FoodHACCP Newsletter
12/23 2013 ISSUE:579

Scientists Studying E. coli Blocking Effect on Immune System
Source :
By Linda Larsen (Dec 22, 2013)
Researchers at Kansas State University are studying how the E. coli O157:H7 bacteria blocks the human immune system to cause illness. The bacteria uses proteins to block the immune system, letting it multiply and release toxins into the bloodstream.
Dr. Philip Hardwidge is the lead scientists for this study. He said, “in terms of infectious disease, this inhibition of the human innate immune response is absolutely critical for the bacteria’s ability to cause an infection. If we can identify choke points in the interaction between the bacterium and the host, we may be able to inhibit the bacterium and prevent its survival in an infected human being.”
The National Institutes of Health is providing the grant for this study. Scientists are looking at a protein the bacteria expresses called NleH1. Hardwidge said, “this protein is one example of an injected bacterial protein that is able to block the innate immune system. This protein has kind of an unusual mechanisms that had not been seen in other bacterial or viral pathogens, so we’re interested in understanding more about how this protein really works and whether it represents a good target for future therapeutics.
The research may also be used in the study of other diseases. The protein could be used as a therapy to fight autoimmune diseases such as cancer and diabetes, which may be caused by an overactive component of the immune system.

Bovine Spongiform Encephalopathy, BSE, or "Mad Cow" Disease
Source :
By Bill Marler (Dec 22, 2013)
Bovine spongiform encephalopathy (BSE), referred to as "mad cow disease," is a chronic degenerative nervous system disease affecting cattle. The disease was first diagnosed in 1986 in Great Britain. BSE is so named because of the spongy appearance of the brain tissue of infected cattle when sections are examined under a microscope.??Affected animals may display changes in temperament, such as nervousness or aggression, abnormal posture and difficulty in rising, decreased milk production, or loss of body weight despite continued appetite. Affected cattle die or are killed.??The incubation period (the time from when an animal becomes infected until it first shows signs of disease) is from 2 to 8 years. Following the onset of clinical signs, the animal's condition deteriorates until it dies. This process usually takes from 2 weeks to 6 months. ??Currently, there is no test to detect the disease in a live animal; veterinary pathologists confirm BSE by postmortem microscopic examination of brain tissue or by the detection of the abnormal form of the prion protein.
Since November 1986, over 178,000 head of cattle have been diagnosed with BSE in Great Britain. The epidemic peaked in January 1993 at approximately 1,000 new cases reported per week. Agricultural officials in Great Britain have taken a series of actions to eradicate BSE, including making BSE a notifiable disease, prohibiting the inclusion of mammalian meat-and-bone meal in feed for all food-producing animals, prohibiting the inclusion of animals more than 30 months of age in the animal and human food chains, and destroying all animals showing signs of BSE and other animals at high risk of developing the disease.
The identification in 2003 of a BSE case in Canada, and the subsequent identification later that year of a BSE case in the United States that had been imported from Canada led to the concern that indigenous transmission of BSE may be occurring in North America. In response, the US Department of Agriculture (USDA) implemented additional safeguards to minimize the risk for human exposure to BSE and on July 1, 2004, initiated a 12- to 18-month-long intensive testing program for BSE among cattle at relatively high risk for the disease (e.g., non-ambulatory cattle). A US-bred cow was found to be BSE-positive in June 2005 in Texas.

Foster Farms Salmonella Toll Rises
Source :
By Bill Marler (Dec 19, 2013)
People are still being sickened and still no recall.
A total of 416 individuals infected with the outbreak strains of Salmonella Heidelberg have been reported from 23 states and Puerto Rico. Most of the ill persons (74%) have been reported from California. The number of ill persons identified in each state is as follows: Alaska (1), Arkansas (1), Arizona (18), California (310), Colorado (9), Connecticut (1), Delaware (1), Florida (4), Idaho (4), Illinois (1), Kentucky (1), Louisiana (1), Michigan (3), Missouri (5), North Carolina (1), Nevada (10), New Mexico (2), Oregon (10), Puerto Rico (1), Texas (10), Utah (2), Virginia (3), Washington (16), and Wisconsin (1).
Epidemiologic, laboratory, and traceback investigations conducted by local, state, and federal officials indicate that consumption of Foster Farms brand chicken is the likely source of this outbreak of Salmonella Heidelberg infections.

Congress to USDA: No Chinese Chicken in School Lunches
Source :
By Linda Larsen (Dec 19, 2013)
Several members of Congress have sent a letter to ranking members of the Senator and House Committee on Appropriations and Agriculture, telling them that chicken processed in China and exported to the U.S. should not be served in school lunches. The letter was sent to Senators Mark Pryor (D-AR), Roy Blunt (R-MO), and Congressmen Robert Aderholt (R-AL) and Sam Farr (D-CA).
Those members of Congress are concerned about the problem with food safety in China. They also believe  FSIS will eventually let China export raw chicken to the U.S. They are asking that language in the Fiscal Year 2014 Agriculture Appropriations Bill should ensure that Chinese-processed chicken will not be included in the National School Lunch Program and other federal food programs, and that no funds should be used to implement a rule that would let poultry slaughtered in China to be exported to the U.S.
They stated that  they are concerned about China’s weak enforcement of food safety regulations that caused problems such as “more than 300,000 Chinese children fell seriously ill, with some dying, from melamine-tained milk powder; dangerously high levels of mercury found in Chinese baby formula; the sale of more than $1 million worth of rat and other small mammal meat passed off to consumers as lamb; and more than 16,000 diseased pig carcasses dumped in a river to rot.”
In addition, last year a Chinese poultry supplier provided Kentucky Fried Chicken restaurants with chickens that were raised with large quantities of illegal drugs. The problem with pet food treats imported form China that has killed and sickened more than 4,000 pets in the U.S. was also raised.
Most of the food that is used in the National School Lunch Program (NSLP) and the School Breakfast Program (SBP) comes from private vendors, not the USDA. Those vendors must use only 51% domestic ingredients, so foods such as chicken soup may contain Chinese-processed chicken at up to 49% of the finished product. The legislators think that allowing Chinese processed chicken into the school lunch program would be taking unnecessary risks, given that children are a vulnerable population with respect to food poisoning and chemical exposure.
Signers of the letter include Rosa DeLauro (D-CT), Chellie Pingree (D-ME), Louise Slaughter (D-NY), Carol Shea-Porter (D-NH), Alcee L. Hastings (D-FL), Charles Rangel (D-NY), Mark Pocan (D-WI), Peter DeFazio (D-OR), Marcy Kaptur (D-OH), John Dingell (D-MI) Janice Schakowsky (D-IL), Jeff Fortenberry (R-NE), Dana Rohrabacher (R-CA),and Tony Cardenas (D-CA).

Pew: USDA Should Protect Consumers From Salmonella on Chicken
Source :
By Carla Gillespie (Dec 19, 2013)
The USDA’s Food Safety and Inspection Service (FSIS) gets poor marks when it comes to protecting consumers from Salmonella on chicken and other poultry, according to a new report from the Pew Charitable Trusts.  The report, entitled Weaknesses in FSIS’s Salmonella Regulation, uses the two Salmonella outbreaks associated with Foster Farms chicken this year to highlight deficiencies in agency’s efforts to regulate poultry production and says the USDA’s new Salmonella Action Plan does not go far enough to protect consumers.
“When more than 500 people get sick from two outbreaks associated with chicken that meets federal safety standards, it is clear that those standards are not effectively protecting public health,” said Sandra Eskin, director of Pew’s food safety project. “The Food Safety and Inspection Service should go beyond what it is proposing in its recently released ‘Salmonella Action Plan’ and do more to target salmonella, which is responsible for more hospitalizations and deaths than any other bacterium or virus.”
In two separate Salmonella outbreaks this year, Foster Farms chicken sickened at least 550 people. Almost  200 people were hospitalized.  Several of the outbreak strains showed resistance to multiple antibiotics.
According to the Centers for Disease Control and Prevention (CDC), Salmonella sickens 1.3 million Americans each year. Of those, about 15,000 are hospitalized and 4,000 die. Salmonella infections can  also trigger long-term health problems such as reactive arthritis, inflammation of the heart, spine, tendons and eye membranes. Direct medical costs associated with the treatment of Salmonella infections total about $1 million each day, according to the CDC.
To better combat the public health threat posed by Salmonella, the Pew report suggests FSIS should: change performance standards for poultry producers so they are updated regularly, enforceable, and linked to public health outcomes; consider establishing limits on salmonella contamination for chickens entering  the slaughterhouse, conduct unannounced salmonella testing at chicken processing facilities, tell consumers about problems through health alerts as early as possible, close facilities under investigation for failing to produce safe food,. The report also suggest Congress give FSIS the authority to mandate reecalls.
Although epidemiological evidence linked Foster Farms to both outbreaks this year, the company never issued a recall.  In the current outbreak, which has sickened 416 people in 23 states, FSIS inspectors found food safety violations at three Foster Farms plants that produced the chicken linked to illnesses. The violations included: fecal material on carcasses, poor sanitary dressing practices, insanitary food contact surfaces, insanitary non food contact surfaces and “direct product contamination.” Despite these findings, the plants were allowed to remain open.  The outbreak is ongoing.

Consumer Reports: Gut Bacteria on 97 Percent of Retail Chicken Breasts
Source :
By James Andrews (Dec 19, 2013)
It won’t all harm you, but some of it might. That’s the caveat in the latest Consumer Reports analysis of tests on raw chicken breasts purchased at retailers nationwide. The analysis found that 97 percent of tested chicken breast samples “harbored bacteria that could make you sick.”
While it is true that the detected bacteria could cause infections if improperly handled, a smaller proportion has the potential to cause foodborne illness in the classic sense.
In their most detailed chicken sampling study to date, Consumer Reports performed contamination testing on 316 samples of raw chicken breast and issued the findings in a report entitled, “The High Cost of Cheap Chicken.” The study will be featured in the February 2014 issue of Consumer Reports and online at
The analysis found high rates of intestinal bacteria: Enterococcus (on 80 percent of samples), E. coli (65 percent), Campylobacter (43 percent), Klebsiella (14 percent), Salmonella (11 percent) and Staphylococcus aureus (9 percent).
What is important to note, however, is that only some of the bacteria present at those levels would pose a food poisoning risk if ingested. For example, Enterococcus does not cause food poisoning, and all of the food poisoning maladies associated with E. coli come from a few select strains, while most are harmless to humans – and some are even beneficial.
“E. coli is ubiquitous in an animal environment, and we have it in our intestines,” said Dr. Maurice Pitesky, poultry health and food safety epidemiologist at UC Davis. “We have to ask what serotypes we’re dealing with.”
But while Enterococcus and most E. coli may not pose a food poisoning threat, they do indicate widespread fecal contamination of chicken meat. They are also capable of causing infections of the skin, blood and urinary tract if presented an opportunity.
Two of the other bacteria – Campylobacter and Salmonella – are more likely to cause diarrhea and vomiting, the classic symptoms of foodborne illness.
What’s more, nearly 17.5 percent of the E. coli strains detected are a type known to more likely cause urinary tract infections, known as ExPEC, or extra-pathogenic E. coli, said Dr. Urvashi Rangan, toxicologist and executive director of the Consumer Reports Food Safety and Sustainability Center.
Antibiotic resistance a growing trend
The report also indicates that antibiotic resistance seems to be a growing trend among bacteria on chicken. About half the samples harbored at least one multi-drug-resistant bacterium, meaning the bacterium was resistant to at least three antibiotics.
Rangan said that not all of the resistant bacteria were resistant to antibiotics commonly meant to treat them, but some were. She added that resistant bacteria are generally more virulent, even if available antibiotics are still effective.
“The more you look at it, the more the drug resistance starts to paint a disturbing picture,” Rangan said.
Pitesky was more reserved with his caution, saying that it would be more concerning if large numbers of bacteria began resisting the specific antibiotics used to treat them. He pointed out that, according to the 2013 report by the National Antimicrobial Resistance Monitoring System (NARMS), data from the report indicate that the first choice in antimicrobial treatment for major bacteria is still effective.
“The legitimate fear is that the antibiotics we use for human infections are going to be compromised by the use in food animals,” Pitesky said. “But we need to separate that from antibiotic resistance that might just be natural or insignificant.”
No progress on Salmonella
Consumer Reports also noted that, since 1998, the organization’s tests on chickens have shown that Salmonella contamination rates have stayed between 11 and 16 percent – a discouraging lack of progress in reducing prevalence of the pathogen.
Rangan said the U.S. can do better, using Europe as an example. More than 20 countries have successfully lowered their Salmonella rates in chicken below 1 percent.
“Salmonella has been the organism with the most focus in terms of hygiene plans, and we aren’t even addressing the beginning of the problem,” Rangan said. “We just have to look across the ocean to the European Union.”
Pitesky said that comparing the poultry systems in the U.S. with those in Europe was difficult because of variations in pathogen testing standards and scales of production.
‘Natural’ label is meaningless
One last thing Consumer Reports points out: That “Natural” label on chicken might not mean what you think it means. More than half of 1,005 survey respondents thought that “natural” chicken was free of antibiotics and genetically modified organisms, while nearly as many thought the label was equal to the “organic” label. Not so.
Chicken brands labeled as “Natural” were almost as likely on average to harbor harmful pathogens as any conventional store brand. This discovery has prompted Consumer Reports to suggest a ban on “Natural” labels, which do not provide any meaningful information to consumers.
“The ‘Natural’ label is incredibly deceptive and misleading,” Rangan said. “It leads to a lot of consumer misconception.”
Lessons learned
Rangan said the latest analysis has two main takeaways.
First, the short term: Consumers should be vigilant about pathogens on their raw meat and use a calibrated thermometer to ensure that poultry is cooked internally to 165 degrees F.
Second, the long term: The food safety system in poultry is in need of an overhaul to tackle contamination at the point source.
“Right now, we have a fragmented food safety system that deals with the end of the line, not the root causes,” Rangan said. “Until we fix that, we’ll just continue to see these problems.”

Food Safety Microbiology ONLINE COURSE IS OPEN

Government of Canada Investment to Further Strengthen Food Safety Standards
Source :
By (Dec 18, 2013)
Canada's agricultural industry will benefit from an enhanced food safety audit system that will increase consistency throughout the sector, with the help of an investment from the Government of Canada. Today's announcement was made by Parliamentary Secretary Pierre Lemieux, on behalf of Federal Agriculture Minister Gerry Ritz, at a press conference in Ottawa.
"Canada is known for its world-class ability to produce a variety of safe, high-quality agricultural and food products," said Parliamentary Secretary Pierre Lemieux. "An important part of Canada's rigorous food safety system is the strength of our oversight - not only do we have strong standards, but we have strong quality-control to back that up."
Up to $173,000 will go to the Canadian Supply Chain Food Safety Coalition (CSCFSC) to develop standard auditor competencies and qualifications which are consistent with private and international standards. This investment will help the Coalition bring all stakeholders to the table to shape a consistent made-in-Canada approach to food safety audit and certification across all sectors, and to develop an action plan to get there.
"This collaboration between industry and federal government comes at an important time," said Albert Chambers, Executive Director of the Coalition. "With the passage of the Safe Food for Canadians Act, which the Coalition strongly supported, the whole supply chain will be implementing new preventive controls and a common set of competence requirements for private sector and, we hope, public sector food safety auditors. This will ensure that both types of audits are done at the highest level."
The standard developed through this project will ensure that all sectors implementing a food safety system will be able to remain competitive in domestic and international markets. Members of the CSCFSC represent every major segment of the agriculture and agri-food value chain.
This investment was made through Agriculture and Agri-Food Canada's AgriMarketing Program, a five-year, $341-million initiative under Growing Forward 2. The Assurance Systems stream of the AgriMarketing Program supports industry-led projects in the development of assurance systems that meet market demands and buyer requirements -- such as food safety and animal care - to enable the sector to proactively manage risks and make credible, meaningful and verifiable assurance claims.
The new Growing Forward 2 policy framework, which came into effect on April 1, 2013, will continue to drive innovation and long-term growth in Canada. In addition to a generous suite of business risk management programs, governments have agreed to invest more than $3 billion over five years in innovation, competitiveness, and market development.
For more information on the Growing Forward 2 agreement and the AgriMarketing Program, please visit

Americans’ Eating Habits Got Worse in 2013
Source :
By Linda Larsen (Dec 18, 2013)
According to a Gallup and Heathways poll, Americans’ eating habits got worse in 2013, with produce consumption declining in most months, compared to polls in 2012. Fewer adults are reporting eating healthy “all day yesterday” in every month this year compared to the same months last year.
The percentage of U.S. adults who ate “healthy” declined from about 67% in 2012 to 63 to 65% in 2012. At least 500 Americans take place in this poll each month.
Health eating usually follows a seasonal pattern. People start out in January eating more healthy foods, but that number gradually declines into the spring months. Produce consumption increases slightly in the summer months, then declines to a low in December, most likely because of holiday indulgence. Fewer Americans eat at least five servings of fruits and vegetables at least four days a week in most months.
The actual recommended daily intake of fruits and vegetables depends on sex, age, and level of physical activity, according to Health experts say that half of your plate should hold fruits and vegetables. Most adults should eat at least 2 cups of fruits and vegetables every day. Children should eat 1 to 1-1/2 cups every day.
The number of recommended daily servings varies depending on the source. According to the Harvard School of Public Health, dietary guidelines call for five to thirteen servings of fruits and vegetables per day, depending on dietary guidelines. For a person consuming 2,000 calories a day, this is 4-1/2 cups, or 2 cups of fruits and 2-1/2 cups of vegetables.

Waipahu School Warned of Food Safety Violations in September
Source :
By Linda Larsen (Dec 18, 2013)
The food service staff at Waipahu Elementary School where at least 30 children were sickened last week were warned of food safety violations in September, according to the Honolulu Star Adviser. Apparently pasta was improperly cooled and held at the wrong temperature then. And that’s what caused the outbreak in early December 2013.
Pasta and rice, along with meats, cheeses, and eggs, must be quickly and thoroughly cooled to below 40 degrees F, then quickly reheated to at least 165 degrees F before serving again. And these foods must be held at temperatures above 140 degrees F to prevent bacterial growth.
Public health officials suspect that in this current outbreak, spaghetti was not cooled quickly enough, then was not reheated hot enough to kill bacteria. The inspection in September was part of a routine semester visit. At that time, staff was told how to correct the problem and was told to follow established time and temperature controls for safe food handling.
Those who got sick experienced dizziness, nausea, vomiting, and feeling clammy and sweaty. Those are classic symptoms of food poisoning. Officials have not yet said which pathogenic bacteria caused the outbreak, but are still investigating. While some students were transported to the hospital from the school for treatment, there is no word on whether anyone was actually hospitalized.

CSPI Urges Dismissal of “Pink Slime” Defamation Suit Against ABC and Whistle Blowers
Source :
By Bill Marler (Dec 18, 2013)
Statement of CSPI Executive Director Michael F. Jacobson
The right of reporters, bloggers, and other members of news media to speak to government or industry whistle blowers and to broadcast or publish their findings is at the heart of the First Amendment. The lawsuit waged by Beef Products, Inc., against ABC News and people the network interviewed is a blatant, even thuggish, attempt to chill the free speech of journalists, government scientists, and anyone else who wants to speak out through the news media. We hope Judge Gering dismisses it altogether.
It’s obvious why BPI prefers the term “lean finely textured beef” to “pink slime.” “Pink slime” is not a particularly appetizing term. But free speech certainly trumps a meat company’s public relations problem. CSPI certainly reserves its right to use the term “pink slime” even though we acknowledge that lean finely textured beef is safe. But in the unlikely event the company were to prevail in its lawsuit, news reporting on virtually everything that Americans come into contact with, from food to drugs to cars to cribs, would change overnight. And people would have no clue what stories weren’t being reported for fear of a lawsuit from a thin-skinned corporate bully like BPI.

Studies on Restaurant Safety Practices Bring More Concerning News
Source :
By James Andrews (Dec 18, 2013)
A recent study on food worker habits found that 60 percent of restaurant employees said they had worked a shift while ill, with 20 percent saying that, in the past year, they had worked at least one shift while experiencing vomiting or diarrhea.
Four articles published in the December edition of Journal of Food Protection spotlight restaurant safety practices across the country. The research was organized by the Environmental Health Specialists Network (EHS-Net) within the U.S. Centers for Disease Control and Prevention.
Food Safety News highlighted two of the studies on Monday in a story entitled, “Studies on Restaurant Food Safety Produce Some Unsettling Data.” Below are some findings from two of the other studies:
Food Worker Experiences with and Beliefs about Working While Ill (article link)
When food handlers work while ill, they run a considerable risk of sickening restaurant patrons. In fact, ill employees contribute to as many as two-thirds of restaurant-related outbreaks. EHS-Net researchers conducted interviews with 491 food workers from 391 randomly selected restaurants in nine states to discover trends behind worker motivations for working while ill.
60 percent of restaurant workers said they had worked a shift while ill. Of those who had done so, 89 percent said they made the decision independently, while the decision was influenced by management 11 percent of the time.
Those were worked while ill did so for one or more reasons: no paid sick leave (44 percent); understaffed or no staff available to cover shift (32 percent); symptoms didn’t feel contagious or bad enough (31 percent); feelings of obligation or strong work ethic (31 percent). More than 70 percent said that the severity of illness, type of symptoms and possibility of making others ill each influenced their decision to work.
20 percent of workers said they had worked one or more shifts while experiencing vomiting or diarrhea in the previous year. Of those, 61 percent did so on two or more shifts.
Managers were aware of sick employees working in 63 percent of circumstances, usually because the employees informed them.
About half of the employees who said they worked while ill changed their behavior in some way, but only one-third of those changes related to food safety, such as more frequent hand washing or avoiding food preparation. “These data suggest that food workers are working while ill and are not taking the necessary precautions to prevent their customers from getting ill,” the authors wrote.
Frequency of Inadequate Chicken Cross-Contamination Prevention and Cooking Practices in Restaurants (article link)
Poultry is the most commonly fatal food associated with foodborne illness, as well as the fourth most common food to cause illness. Between 1998 and 2008, 61 percent of poultry-related outbreaks were connected to restaurants. EHS-Net researchers interviewed kitchen managers in 448 restaurants concerning chicken preparation and cooking practices.
80 percent of managers said their restaurants washed, rinsed and sanitized raw chicken contact surfaces as recommended by the U.S. Food and Drug Administration. Another 10 percent said they washed and rinsed surfaces but did not sanitize them, which does not meet FDA’s recommendations, while 4 percent said they only used a sanitizing solution.
60 percent of restaurants had designated cutting boards for raw meat, while 40 had them never, rarely or only sometimes.
Cooks determined whether chicken was fully cooked by using a thermometer 46 percent of the time.
Chickens were rinsed or washed in 42 percent of kitchens. While proper washing may reduce the bacterial load on a chicken, it also increases the potential for cross-contamination from spraying water if not done correctly.
When asked the safe minimum temperature for cooking raw chicken, 43 percent of managers answered FDA’s recommended temperature of 165 degrees F, while 25 percent answered with a temperature below that and another 25 percent provided an answer below. Only 7 percent said they did not know. The lowest temperature answered was 90 F, and the highest 500 F.
“A limitation of our study is that the data were collected through self-report methods and thus may be susceptible to a bias toward over-reporting socially desirable behaviors, such as preparing chicken properly,” the authors wrote. “Data were collected from English-speaking managers only; thus, our data may not represent the proportion of kitchen managers who are not English speakers.”

Outbreak at Waipahu Elementary School in Hawaii was Food Poisoning
Source :
By Linda Larsen (Dec 17, 2013)
Public health officials in Hawaii are confirming that the outbreak of illness at the Waipahu Elementary School in Oahu last week was food poisoning. Apparently, spaghetti cooked the day before wasn’t properly reheated the day it was served, which created an environment for bacterial growth.
Carbohydrates such as spaghetti and rice can contain bacteria. When they are cooked, bacterial spores are activated. When the foods are not properly refrigerated and reheated to a safe temperature, bacteria can easily grow.
Peter Oshiro, head of the Department of Health Sanitation Branch said in a statement, “an inspection and interviews with cafeteria employees revealed food preparation violations that could be corrected with proper training and follow through.”
More than thirty children were sickened with nausea, vomiting, and dizziness on December 10, 2013. The school’s cafeteria employees are taking health and safety training, and meals are being brought in from a neighboring school until those classes are completed.
To prevent bacterial growth, foods must be held below 40 degrees F or above 140 degrees F. Always reheat foods to 165 degrees F before serving. And always refrigerate perishable foods within two hours; one hour if the ambient temperature is above 90 degrees F.

Culture and food safety; Salmonellosis and meat purchased at live-bird and animal-slaughter markets, United States, 2007–2012
Source :
By Doug Powell (Dec 16, 2013)
Since 2007, state and local health departments and the Centers for Disease Control and Prevention have investigated multiple salmonellosis outbreaks linked to meat purchased at live-bird markets (LBMs) and live-animal markets (LAMs), where poultry and livestock are sold for onsite slaughter. These markets typically operate in large cities and serve populations of diverse ethnic backgrounds.
In 2007, an outbreak involving 62 case-patients infected with 1 of 3 S. enterica serotype Schwarzengrund strains was investigated in Massachusetts; 61% were children <5 years of age, including 14 (23%) infants <1 year of age, and 96% were Asian. Exposure to poultry purchased at LBMs was reported, and environmental sampling at an implicated LBM identified 6 S. enterica serotypes, including 1 outbreak strain.
Three subsequent investigations of S. enterica serotype Schwarzengrund infections were conducted: a 2009 outbreak of 50 cases in New York, New York; a 2010–2011 multistate outbreak of cases predominantly in New York, New Jersey, and Massachusetts; and a 2012 multistate outbreak of cases mostly in Illinois and Michigan. Most case-patients in these outbreaks were of Asian race or Hispanic ethnicity, but 3/5 case-patients in Michigan reported Arab ethnicity; >50% were infants or children <5 years of age.
Among case-patients with available information, exposure to poultry from LBMs was reported by 88% of case-patients in the 2009 New York investigation, 35% in the 2010–2011 multistate investigation, and 50% in the 2012 multistate investigation. In Michigan, the outbreak strain was isolated from chicken purchased at an LBM and collected from households of 2 case-patients.
During 2011–2012, the Centers for Disease Control and Prevention investigated a nationwide increase in S. enterica I,4,[5],12:i- infections (pulsed-field gel electrophoresis XbaI restriction enzyme pattern JPXX01.1314). Although no single vehicle was implicated, clusters linked to LAMs were identified. In Minnesota, 14 illnesses were linked to meat from 3 neighboring LAMs. Environmental sampling identified the outbreak strain from an animal-holding pen at 1 of the markets. Seven case-patients were infants <1 year of age, and 10 reported Hmong ethnicity. In California, 10 illnesses likely associated with pork, lamb, and beef purchased at 3 LAMs were identified; case-patients reported Ethiopian and Hmong ethnicity. The outbreak strain was isolated from a pork leg collected from the freezer of a case-patient.
LBMs and LAMs appear to be preferred by certain populations for cultural, culinary, or religious reasons. Exposure to meat from these markets is being increasingly recognized as a potential source of salmonellosis. The cause is uncertain, but one factor may be an increased number of markets: in New York, New York, the number of LBMs nearly doubled from 44 to >80 during 1994–2002 (4). Most case-patients in these outbreaks had minimal direct contact with poultry or livestock at these markets; many case-patients were infants or young children who had not visited the markets or consumed meat. Therefore, one risk factor appears to be living in a household where the meat purchased from these markets is handled or consumed.
Several factors could make meats from these markets more risky for acquiring salmonellosis. Although LBMs and LAMs must meet sanitation requirements and prevent product adulteration (5–7), most are exempt from Food Safety and Inspection Service pathogen reduction performance standards (8,9) and probably do not require suppliers to use pathogen control measures on the farm or during slaughter. Regulatory oversight by state agencies varies. Investigation findings, including environmental sampling, indicate that these markets could be heavily contaminated with S. enterica.

Preliminary results of a Massachusetts study found that fresh-killed chickens from LBMs had higher Salmonella and Campylobacter spp. contamination rates than those for chickens purchased at grocery stores (10; T. Stiles, unpub. data). High-risk cultural preferences identified in these outbreaks included consuming raw or undercooked meat and cooking parts (e.g., feet, intestines) that are more likely to harbor Salmonella spp. Further processing (e.g., de-feathering, butchering) conducted inside homes could lead to cross-contamination in the household environment. Because of language and cultural barriers, existing food safety messages may not have been effective.
The number and type of LBMs and LAMs, the populations these markets serve, and regulatory authority vary considerably by state, and many case-patients and market owners have been reluctant to speak with public health authorities. Therefore, illness prevention requires a local, targeted approach. To strengthen regulations, some states have created guidelines and begun regular inspection of these markets. Educational outreach has included distribution of posters, flyers, and magnets with safe food handling messages in multiple languages; collaboration with community groups; and education of market owners and workers. Given the various communities who use LBMs and LAMs, multifaceted interventions, including collaboration between human and animal health agencies, are needed to reduce disease risk among market patrons and their families.


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