04/23,2012
ISSUE:492

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California Fights Citrus-Killing Bacteria
Source : http://www.foodsafetynews.com/2012/04/california-fights-citrus-killing-bacteria/
By Dan Flynn (Apr 18, 2012)
There's no threat to human health in a growing quarantine in Southern California, but an annual $2 billion worth of citrus fruits are at risk in a war with a tiny insect and the bacteria its spreads.
Earlier this month, the state of California added 93-square miles in the Hacienda Heights area of Los Angeles County to the quarantine after the citrus greening disease known as huanglongbing was discovered in the state for the first time.
Until then, California had been combatting the insect that precedes the disease, which does not harm humans or animals, but causes citrus trees to decline and eventually die.
20120423_120120423_2
Now covering most of Southern California, the quarantine means no nursery stock can be moved out of the area and only commercially cleaned and cleared citrus fruit may be shipped from there. Residential citrus can't be removed from the property on which it's grown, although it can be processed and consumed on the premises.
"The success of any quarantine depends on cooperation from those affected," says Karen Ross, secretary of the California Department of Food and Agriculture (CDFA), in a news release.  "The stakes could not be higher for California citrus."
The tiny insect known as Asian citrus psyllid spreads the huanglongbing bacterium and the disease it causes is fatal to citrus trees. As yet, there is no remedy. Before an infected tree dies, it will produce only bitter, misshaped fruit.
That's why California's entire $2 billion citrus industry, along with its cultivation of 300,000 acres of citrus trees, are at risk. The insect was discovered in the state in 2008, and both the industry and agricultural officials have been fighting an aggressive battle ever since.
Ted Batkin, president of the California Citrus Research Board, has called the insect-borne tree killer "a kick in the stomach." Huanglongbing has already ravaged citrus growing areas in China, Brazil and Florida. Since showing up in California, the insects have also been found in Texas, Arizona and several other states.
CDFA officials say because the latency period for development of huanglongbing symptoms in an infected tree can be two years, the current quarantine is expected to last at least that long. The strategy remains to control the spread of the insect while California's researchers work to come up with a cure.
The quarantine now includes all or part of Ventura, San Diego, Imperial, Orange, Los Angeles, San Barbara, San Bernardino and Riverside counties. Backyard citrus trees have a lot to do with not only how Southern California looks, but also how it smells.  
The infected tree taken from the Hacienda Heights yard of a suburban homeowner was first sprayed to eliminate the psyllids. The tree was then dug up, placed in a sealed bag and taken away in a van to a state lab.

Analysing trends could identify future food safety threats - expert
Source : http://www.foodproductiondaily.com/Quality-Safety/Analysing-trends-could-identify-future-food-safety-threats-expert
By Mark Astley (Apr 17, 2012)
Analysing future changes and trends in the food industry could identify potential food safety threats, lead to technological advances and improve industry practices, an expert has claimed.
Horizon scanning and futures research, which are techniques to identify, analyse and communicate insights about the future, could lead to an increased ability to anticipate new risks within the global food supply, said Cranfield University’s Fiona Lickorish.
Lickorish, whose work focuses on the use of these methods, presented her views on the use of futures research during the recent UK National Science and Engineering Week.
During the event, which was organised to evaluate potential food safety and security risks, she highlighted how analysis of these trends and changes can pinpoint potentials risks to food safety and even lead to the development of new technology, industry practices and regulations.
Potential threats
“We’re trying to identify potential threats, opportunities and challenges that are normally on the margins of current thinking and planning,” said Lickorish.
“By looking at those trends, we can then decide on the areas that we might want to put further research or investigate further.”
The ever-growing meat production industry, which is predicted to double in size by 2050, is one area of concern identified using these methods. The increasing complexity of the food supply chain means there is a greater proportion of meat imports from regions including Southeast Asia, said Lickorish.
The increasing intensity of meat production could lead to a reduction in standards, she added.
“Around a quarter of the meat sold in the UK now has been imported from nations which have weaker rules and regulations in animal welfare, and there is an increasing concern about that, in the imports from food from the emerging economies.”
“Researchers are suggesting that the precautionary measures for scientific labs, slaughterhouses and animal feed plants need to be looked at in more detail and we don’t actually know what’s happening a lot in those slaughterhouses and meat production plants elsewhere in the world.”
Processing and packaging
According to Lickorish, this greater use of information can lead to advances in technology and better practices within the food processing and packaging industry.
Breakthroughs in the use of nanotechnology and intelligent packaging have come as a result of similar research, she added.
“There has been greater use of information and communications technology to enable good control and monitoring of food supply chains from producer to point of supplier or retailer. And there has also been a diffusion of small, inexpensive analytical tools which enable people to monitor food more cheaply.”
“Finally, in relevance to food risks around food packaging and processing, we hope that there will be a reduction in food poisoning cases due to these interesting insights around packaging.”

Dole recalls bagged salad for salmonella risk
Source : http://www.msnbc.msn.com/id/47065183/ns/health-food_safety/
By Natalie Lopez (Apr 16, 2012)
Dole Food Co. has recalled 756 cases of bagged salads in 15 states, including Maryland and Virginia, because they could be contaminated with salmonella.
The fresh vegetables division of Dole Food Co. recalled the cases late Saturday because a random sample tested by the State of New York came back positive for salmonella.
You can check if you’ve purchased one of the possibly contaminated salads by checking their product codes.
The bags of Seven Lettuces salad are stamped with a use-by date of April 11, 2012, with a UPC code of 71430 01057. The product codes are 0577N089112A and 0577N089112B and are located in the upper right hand corner of the package.
If you believe you have one of these particular bags, throw it away or return the unopened package to your grocery store.
The company says its cooperating with regulatory officials and that no illnesses have been reported so far.
Dole said it’s contacting retailers to ensure the bags in question are not available for sale.
Salmonella symptoms include diarrhea, abdominal cramps, and fever within eight to 72 hours of eating contaminated food.

Does Pink Slime Really Help Fight Childhood Obesity?
Source : http://foodpoisoningbulletin.com/2012/does-pink-slime-really-help-fight-childhood-obesity/
By Kathy Will (Apr 16, 2012)
At a March 2012 news conference, Agriculture Secretary Tom Vilsack and Iowa Governor Terry Branstad defended Lean Finely Textured Beef (LFTB), popularly known as “pink slime”, because they say it is “crucial to combating child obesity.”
Pink slime is added to regular ground beef at amounts up to 15% of the total product. The industry claims that LFTB is 92 to 97% lean because it is made from beef trimmings that has the fat removed by centrifuge.
Food Poisoning Bulletin requested a nutrition label from BPI. Rich Jochum, Corporate Administrator with Beef Products, Inc. complied with our request.
The label they sent states that in one four-ounce serving of the product, there are 160 calories, with 8 grams of fat. That works out to 7% fat by weight, which makes it 93% lean.
Food Poisoning Bulletin wondered exactly how many calories LFTB saves in one serving of ground beef, so we crunched the numbers, using the USDA’s Ground Beef Calculator.
Adding 15% of 93% lean LFTB by weight to 85% of 80/20 ground beef (80% lean, 20% fat) by weight to make one pound will save approximately 18 calories per four ounce serving. If a child ate three servings of ground beef every week, that would add up to a savings of 2808 calories over the course of a year, or a little more than 3/4 pound.
Nutritionist Shereen Jegtvig, editor of Nutrition at About.com, said that 18 calories per serving is “not going to made a huge difference in the fight against childhood obesity.”
How much is 18 calories? The American Diabetes Association says that “any food, drink, condiment or seasoning that contains 20 calories or fewer is a ‘free food’ that does not count toward one day’s total caloric intake.” You can burn off 20 calories by walking 5 minutes at 3 miles per hour, or by sitting and reading a book for 20 minutes.
Dr. Ted Labuza, professor of Food Science at the University of Minnesota, agrees that amount isn’t significant. He said, “that’s far fetched. While every little bit helps, that’s not going to make a big dent in childhood obesity.”
Another interesting fact popped up during this research. There are two ways to look at the fat content of foods. The amount of fat in beef that is declared on the label is calculated by weight in grams. But when nutritionists talk about the amount of fat in food, they usually use calories. Any food with 30% or fewer calories from fat is classified as a low fat food.
Calculated by calories instead of weight, the LFTB from BPI Inc. gets 44% of its total calories from fat. Many people may look at a package of ground beef that says 93% lean and think, “gee, only 7% fat. That’s not much.” But fat provides 9 calories per gram, more than twice as much as protein (4 calories per gram) and carbohydrates (4 calories per gram) and that adds up quickly.

Food Poisoning Strikes 250 Inmates at Michigan Jail
Source : http://www.foodsafetynews.com/2012/04/food-poisoning-strikes-over-200-inmates-at-michigan-jail/
By News Desk (Apr 19, 2012)
About 250 inmates being held at the Kent County Jail in Grand Rapids, MI suffering with food poisoning symptoms since Sunday still do not know for certain what ails them.
None required hospitalization and all are said to be recovering.
The illnesses among the inmates began on Sunday, when Undersheriff Jon Hess says the jail served a taco-type meal that included a "chicken product."  Hess said the meat was cooked at the proper temperature in a kettle, and then kept warm in a steamer.
Because the steamer was not keeping the meat warm enough, a pizza oven was substituted.  Later Sunday afternoon, inmates said the meat did not smell or taste right. The jail feeds 1,000 inmates for every meal.
Food samples from all meals served over the weekend were provided to the Kent County Health Department for lab analysis. 
The Health Department's Lisa LaPlante told Food Safety News the investigation is "leaning away" from finding norovirus responsible for the illnesses.  She said the investigation is continuing.

Salmonella outbreak associated with frozen 'scraped' yellowfin tuna mounts
Source : http://nrn.com/article/salmonella-outbreak-associated-frozen-%E2%80%98scraped%E2%80%99-yellowfin-tuna-mounts
By Alan J. Liddle (Apr 18, 2012)
Restaurateurs who use frozen raw “scraped” yellowfin tuna for sushi or other products should check with their suppliers to make sure they are not using a brand under recall for links to a 20-state outbreak of Salmonella Bareilly illnesses, federal officials said.
The Centers for Disease Control and Prevention, U.S. Food & Drug Administration, or FDA, and state health agencies are continuing the investigation that for weeks was publicly associated with consumption of raw yellowfin tuna, but only late last week was linked to a specific product that investigators believe “is the likely source” of the Salmonella outbreak.
FDA officials Friday said that Cupertino, Calif.-based Moon Marine USA Corp., which is also known as MMI, was voluntarily recalling more than 29 tons of a frozen raw yellowfin tuna product labeled as Nakaochi Scrape AA or AAA because it was associated with the growing number of illnesses. Nakaochi Scrape, they said, is tuna backmeat, which is specifically scraped off from the bones, and looks like a ground product.
Because the Moon Marine/MMI product may have been removed from original packaging with labels for redistribution to restaurants and retail outlets, FDA officials are advising businesses that use frozen ground yellowfin tuna to check with their suppliers to make sure they did not deliver the recalled Nakaochi Scrape.
The recalled product is not available for sale to individual consumers, but may have been used to make sushi, sashimi, ceviche and similar dishes available in restaurants and grocery stores, the FDA said. It said many of the people sickened reported eating a “spicy tuna” product.
On Tuesday, officials at the CDC in Atlanta said that the number of people stricken in the multi-state outbreak had risen to 141, with 21 of those individuals requiring hospitalization. As of April 17, the number of ill persons identified in each state was as follows: Alabama (2), Arkansas (1), Connecticut (6), District of Columbia (2), Florida (1), Georgia (6), Illinois (13), Louisiana (3), Maryland (14), Massachusetts (9), Mississippi (2), Missouri (4), New Jersey (8), New York (28), North Carolina (2), Pennsylvania (6), Rhode Island (5), South Carolina (3), Texas (4), Virginia (8) and Wisconsin (14).
CDC officials said that among the 139 stricken persons for whom information was available, illness onset dates ranged from January 28 to April 1. They noted that no deaths have been reported and that illnesses that occurred after March 20, 2012, might not be reported yet due to the time it takes between when a person becomes ill and when the illness is reported.
The CDC said hypothesis-generating interviews with stricken individuals beginning in March and running through April 12 pointed outbreak investigators in the direction of sushi made with raw tuna as a source of infections.
As of April 13, the federal agency said, among 53 ill persons asked questions about eating sushi and other seafood in the week before becoming sick, 43, or 81 percent, reported eating sushi. This proportion was significantly higher when compared with results from a survey of healthy persons in which 5 percent reported eating "sushi, sashimi or ceviche made with raw fish or shellfish" in the seven days before they were interviewed. Of the 43 ill persons reporting eating sushi, 39, or 91 percent, reported eating a sushi item containing tuna, and 36, or 84 percent, reported eating a sushi item containing "spicy tuna," CDC sources added.
A total of seven clusters at restaurants or grocery stores were identified as of April 13 where two or more unrelated ill persons reported eating in the week before illness, according to the CDC. It said that in each cluster, at least one ill person reported eating sushi purchased at the restaurant or grocery store. The clusters were located in 5 states: Connecticut, Maryland, Rhode Island, Texas and Wisconsin.
Additional investigation details and outbreak information is available at the CDC's website. The full FDA statement about the Moon Marine USA Corp. recall is available at the FDA's website.

Oregon Raw Milk Farm Tests Positive for E. Coli 0157
Source : http://foodpoisoningbulletin.com/2012/oregon-raw-milk-farm-tests-positive-for-e-coli-0157/
By Linda Larsen (Apr 18, 2012)
Test results of samples taken from the cows, manure, and surfaces of Foundation Farm have tested positive for E. coli 0157. In addition, raw milk from a farm customer has tested positive for the bacteria.
A press release sent to Food Poisoning Bulletin by Christine Stone of the Oregon Public Health stated that rectal swabs from two of four cows, multiple manure samples, and other environmental samples collected at the farm were contaminated with E. coli 0157.
Five children are sick; four of them have been hospitalized, and three have hemolytic uremic syndrome, which can cause kidney failure. There may be as many as 18 people sickened in this outbreak; test results are pending.
Oregon Public Health State Epidemiologist Katrina Hedberg, M.D., M.P.H. said, “We continue to warn people to not drink the raw milk or any products made from the raw milk that came from this farm or any other source. Pasteurized milk is the only safe milk because it kills harmful bacteria such as E. coli 0157.”

Another Norovirus Outbreak in Indiana
Source : http://foodpoisoningbulletin.com/2012/another-norovirus-outbreak-in-indiana/
By Kathy Will (Apr 10, 2012)
Another norovirus outbreak at another Mexican restaurant in Fort Wayne, Indiana has been reported. John Silcox, director of Communications for the Fort Wayne-Allen County Department of Health, confirmed that illness reports from consumers who at at El Azteca Mexican restaurant on State Blvd. were received during the week of April 2, 2012.
Ten complaints have been received about 35 consumers who ate at the restaurant during the potential outbreak timeframe. Mr. Silcox stated, “the outbreak appears to be contained, but final numbers of those reporting to have become ill are still under investigation.”
Mr. Silcox continued, “the establishment did report two employees who worked or were present in the establishment while ill. Cultures obtained by patrons and employees and both tested positive for Norovirus.”
Norovirus is the leading cause of food poisoning in this country, and is the second leading cause of food poisoning deaths. The virus is very contagious and spreads quickly in crowded places.
The symptoms of norovirus include nausea, diarrhea, vomiting, and stomach cramps. Victims sometimes have fever, chills, muscle aches, and headaches. Most people recover within a few days, but some have complications and require hospitalization.

Oregon, HUS, and Raw Milk: E. coli outbreak leads to kidney failure for 2 children
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/oregon-hus-and-raw-milk-e-coli-outbreak-leads-to-kidney-failure-for-2-children/
By Drew Falkenstein (Apr 16, 2012)
Raw milk from Foundation Farm in Wilsonville, Oregon has sickened at least 11 people with serious E. coli O157:H7 illnesses.  Two children have developed hemolytic uremic syndrome, or HUS.  The milk was "sold" as part of a cow or herd-share agreement, which is an attempt to avoid the State of Oregon's restrictions on the sale of raw milk.
So what of Oregon's history with E. coli and HUS? Oregon residents are certainly no stranger to E. coli, HUS, or HUS caused by E. coli infection, which, in turn, was caused by raw milk.  Multiple Oregon residents were sickened by E. coli from raw milk from November to December 2005, after consuming raw milk produced and sold by Dee Creek Farm.  Several children developed hemolytic uremic syndrome.
During the December 2005 investigation into the E. coli outbreak, WSDA noted several milk processing violations that would have been addressed during the licensing process had Dee Creek applied for the license. Among the violations were the following:
•No animal health testing documentation for brucellosis and tuberculosis or health permits
•Beef cattle contact with wild elk
•No water or waste water system available at milk barn for milking operations or cleaning
•No hand washing sinks available for cleaning and sanitizing
•No bacteriological test results available for the farm’s well-water system
•Mud/manure with standing water at the entrance to the milk barn parlor
•Milking bucket in direct contact with unclean surfaces during milk production
•Multiple instances providing for the opportunity for cross-contamination
•No separate milk processing area from domestic kitchen
•No raw milk warning label provided on containers
In addition, sample testing confirmed the presence of E. coli O157:H7 in two milk samples provided by Dee Creek Farm and in five environmental samples taken from Dee Creek Farm milk-barn areas by investigators.
Of course, Oregon has seen many more E. coli outbreaks.  Here are a few of the recent ones:
Jaquith Strawberry Farms Strawberry E. coli outbreak 2011
Interstate Meat Distributors E. coli outbreak 2007
McGrath's Fish House Parsley E. coli outbreak 2005
Camp Yamhill Drinking Water E. coli outbreak 2005
Here are a few more statistics on raw milk in recent years:
Outbreaks
• 26 raw dairy outbreaks with 333 illnesses, no deaths (24 fluid raw milk, 2 aged raw milk cheese)
•2 pasteurized dairy outbreak with 39 illnesses, no deaths
•1 pasteurized Mexican-style cheese sporadic illness, no deaths
•2 queso fresco Mexican-style cheese outbreak with 67 illnesses, no deaths
•3 sporadic illnesses and hospitalizations from illegal Mexican-style cheese, no deaths
Recalls (no illnesses reported)
•14 raw dairy (7 fluid raw milk, 7 aged raw milk cheese)
•7 queso fresco Mexican-style cheese
•8 pasteurized (non-queso fresco) cheese
•4 dairy product recalls due to inadequate pasteurization
Also see, Outbreaks from Unpasteurized (Raw) Milk and non-Mexican Style Raw Milk Cheeses, United States, 1998-2011. (1998-2011-outbreaks-raw-dairy.pdf)
For real facts about the risks of raw milk, visit Real Raw Milk Facts.

Medical reports confirm food poisoning, no cholera outbreak
Source : http://www.foodpoisonjournal.com/uploads/image/1998-2011-outbreaks-raw-dairy.pdf
By admin(Apr 17, 2012)
Days after food poisoning complaints and rumours of cholera made rounds in parts of Thousand Lights area, the corporation and metro water officials continued to collect water and food samples on Monday.
“Five people have been admitted to communicable diseases Hospital Tondiarpet and there is no cholera outbreak in city. Medical reports have confirmed food poisoning,” a senior corporation official said.
Several guest houses in the locality are congested and lacks sanitation and the civic body is monitoring the system, the official added.
Earlier in the day, a team led by corporation health officer Dr P. Kuganantham inspected Thousand Lights area and ascertained the sanitation in the area.
The corporation medical team conducted medical camp and screened local residents. Preventive medicines for public with fever and cough were provided.
Similarly a group of metro water staff led by local area engineer S. Muthukrishnan conducted door-to-door sample survey and enquired about the drinking water supplied to residents.
The metro water has also planned to install spot chlorination injectors in congested areas and liquid chlorine will be mixed in water supplied through pipes.
Preliminary water samples confirmed satisfactory chorine level and the water supply is periodically monitored, he said.

Yellowfin Tuna Linked with Salmonella Outbreak in 20 States
Source : http://healthland.time.com/2012/04/16/yellowfin-tuna-linked-with-salmonella-outbreak-in-20-states/
By (Apr , 2012)
A yellowfin tuna product used to make dishes like sushi and sashimi sold at restaurants and grocery stores has been linked with an outbreak of salmonella that has sickened more than 100 people in 20 states and the District of Columbia, federal health authorities said Friday.
The Food and Drug Administration said 116 illnesses have been reported, including 12 people who have been hospitalized. No deaths have been reported.
20120423_3Moon Marine USA Corp. of Cupertino, Calif., also known as MMI, is voluntarily recalling 58,828 pounds of frozen raw yellowfin tuna. It was labeled as Nakaochi Scrape AA or AAA when it was sold to grocery stores and restaurants and is scraped off the fish bones and looks like a ground product.
The product is not available for sale to individual consumers but may have been used to make sushi, sashimi, ceviche and similar dishes available in restaurants and grocery stores. Many of the people who became ill reported eating raw tuna in sushi as “spicy tuna,” the FDA said.
Reports of the foodborne illness caused by salmonella bareilly have mainly come from the Eastern Seaboard and South, though cases have been reported as far west as Missouri and Texas.
As of Friday, illness had been reported these states and the District of Columbia: Alabama (2), Arkansas (1), Connecticut (5), District of Columbia (2), Florida (1), As Georgia (5), Illinois (10), Louisiana (2), Maryland (11), Massachusetts (8), Mississippi (1), Missouri (2), New Jersey (7), New York (24), North Carolina (2), Pennsylvania (5), Rhode Island (5), South Carolina (3), Texas (3), Virginia (5), and Wisconsin (12).
The memo notes there is likely a 30-day lag time between when people become sick and when cases are reported to health officials.
The raw yellowfin tuna product may have passed through several distributors before reaching the restaurant and grocery market and may not be clearly labeled.
Previous outbreaks of salmonella bareilly have been linked to bean sprouts, which are grown in warm, damp conditions.
The most common symptoms of salmonella are diarrhea, abdominal cramps and fever within eight to 72 hours of eating the contaminated food. The illness can be severe or even life-threatening for infants, older people, pregnant women and people with weakened immune systems.
The FDA recommended that people be cautious about eating raw seafood, inquire about the source and “when in doubt, don’t eat it.”

Update on the Salmonella Outbreak Linked to Nakaochi Scrape
Source : http://foodpoisoningbulletin.com/2012/update-on-the-salmonella-outbreak-linked-to-nakaochi-scrape/
By Linda Larsen (Apr 15, 2012)
The CDC has released more details about their investigation into the Salmonella Bareilly outbreak that has sickened 116 people in 20 states and the District of Columbia.
Nakaochi Scrape, which is tuna scraped from the bone and chopped, from Moon Marine USA Corporation is “the likely source of this outbreak of Salmonella Bareilly infections”, according to the government. The CDC interviewed 53 of the patients about what they ate the week before they got sick. Forty-three of them (81%) reported eating sushi.
This proportion is significantly higher than indicated in a FoodNet Survey conducted by the CDC for the years 2006 to 2007. In that report, on page 20, 5.3% of healthy adults reported consuming sushi in the past seven days.
Of those 43 people, 39, or 91%, reported eating a sushi item made with tuna, and 36, or 84%, reported eating a sushi item containing “spicy tuna”. Spicy tuna rolls are made with chopped tuna or Nakaochi Scrape.
Nakaochi Scrape looks like, and is, raw ground tuna. And when meat is ground or chopped, any bacteria on the surface of the meat is mixed throughout the entire batch. That makes raw fish made with this method, also called comminuted, very different from other types of sushi, in which the flesh is left whole.
And when food is produced on a large scale, as with this product, where more than 58,000 pounds, or 29 tons, were made and shipped around the country, problems with temperature control and cross-contamination can occur anywhere on the supply chain.
Food Poisoning Bulletin asked Michael Batz, Head of Food Safety Programs at the University of Florida Emerging Pathogens Institute, about this outbreak. He said, “we consume more perishable goods than we used to, and the items we’re consuming change all the time. I expect the trend for consuming raw finfish products – as in sushi – is much higher today than 20 years ago. Thus, I would say that the number of people affected in a wide geographic region, combined with a complicated supply chain, is indicative of a modern food safety challenge.”
The CDC states that seven clusters of restaurants or grocery stores, where two or more unrelated ill people ate, have been identified. The clusters are located in Connecticut, Maryland, Rhode Island, Texas, and Wisconsin. Information has been collected from four of the seven clusters as of April 13, 2012. An average of 61% of sushi orders in those clusters contained tuna.
The government recommends that anyone in a high risk group: infants, the elderly, pregnant women, the chronically ill, and those with compromised immune systems, refrain from eating raw or undercooked fish.
If you order spicy tuna roll or any food made from tuna from a restaurant or grocery store, ask to make sure it is not part of this recall. And if you or anyone you know has the symptoms of Salmonella poisoning, including diarrhea, often bloody, vomiting, and severe stomach cramps, see your doctor immediately and let her know what you’ve eaten in the past week.

 


 



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