply sound science to any requirements that might impact wildlife and wildlife habitat on farms.
Negotiations are ongoing over an amendment proposed by Senator Sherrod Brown (D-OH) to amend the traceability and recordkeeping section of the bill, according to NSAC's update. "We hope to be able to report on the results of that discussion in the coming days," the group said.
Strong disagreement over small farm exemptions
The most contentious amendment in consideration (pdf), proposed by Senator John Tester (D-MT), to exempt food facilities with under $500,000 gross sales from preventative control plan requirements, and traceback and recordkeeping provisions, will not be part of the manager's amendment, but will be debated separately when the bill is brought to the floor.
Tester's language has strong support within the sustainable ag community. In the past week alone, dozens of different action alerts were circulating the internet urging family farmers and supporters of the burgeoning local food movement to call their Senators on behalf of Tester's amendment.
Roland McReynolds, executive director of the Carolina Farm Stewardship Association--a group that has actively organized to press North Carolina Senators to support changes to the bill--said Tester's amendment is the "simplest solution for promoting a healthy, safe food supply." But, many in the food safety community dispute the claim that locally grown, sustainable food is safer, and want to see new federal regulations apply to all producers, regardless of size.
"The concept that small, local, organic equals safe and that large, global, multinational is unsafe is wrong," said David Acheson, former associate commissioner of foods at FDA, adding that he has seen no solid evidence that unconventionally-grown food is microbiologically safer. Acheson thinks Tester's proposal goes too far. "It is asking for trouble...and it is not sound public health policy," he said.
Tony Corbo, a lobbyist for Food & Water Watch, also expressed very strong reservations about the proposal, pointing out that, based on the 2007 Agriculture Census released by the USDA last year, nearly 95 percent of domestic farms would be exempt.
Corbo also noted the exemption could have unintended consequences on the safety of imported food. "If you exempt domestic farms that earn below $500,000 annual income from the bill's provisions, you would also have to exempt any foreign farm below that income level as well--so cheap and unsafe imports could enter our food supply," he said.
Many of the key groups in the Make Our Food Safe coalition, a campaign made up of consumer, public health, and industry groups pushing for the passage of a strong FDA food safety bill, chose not to comment on the changes until final language is agreed upon.
David Plunkett, a senior staff attorney at the Center for Science in the Public Interest (CSPI), who is familiar with the negotiations, indicated yesterday that Senate staff are continuing to work on a compromise. "Stakeholders have been briefed on the broad outlines of the agreements and it appears the offices negotiating the bill want to find good agreements that preserve the bill's public health focus while addressing any legitimate concerns of small and sustainable agriculture," he said.
Both the House and Senate version of the bill--the House passed a food safety reform bill in July--give FDA mandatory recall authority, require more frequent inspections, and ask food facilities to implement food safety plans.

Raw Milk Website Launched
by Zach Mallove | Apr 15, 2010
In the last month alone, two of the largest distributors of raw (unpasteurized, unprocessed) milk in the Northwest, PCC Natural Markets and Whole Foods, announced plans to discontinue the sale of raw milk altogether. The reason, they said, was that many experts, including government officials and scientists, warn that raw milk is a high risk food that potentially contains a wide variety of harmful bacteria--including Salmonella, E. coli O157:H7, Listeria, Campylobacter and Brucella--that may cause illness and possibly death.
State laws in California, Washington state, Pennsylvania, and Connecticut, however, allow raw milk and raw milk products that meet state standards to be sold in retail stores. And proponents say it is more nutritious, tastes better, and is no more harmful than pasteurized milk.
In 2009, two leading public health agencies, the American Veterinary Medical Association (AVMA) and the International Association for Food Protection (IAFP), held informational sessions to discuss emerging issues surrounding the increasing popularity of raw milk. After examining the scope and complexity of the debate, many participants felt that there was a need for a website entirely devoted to raw milk. Last night, such a website was launched.
The site,, is designed to serve as a clearinghouse for scientific studies, presentations, commentaries, regulations, and position statements on the topic. Developed and reviewed by scientists and health educators in universities, government, industry, and trade organizations, the site offers news, Q&A, personal stories, and lucid analysis of the real risks and benefits of raw milk.
Michele Jay-Russell, Co-Organizer of the American Veterinary Medical Association Raw Milk Symposium and President of the American Association of Public Health Veterinarians, said discussions during the session were the inspiration for creating a new Website.
"We continued to exchange information after the meeting, and created a place online where consumers interested in natural foods and health could obtain factual information about the benefits and risks related to raw milk," Jay-Russell said.
Bill Marler, managing partner of Marler Clark, the Seattle-based food safety law firm, said the site is an amazing collaboration of experts, academics, and scientists.
"Marler Clark was proud to support the work of everyone who participated in putting the site together," he said. "Special thanks go to our clients who were willing to share their stories of the real risk of raw milk."

Fish Tale
Published: April 5, 2010Linkedin

Dr. Kurtland Ma found the young man lying on the stretcher in the quiet of the predawn night. He was surprised by how healthy the patient looked: he had learned over the first year of his residency training that those who came to the Jacobi Medical Center emergency room in the Bronx at that hour were often the very sickest patients.
The thin chart reported that the patient came to the E.R. because he was having trouble walking. He had a headache; he felt weak and dizzy, and yet his vitals and initial blood work were completely normal. He was a puzzle, the senior resident told him as she handed Dr. Ma the chart. ¡°I have no idea what¡¯s going on with this guy,¡± she told Dr. Ma. ¡°But he is probably going to need a head CT.¡±
The patient was 28 and said he was healthy until three days ago, when he and his girlfriend went to the Bahamas to celebrate his birthday. After a long day of swimming and snorkeling, they decided to try a restaurant they had heard good things about. They both ordered seafood ? she had the red snapper, he the barracuda ? and then went out dancing. Out on the dance floor the patient doubled over, caught off guard by an intense pain that knifed through his gut and took away his breath. He stumbled to the bathroom. The abdominal cramps and diarrhea came in waves. He kept thinking it would pass, but it didn¡¯t. Finally he decided to go back to the hotel.
As they walked through the streets crowded with other vacationers, his girlfriend teased him for letting a little bug ruin his birthday. But by then all he wanted was to lie down and go to sleep. Once in bed, sleep was elusive. His body ached with fever, and the cramping and diarrhea kept sending him to the bathroom. Finally he woke his girlfriend and told her he had to go to the hospital.
They were in the tiny emergency room in the Bahamian hospital when the vomiting started. Relentless heaves racked his body long after all he¡¯d consumed had been eliminated. The rest of the night was a blur of tests and treatments punctuated by slowly diminishing waves of pain and nausea. The Bahamian doctors returned to the patient¡¯s bedside frequently. He was feverish and even the lightest pressure on his abdomen was excruciating. Was this appendicitis? Hepatitis? Or just a bad case of food poisoning? The CT scan showed a normal appendix. The blood tests showed no signs of hepatitis or any other infection. The antinausea medication stopped the vomiting and slowed the diarrhea.
This was probably food poisoning, a doctor told the exhausted patient. Most food poisoning is caused by ingested bacteria ? E. coli, salmonella or staphylococcus aureus. Seafood-related food poisoning is often linked to a less well-known bug ? Vibrio parahaemolyticus, although that bacteria is usually killed by cooking. Had they eaten sushi? No, their food was well cooked, the girlfriend assured him. The doctor shrugged. Generally it doesn¡¯t make sense to try to identify the bug because the treatment tends to be the same no matter what you¡¯ve got, he told the couple. The most important thing was to avoid becoming dehydrated, and this patient was getting plenty of fluids.
By morning, the patient felt a little better. He was given a prescription for an antibiotic and something for the nausea and sent back to recover in his hotel. He slept for the next two days. Finally the patient felt well enough to venture out. As he dressed he noticed that his hands seemed clumsy. And his feet felt as if they were asleep, as if he were walking on a shifting carpet of tiny nails.
He wasn¡¯t sure he could eat. His girlfriend bought him a smoothie from a juice stand. The fruit drink smelled delicious, and his stomach rumbled eagerly. He took a sip and immediately spit it out. The icy cold drink felt as if it had come straight off the stove ? as if it were boiling hot rather than freezing cold. He took another sip. His mouth burned. It felt too hot to swallow. At this point, the patient decided he¡¯d had enough, and the couple soon flew back to New York. The young man dropped off his girlfriend at home and continued on to the Jacobi emergency room.
Dr. Ma was taking notes as the patient told his story, but when he mentioned this strange reversal of hot and cold, the doctor gasped. ¡°I know what this is!¡± he shouted, interrupting the patient¡¯s story. ¡°I know what this is!¡± And with that he ran down the crowded hallway to where the attending physician and senior resident were sitting. ¡°He doesn¡¯t need a head CT! He has ciguatera poisoning.¡±
Ciguatera poisoning comes from eating fish that has been contaminated with a toxin produced by an organism that grows on reef algae in some infested tropical waters. Because the toxin is stored in fat, its concentration increases as it moves up the food chain from the little fish who eat the tainted algae to the larger, predatory fish, like shark, snapper, grouper and barracuda, and from there to the human consumer. Unlike most other causes of food poisoning, this toxin is colorless and odorless and isn¡¯t destroyed by cooking.
The illness was first described in 1774 by a surgeon¡¯s mate on the crew of Captain Cook¡¯s South Pacific exploration aboard the HMS Resolution. The crewman, John Anderson, documented the symptoms described by several shipmates who had eaten a large fish caught in the tropical waters. There was ¡°a flushing heat and violent pains in the face and head, with a giddiness and increase in weakness; also a pain, or as they expressed it, a burning heat in the mouth and throat.¡± Many since then have described the rapid onset of nausea, vomiting and diarrhea ? similar to other types of food poisoning ? but followed by the kind of strange neurological symptoms this patient had. Alterations in sensation ? like the numbness, tingling and the bizarre hot-cold reversal ? are most common and most characteristic. The toxin can sometimes affect the heart ¡©? causing it to beat too slowly or irregularly. It is rarely fatal, but there is no effective treatment, and the symptoms can persist for weeks, sometimes months, occasionally years.
It was a great diagnosis, the senior doctor told Dr. Ma. But how did he know? It was easy, Dr. Ma told his doctor-teachers. He took care of a family with ciguatera poisoning several months earlier. A whole family had eaten barracuda for their Christmas dinner. They came to the hospital a few hours later, after the nausea, vomiting and diarrhea had given way to these strange neurological problems. He¡¯d never forget them.
Dr. Ma went back to the patient¡¯s room. He apologized for his unexpected exit and began to explain the illness and where it had come from. Although the pathology of this poison is still not well understood, current thinking is that the toxin damages the protective sheath covering the nerves, causing the sheath to swell and compress the delicate tissue it¡¯s supposed to protect.
¡°Even before they told me, I knew it had to be the fish ? the barracuda,¡± the patient told me sadly. Barracuda has recently been identified as a common source of the toxin, and the C.D.C. now advises against eating the fish, especially when it¡¯s been caught in the Caribbean. These days ciguatera is not just a tropical threat. In the U.S., it has become one of the most common fish-related illnesses as the waters off the coasts of Florida, Texas, South Carolina and most recently North Carolina become warm enough to host these once tropical organisms.
It has been more than six months since the patient returned from the Caribbean, and he still has not fully recovered. He can eat again ? he lost 20 pounds in the first few weeks of the illness. He still has occasional numbness and weakness. The patient sighed: ¡°And it was such good fish too. I ate a lot of it.¡±
Lisa Sanders is the author of ¡°Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis.¡±

U.S. standards on beef are lax, inspector general says
From Dugald McConnell, CNN
April 14, 2010 2:30 a.m. EDT
Washington (CNN) -- The U.S. government is not fully guarding against the contamination of meat by traces of antibiotics, pesticides or heavy metals, a new report warns.

The U.S. Department of Agriculture's inspector general said federal agencies have failed to set limits on many potentially harmful chemical residues, which "has resulted in meat with these substances being distributed in commerce."

When it comes to pesticide traces, only one type is tested for, according to the report. There are also no set limits for some heavy metals, like copper.

In 2008, Mexican authorities turned away an American shipment of beef, because it did not meet Mexico's limits when tested for copper traces. But the very same rejected meat could be sold in the United States, since no limit has been set, the analysis says.

That example shows "the government has fallen down on the job here," said Tony Corbo of the consumer advocacy group Food and Water Watch.

"Some of the residues that the inspector general cited could be carcinogenic, as they accumulate over a period of time in the body," he said.

The study focused on contamination by chemical residues, rather than bacteria. While bacteria like E. coli and Salmonella can cause an illness that is acute but brief, chemical residues are more like to build up over time, and no amount of cooking will destroy them.

The USDA pledged to "swiftly implement the corrective actions" recommended by the inspector, which including testing for more kinds of residue and setting limits on how much of each substance is allowable. A department spokesman pointed out that this kind of fix, which is expected to require coordination with the FDA and the EPA, was one of the main reasons President Obama created a Food Safety Working Group last year.

The National Cattlemen's Beef Association said in a statement, "We fully support the critical role of the federal government in ensuring beef safety."

"While the U.S. beef supply is extraordinarily safe by any nation's standards," it added, "the beef industry is constantly looking for ways to improve the systems that ensure the safest product possible for our consumers."

The study, first reported by USA Today, also says that when cattle test positive for residue, it is difficult to track back where it came from because it often passes through several buyers and sellers.
The American Meat Institute said that problem "underscores the need to implement comprehensive livestock traceback procedures," with a national animal identification system.
CNN's Brian Todd contributed to this report.

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