How Private Companies are Changing Food Safety
Source : http://smallbiztrends.com/2015/04/private-companies-changing-food-safety.html
By Annie Pilon (Apr 12, 2015)
When you buy food at the grocery store, you likely assume that the labels accurately describe the food and its ingredients. But that isn’t always the case.
Sometimes, food products are contaminated by outside ingredients. And other times, suppliers or manufacturers are downright fraudulent.
That’s where companies like IEH Laboratories come in. Suppliers, manufacturers and marketers hire the company to test for outside contaminants or to verify if items are organic or free of genetically modified organisms.
Most of the food companies that work with IEH and similar labs prefer to remain anonymous so they don’t reveal to consumers any specific worries about food safety. But Costco is one food retailer that uses the testing services and doesn’t mind talking about it. Craig Wilson, Costco’s vice president for quality assurance and food safety tells the New York Times:
“We have to inspect what we expect.”
In this case, Wilson means that the company wants its products to live up to what is written on their labels. It seems like it should be a pretty standard practice. But even the companies that pass required public standards may be found wanting in their claims to consumers.
Wilson says that he uses the government guidelines as a minimum standard, but always tries to go above and beyond them.
Public food safety efforts have traditionally relied more on reaction than preemptive measures. But many in the industry believe that change is necessary. No longer should response wait for large recalls after several consumers have fallen ill from contaminated food.
That’s part of what IEH is working to change. But the company has also become increasingly relevant thanks to a few other industry changes.
First, the increase in demand for organic products has led many food suppliers to make those claims about their products. Some of those claims are accurate and others aren’t.
Second, there has been an increase in imported food items in recent years. And since other countries don’t always have the same standards or food safety practices, the quality of those food items can sometimes be in question.
Founder Mansour Samadpour opened the first IEH lab in 2001 with only six employees. The company now has 116 labs across the U.S. and Europe, employing more than 1,500 workers.
Samadpour describes the company as “a privately financed public health organization.” But with more and more consumer concerns about health and food ingredients, IEH could continue to grow even further.
Consumers want to know that their food is safe and that the labels are accurate. So if the public standards for food safety and quality aren’t doing the job up to their expectations, they could start to demand more.
And stores and food suppliers that step up to take preemptive measures rather than reactive ones will be an ever-growing market for the company in the foreseeable future.
Texas Health Issues Listeria Advisory to Healthcare Providers
Source : http://foodpoisoningbulletin.com/2015/texas-health-issues-listeria-advisory-to-healthcare-providers/
By Carla Gillespie (Apr 12, 2015)
The Texas State Department of Health Services has issued a Listeria advisory to healthcare providers. Patients with symptoms, who are in high-risk groups and may have been exposed to Listeria through a contaminated product should be tested, the advisory states. Specifically, “diagnostic testing should include cultures of blood and other specimens, such ascerebrospinal fluid, as indicated by the clinical presentation.”
Symptoms of a Listeria infection can take 70 days to develop. They include high fever, severe headache, stiff neck, other muscle stiffness, nausea, abdominal pain and diarrhea. Listeria infections can cause miscarriages and stillbirths among pregnant women.
Those at high risk for an invasive Listeria infection include pregnant women, adults 65 and older, those with weakened immune systems and children. Others at risk include those who have eaten recalled Blue Bell ice cream products.
The advisory states all cases of Listeria infection need to be reported to the state health department. It includes a link to the CDC’s “Suggested framework for medical management of people at elevated risk for invasive listeriosis who are exposed to Listeria monocytogenes.” However, it cautions against the use of stool culture as a screening option.
Marler: All You Need To Know About E. coli
Source : http://www.foodpoisonjournal.com/food-poisoning-information/marler-what-you-need-to-know-about-e-coli/#.VStKzdj9ns1
By Bruce Clark (Apr 12, 2015)
What is E. coli?
Escherichia coli (or E. coli) is the most prevalent infecting organism in the family of gram-negative bacteria known as enterobacteriaceae. E. coli bacteria were discovered in the human colon in 1885 by German bacteriologist Theodor Escherich. Dr. Escherich also showed that certain strains of the bacterium were responsible for infant diarrhea and gastroenteritis, an important public health discovery. Although E. coli bacteria were initially called Bacterium coli, the name was later changed to Escherichia coli to honor its discoverer.
E. coli is often referred to as the best or most-studied free-living organism. More than 700 serotypes of E. coli have been identified. The “O” and “H” antigens on the bacteria and their flagella distinguish the different serotypes. It is important to remember that most kinds of E. coli bacteria do not cause disease in humans. Indeed, some E. coli are beneficial, while some cause infections other than gastrointestinal infections, such as urinary tract infections.
The E. coli that are responsible for the numerous reports of contaminated foods and beverages are those that produce Shiga toxin, so called because the toxin is virtually identical to that produced by Shigella dysenteria type 1. The best-known and also most notorious E. coli bacteria that produce Shiga toxin is E. coli O157:H7. The Centers for Disease Control and Prevention (CDC) has estimated that every year at least 2,000 Americans are hospitalized, and about 60 die as a result of E. coli infection and its complications. A study published in 2005 estimated the annual cost of E. coli O157:H7 illnesses to be $405 million (in 2003 dollars), which included $370 million for premature deaths, $30 million for medical care, and $5 million for lost productivity.
E. coli O157:H7—a foodborne pathogen
E. coli O157:H7 is one of thousands of serotypes of Escherichia coli. The testing done to distinguish E. coli O157:H7 from its other E. coli counterparts is called serotyping.
Pulsed-field gel electrophoresis (PFGE), sometimes also referred to as genetic fingerprinting, is used to compare E. coli O157:H7 isolates to determine if the strains are distinguishable. A technique called multilocus variable number of tandem repeats analysis (MLVA) is used to determine precise classification when it is difficult to differentiate between isolates with indistinguishable or very similar PFGE patterns.
E. coli O157:H7 was first recognized as a pathogen in 1982 during an investigation into an outbreak of hemorrhagic colitis associated with consumption of hamburgers from a fast food chain restaurant. Retrospective examination of more than three thousand E. coli cultures obtained between 1973 and 1982 found only one isolate with serotype O157:H7, and that was a case in 1975. In the ten years that followed, there were approximately thirty outbreaks recorded in the United States. This number is likely misleading, however, because E. coli O157:H7 infections did not become a reportable disease in any state until 1987, when Washington became the first state to mandate its reporting to public health authorities. Consequently, an outbreak would not be detected if it was not large enough to prompt investigation.
E. coli O157:H7’s ability to induce injury in humans is a result of its ability to produce numerous virulence factors, most notably Shiga toxin (Stx), which is one of the most potent toxins known to man. Shiga toxin has multiple variants (e.g., Stx1, Stx2, Stx2c), and acts like the plant toxin ricin by inhibiting protein synthesis in endothelial and other cells. Endothelial cells line the interior surface of blood vessels, and are known to be extremely sensitive to E. coli O157:H7, which is cytotoxigenic to these cells.
In addition to Shiga toxin, E. coli O157:H7 produces numerous other putative virulence factors, including proteins which aid in the attachment and colonization of the bacteria in the intestinal wall and which can lyse red blood cells and liberate iron to help support E. coli metabolism.
E. coli O157:H7 evolved from enteropathogenic E. coli serotype O55:H7, a cause of non-bloody diarrhea, through the sequential acquisition of phage-encoded Stx2, a large virulence plasmid, and additional chromosomal mutations. The rate of genetic mutation indicates that the common ancestor of current E. coli O157:H7 clades likely existed some 20,000 years ago. E. coli O157:H7 is a relentlessly evolving organism, constantly mutating and acquiring new characteristics, including virulence factors that make the emergence of more dangerous variants a constant threat. The prospect of emerging pathogens as a significant public health threat has been emphasized by the CDC for some time. As Robert Tauxe of the CDC notes:
After 15 years of research, we know a great deal about infections with E. coli O157:H7, but we still do not know how best to treat the infection, nor how the cattle (the principal source of infection for humans) themselves become infected.
Although foods of a bovine origin are the most common cause of both outbreaks and sporadic cases of E. coli O157:H7 infections, outbreaks of illnesses have been linked to a wide variety of food items. For example, produce has been the source of substantial numbers of outbreak-related E. coli O157:H7 infections since at least 1991. Outbreaks have been linked to alfalfa, clover and radish sprouts, lettuce, and spinach. Other vehicles for outbreaks include unpasteurized juices, yogurt, dried salami, mayonnaise, raw milk, game meats, hazelnuts, and raw cookie dough.
Non-O157 Shiga Toxin-Producing E. coli
E. coli are classified by their O and H antigens (e.g., E. coli O157:H7, E. coli O26:H11) and broadly categorized as Shiga toxin-producing E. coli (STEC) O157 or non-O157 STEC. For many years, most recognized STEC outbreaks were associated with STEC O157. Despite the dominance of STEC O157, at least 150 non-O157 strains of E. coli are known to cause human illness and have been associated with outbreaks.
In the US, documented outbreaks of non-O157 E. coli include 10 involving O111; 6 involving O26; 3 involving O45; 2 involving O145, O104, and O6; and, one each involving O51; O103; O27; and, O84. Non-O157 STEC outbreaks are rare, but tend to primarily be due to contaminated food and person-to-person transmission.
Non-O157 STEC infections are under-recognized and under-reported due to inadequate epidemiological and laboratory surveillance. In the United States, E. coli O157:H7 became nationally notifiable in 1994, whereas non-O157 STEC infections were not reportable until 2000. Screening for non-O157 STEC remains rare. This is no surprise since by 2007 only 66% of clinical labs screened all stool samples for E. coli O157:H7 and fewer than 10% of labs ever conducted on-site testing for non-O157 STEC. As with E. coli O157:H7, non-O157 STEC cases tend to occur during the summer months.
Non-O157 STEC can be difficult to identify in laboratory screening for E. coli O157 because they do not ferment sorbitol. Most stool cultures suspected to contain STEC are first screened for Shiga toxin; a positive test could be either E. coli O157:H7 or non-O157 STEC. Unfortunately, some labs will discard Shiga toxin-positive cultures after reporting to the referring doctor without identifying the strain. State laboratories can send STEC cultures to the CDC to determine the serotype. Some states, such as Minnesota and Connecticut have begun studies of their own to identify non-O157 STEC.
In recent years, improved diagnostic assays for non-O157 STEC have contributed to an increased appreciation of the severity of disease caused by these strains, including hemolytic uremic syndrome (HUS). Notably, the number of non-O157 STEC cases reported to CDC’s FoodNet has risen steadily each year; from 2000-2006, there was an overall 4-fold increase in incidence (0.12 cases per 100,000 to 0.42 cases per 100,000 population) at FoodNet sites. The most common serogroups reported to cause foodborne illness in the United States are O26, O111, O103, O121, O45, and O145.  These six serotypes account for 75% of human infections.
Worldwide, non-O157 STEC outbreaks emerged in the 1980s, and the first reported outbreaks in the United States occurred in the 1990s. The number of reported outbreaks due to non-O157 STECs remains relatively low in the United States, but experts agree that documented outbreaks probably represent the “tip of the iceberg.” From 1983-2002, seven non-O157 STEC outbreaks were reported in the United States.  During the following five-year period from 2003-2007, CDC documented an additional five non-O157 STEC outbreaks (CDC Outbreak Surveillance Data, http://www.cdc.gov/foodborneoutbreaks/outbreak_data.htm).
An extraordinary non-O157 outbreak occurred in Germany beginning in May 2011. The STEC involved was extremely rare: E. coli O104:H4. It was also extremely virulent. Ultimately, the outbreak sickened nearly 4,000 people and killed more than 50. This strain was not only resistant to many antibiotics, it possessed a novel mechanism for sticking to intestinal cells. Other unusual aspects of this outbreak were that it affected a disproportionately large percentage of women. Further, nearly a quarter of those infected developed HUS and of those the vast majority was women. It appears that this non-O157 STEC acquired its particular virulence factors and antibiotic resistance through horizontal gene acquisition rather than point mutations or descent from prior generations of bacteria. The outbreak was ultimately traced to contaminated seeds of fenugreek from Egypt, sold as sprouts by an organic farm in Germany.
A study of non-O157 STEC concluded that these strains may account for up to 20 to 50% of all STEC infections in the United States. The prevalence of non-O157 STEC infections is placing an increasing burden on society and the health care system in the United States.
E. coli O157:H7 bacteria and other pathogenic E. coli mostly live in the intestines of cattle, but E. coli bacteria have also been found in the intestines of chickens, deer, sheep, and pigs. A 2003 study on the prevalence of E. coli O157:H7 in livestock at 29 county and three large state agricultural fairs in the United States found that E. coli O157:H7 could be isolated from 13.8% of beef cattle, 5.9% of dairy cattle, 3.6% of pigs, 5.2% of sheep, and 2.8% of goats.  Over 7% of pest fly pools also tested positive for E. coli O157:H7. Shiga toxin-producing E. coli does not make the animals that carry it ill. The animals are merely the reservoir for the bacteria.
According to a study published in 2011, an estimated 93,094 illnesses are due to domestically acquired E. coli O157:H7 each year in the United States. Estimates of foodborne-acquired O157:H7 cases result in 2,138 hospitalizations and 20 deaths annually.
What makes E. coli O157:H7 remarkably dangerous is its very low infectious dose, and how relatively difficult it is to kill these bacteria. “E. coli O157:H7 in ground beef that is only slightly undercooked can result in infection.” As few as 20 organisms may be sufficient to infect a person and, as a result, possibly kill them. And unlike generic E. coli, the O157:H7 serotype multiplies at temperatures up to 44° Fahrenheit, survives freezing and thawing, is heat-resistant, grows at temperatures up to 111 F, resists drying, and can survive exposure to acidic environments. And, finally, to make it even more of a threat, E. coli O157:H7 bacteria are easily transmitted by person-to-person contact.
The colitis caused by E. coli O157:H7 is characterized by severe abdominal cramps, diarrhea that typically turns bloody within 24 hours, and sometimes fever. The incubation period—that is, the time from exposure to the onset of symptoms—in outbreaks is usually reported as 3 to 4 days, but may be as short as 1 day or as long as 10 days. Infection can occur in people of all ages but is most common in children.
Unlike other E. coli pathogens, which remain on intestinal surfaces, Shiga toxin-producing bacteria, like O157:H7, are invasive. After ingestion, E. coli bacteria rapidly multiply in the large intestine and then bind tightly to cells in the intestinal lining. This snug attachment facilitates absorption of the toxins into the small capillaries within the bowel wall. Once in the systemic circulation, Shiga toxin becomes attached to weak receptors on white blood cells, thus allowing the toxin to “ride piggyback” to the kidneys where it is transferred to numerous avid (strong) Gb3 receptors that grasp and hold on to the toxin.
Inflammation caused by the toxins is believed to be the cause of hemorrhagic colitis, the first symptom of E. coli infection, which is characterized by the sudden onset of abdominal pain and severe cramps. Such symptoms are typically followed within 24 hours by diarrhea, sometimes fever.
As the infection progresses, diarrhea becomes watery and then may become grossly bloody; that is, bloody to the naked eye. E. coli symptoms also may include vomiting and fever, although fever is an uncommon symptom.
On rare occasions, E. coli infection can cause bowel necrosis (tissue death) and perforation without progressing to hemolytic uremic syndrome (HUS)—a complication of E. coli infection that is now recognized as the most common cause of acute kidney failure in infants and young children. In about 10 percent of E. coli cases, the Shiga toxin attachment to Gb3 receptors results in HUS.
The duration of an uncomplicated illness can range from one to twelve days. In reported outbreaks, the rate of death is 0-2%, with rates running as high as 16-35% in outbreaks involving the elderly, like those that have occurred at nursing homes.
Shiga toxin–producing E. coli (STEC) cause approximately 100,000 illnesses, 3,000 hospitalizations, and 90 deaths annually in the United States. As noted, most reported STEC infections in the United States are caused by E. coli O157:H7, with an estimated 73,000 cases occurring each year. According to the CDC:
Non-O157 STEC bacteria also are important causes of diarrheal illness in the United States; at least 150 STEC serotypes have been associated with outbreaks and sporadic illness. In the United States, six non-O157 serogroups (O26, O45, O103, O111, O121, and O145) account for the majority of reported non-O157 STEC infections.
Persons with non-O157 STEC tend to have less severe illness, but some non-O157 STEC members can cause very severe infections, including those that result in HUS and death. Non-O157 STEC that cause HUS overwhelmingly produce Shiga toxin 2 with or without Shiga toxin 1. As with E. coli O157:H7, more severe disease results from Shiga toxin 2 production by non-O157 STEC.
How is an E. coli Infection Diagnosed?
Infection with E. coli O157:H7 or other Shiga toxin-producing E. coli is usually confirmed by the detection of the bacteria in a stool specimen from an infected individual. Most hospitals labs and physicians know to test for these particular bacteria, especially if the potentially infected person has bloody diarrhea. Still, it remains a good idea to specifically request that a stool specimen be tested for the presence of Shiga toxin-producing E. coli.
Treatment for an E. coli Infection
In most infected individuals, symptoms of a Shiga toxin-producing E. coli infection last about a week and resolve without any long-term problems. Antibiotics do not improve the illness, and some medical researchers believe that these medications can increase the risk of developing HUS. Therefore, apart from supportive care, such as close attention to hydration and nutrition, there is no specific therapy to halt E. coli symptoms. The recent finding that E. coli O157:H7 initially speeds up blood coagulation may lead to future medical therapies that could forestall the most serious consequences. Most individuals who do not develop HUS recover within two weeks.
A Life-Threatening Complication—Hemolytic Uremic Syndrome
E. coli O157:H7 infections can lead to a severe, life-threatening complication called the hemolytic uremic syndrome (HUS). HUS accounts for the majority of the acute deaths and chronic injuries caused by the bacteria. HUS occurs in 2-7% of victims, primarily children, with onset five to ten days after diarrhea begins. “E. coli serotype O157:H7 infection has been recognized as the most common cause of HUS in the United States, with 6% of patients developing HUS within 2 to 14 days of onset of diarrhea.” And it is the most common cause of renal failure in children.
Approximately half of the children who suffer HUS require dialysis, and at least 5% of those who survive have long term renal impairment. The same number suffers severe brain damage. While somewhat rare, serious injury to the pancreas, resulting in death or the development of diabetes, also occurs. There is no cure or effective treatment for HUS. And, tragically, children with HUS too often die, with a mortality rate of five to ten percent.
Once Shiga toxins attach to receptors on the inside surface of blood vessel cells (endothelial cells), a chemical cascade begins that results in the formation of tiny thrombi (blood clots) within these vessels. Some organs seem more susceptible, perhaps due to the presence of increased numbers of receptors, and include the kidney, pancreas, and brain. Consequently, organ injury is primarily a function of receptor location and density.
Once they move into the interior of the cell (cytoplasm), Shiga toxins shut down protein machinery, causing cellular injury or death. This cellular injury activates blood platelets too, and the resulting “coagulation cascade” causes the formation of clots in the very small vessels of the kidney, leading to acute kidney failure.
The red blood cells are either directly destroyed by Shiga toxin (hemolytic destruction), or are damaged as cells attempt to pass through partially obstructed micro-vessels. Blood platelets become trapped in the tiny blood clots, or they are damaged and destroyed by the spleen.
By definition, when fully expressed, HUS presents with the triad of hemolytic anemia (destruction of red blood cells), thrombocytopenia (low platelet count), and renal failure (loss of kidney function). Although recognized in the medical community since at least the mid-1950s, HUS first captured the public’s widespread attention in 1993 following a large E. coli outbreak in Washington State that was linked to the consumption of contaminated hamburgers served at a fast-food chain. Over 500 cases of E. coli were reported; 151 were hospitalized (31%), 45 persons (mostly children) developed HUS (9%), and three died.
Of those who survive HUS, at least five percent will suffer end stage renal disease (ESRD) with the resultant need for dialysis or transplantation. But, “[b]ecause renal failure can progress slowly over decades, the eventual incidence of ESRD cannot yet be determined.” Other long-term problems include the risk for hypertension, proteinuria (abnormal amounts of protein in the urine that can portend a decline in renal function), and reduced kidney filtration rate. Since the longest available follow-up studies of HUS victims are 25 years, an accurate lifetime prognosis is not really available and remains controversial.
Other Complications from Infection
IBS is a chronic disorder characterized by alternating bouts of constipation and diarrhea, both of which are generally accompanied by abdominal cramping and pain. Suffering an E. coli O157:H7 infection has been linked to the development of post-infectious irritable bowel syndrome (IBS). This link was demonstrated by the Walkerton Health Study (WHS), which followed one of the largest O157:H7 outbreaks in the history of North America. In this outbreak, contaminated drinking water caused over 2,300 people to be infected, resulting in 27 recognized cases of HUS, and 7 deaths. The WHS followed 2,069 eligible study participants. Among its findings, WHS noted that, “Between 5% and 30% of patients who suffer an acute episode of infectious gastroenteritis develop chronic gastrointestinal symptoms despite clearance of the inciting pathogens.”
Not surprisingly, E. coli O157:H7 infection is associated with long-term emotional disruption as well, not just for the victim, but for entire families. A recent study reported that “parents experienced long-term emotional distress and substantive disruption to family and daily life” following an E. coli O157:H7 infection in the family.
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Marler: All You Need To Know About Salmonella
Source : http://www.foodpoisonjournal.com/food-poisoning-information/what-you-need-to-know-about-salmonella-2/#.VStLKNj9ns1
y Drew Falkenstein (Apr 11, 2015)
Salmonella is a bacterium that causes one of the most common enteric (intestinal) infections in the United States – salmonellosis. It has long been said that, in 1885, pioneering American veterinary scientist, Daniel E. Salmon, discovered the first strain of Salmonella. Actually, Theobald Smith, research-assistant to Dr. Salmon, discovered the first strain of Salmonella–Salmonella cholerae suis. But, being the person in charge, Dr. Salmon received credit for the discovery. In any case, today the number of known strains of the bacteria totals over two thousand.
The term Salmonella refers to a group or family of bacteria that variously cause illness in humans. Salmonella serotype typhimurium and Salmonella serotype enteritidis are the most common in the United States. Salmonella javiana is the fifth most common serotype in the United States and accounted for 3.4% of Salmonella isolates reported to the CDC during 2002. According to one study:
During the 1980s, S. Enteritidis emerged as an important cause of human illness in the United States. In 1976, the incidence of S. Enteritidis was 0.55 per 100,000 population and represented only 5% of all Salmonella isolates. By 1985, this proportion reached 10%, and the rate increased to 2.4 per 100,000 population. During the same time, total Salmonella infection rates rose from 10.7 per 100,000 in 1976 to 24.3 in 1985. The highest rates of S. Enteritidis were seen in the Northeast, although rates in the western region also increased during this time.
The number of outbreaks of S. Enteritidis infection also increased during the 1980s, particularly in the northeastern United States. Laboratory subtyping of S. Enteritidis isolates from outbreaks indicated that phage types (PT) 8 and 13a were the most common phage types in the United States. Although PT4 was common in Europe, where it coincided with a large increase in S. Enteritidis infections, it was seen in the United States only among persons with a history of foreign travel.
Of the Salmonella outbreaks that occurred from 1985 through 1999, “[f]ive hundred twenty-two (62%) outbreaks of S. Enteritidis infection were associated with food prepared at commercial food establishments (restaurants, caterers, delicatessens, bakeries, cafeteria, or market).”
Symptoms of a Salmonella Infection
Salmonella infections can have a broad range of illness, from no symptoms to severe illness. The most common clinical presentation is acute gastroenteritis. Symptoms include diarrhea, and abdominal cramps, often accompanied by fever of 100°F to 102°F (38°C to 39°C). Other symptoms may include bloody diarrhea, vomiting, headache and body aches. The incubation period, or the time from ingestion of the bacteria until the symptoms start, is generally 6 to 72 hours; however, there is evidence that in some situations the incubation can be longer than 10 days. People with salmonellosis usually recover without treatment within 3 to 7 days. Nonetheless, the bacteria will continue to be present in the intestinal tract and stool for weeks after recovery of symptoms—on average, 1 month in adults and longer in children.
Typhi and Paratyphi generally cause a bacteremic illness—Salmonella found in the blood—of long duration. This illness is called enteric, typhoid, or paratyphoid fever. Symptoms start gradually, and include fever, headache, malaise, lethargy, and abdominal pain. In children, it can present as a non-specific fever. The incubation period for S. Typhi is usually 8 to 14 days, but it can range from 3 to 60 days. For S. Paratyphi infections, the incubation period is similar to that of non-typhoidal Salmonella, 1 to 10 days.
Complications of a Salmonella Infection
In approximately 5% of non-typhoidal infections, patients develop bacteremia. In a small proportion of those cases, the bacteria can cause a focal infection, where it becomes localized in a tissue and causes an abscess, arthritis, endocarditis, or other severe illness. Infants, the elderly, and immune-compromised persons are at greater risk for bacteremia or invasive disease. Additionally, infection caused by antimicrobial-resistant non-typhoidal Salmonella serotypes appears to be more likely to cause bloodstream infections.
Overall, approximately 20% of cases each year require hospitalization, 5% of cases have an invasive infection, and one-half of 1% die. Infections in infants and in people 65 years of age or older are much more likely to require hospitalization or result in death. There is some evidence that Salmonella infections increase the risk of developing digestive disorders, including irritable bowel syndrome.
Although most persons that become ill with diarrhea caused by Salmonella recover without any further problems, a small number of persons develop a complication often referred to as reactive arthritis. The terminology used to describe this type of complication has changed over time. The term “Reiter’s Syndrome” was used for many years, but has now fallen into disfavor. The precise proportion of persons that develop reactive arthritis following a Salmonella infection is unknown, with estimates ranging from 2 to 15%. Symptoms of reactive arthritis include inflammation (swelling, redness, heat, and pain) of the joints, the genitourinary tract (reproductive and urinary organs), or the eyes.
More specifically, symptoms of reactive arthritis include pain and swelling in the knees, ankles, feet and heels. It may also affect wrists, fingers, other joints, or the lower back. Tendonitis (inflammation of the tendons) or enthesitis (inflammation where tendons attach to the bone) can occur. Other symptoms may include prostatitis, cervicitis, urethritis (inflammation of the prostate gland, cervix or urethra), conjunctivitis (inflammation of the membrane lining the eyelid) or uveitis (inflammation of the inner eye). Ulcers and skin rashes are less common. Symptoms can range from mild to severe.
One study showed that on average, symptoms developed 18 days after infection. A small proportion of those persons (15%) had sought medical care for their symptoms, and two thirds of persons with reactive arthritis were still experiencing symptoms 6 months later. Although most cases recover within a few months, some continue to experience complications for years. Treatment focuses on relieving the symptoms.
There are a lot of gaps in our knowledge surrounding this complication. Since there is no specific test for reactive arthritis, doctors rely on signs and symptoms of the patient in order to make the diagnosis. However, there are no clearly defined criteria or set of symptoms used to diagnose this condition. The role of genetics is also unclear. It is thought that the presence of a gene called human leukocyte antigen (HLA)-B27 predisposes a person to develop reactive arthritis, along with other autoimmune diseases; however, several studies have shown that many persons that develop reactive arthritis lack this genetic factor.
Diagnosis of Salmonella Infections
Salmonella bacteria can be detected in stool. In cases of bacteremia or invasive illness, the bacteria can also be detected in the blood, urine, or on rare occasions in tissues. The test consists of growing the bacteria in culture. A fecal, blood or other sample is placed in nutrient broth or on agar and incubated for 2-3 days. After that time, a trained microbiologist can identify the bacteria, if present, and confirm its identity by looking at biochemical reactions. Treatment with antibiotics before collecting a specimen for testing can affect bacterial growth in culture, and lead to a negative test result even when Salmonella causes the infection.
Treatment for Salmonella Infections
Salmonella infections usually resolve in 3 to 7 days, and many times require no treatment. Persons with severe diarrhea may require rehydration, often with intravenous fluids. Antimicrobial therapy (or treatment with antibiotics) is not recommended for uncomplicated gastroenteritis. In contrast, antibiotics are recommended for persons at increased risk of invasive disease, including infants younger than 3 months of age.
In situations in which antibiotics are needed, trimethoprim/sulfamethoxazole, ampicillin, or amoxicillin, are the best choices. Ceftriaxone, cefotaxime, or flouroquinolones are effective options for antimicrobial-resistant strains, although fluoroquinolones are not approved for persons less than 18 years of age. For persons with an infection in a specific organ or tissue (invasive disease), treatment with an expanded-spectrum cephalosporin is recommended, until it is known if the bacteria is susceptible to one of the more commonly used antibiotics listed above. For these rare situations, treatment with antibiotics for 4 weeks is generally recommended. For enteric fever, including S. Typhi infections, treatment for 14 days is recommended. The specific antibiotic chosen depends on the susceptibility of the bacteria and the response to treatment.
The Incidence of Salmonella Infections
In 2009, over 40,000 cases of Salmonella (13.6 cases per 100,000 persons) were reported to the Centers for Disease Control and Prevention (CDC) by public health laboratories across the nation, representing a decrease of approximately 15% from the previous year, but a 4.2% increase since 1996. Overall, the incidence of Salmonella in the United States has not significantly changed since 1996.
Only a small proportion of all Salmonella infections are diagnosed and reported to health departments. It is estimated that for every reported case, there are approximately 38.6 undiagnosed infections. The CDC estimates that 1.4 million cases, 15,000 hospitalizations, and 400 deaths are caused by Salmonella infections in the U.S. every year.
Salmonella can be grouped into more than 2,400 serotypes. The two most common serotypes in the U.S. are S. Typhimurium and S. Enteritidis. S. Typhi, the serotype that causes typhoid fever, is uncommon in the U.S. But, globally, typhoid fever continues to be a significant problem, with an estimated 12-33 million cases occurring annually. Moreover, outbreaks in developing countries have a high death-rate, especially when caused by strains of the bacterium that are resistant to antibiotic treatment.
Salmonella are found in the intestinal tract of wild and domesticated animals and humans. Some serotypes of Salmonella, such as S. Typhi and S. Paratyphi are only found in humans. For ease of discussion, it is generally useful to group Salmonellae into two broad categories: typhoidal, which includes S. Typhi and S. Paratyphi, and non-typhoidal, which includes all other serotypes.
The Prevalence of Salmonella in Food and Elsewhere
Eating contaminated food, especially food from animal origins, causes most Salmonella infections. One study found that 87% of all confirmed cases of Salmonella were foodborne, with 10 percent from person-to-person infection and 3% caused by pets. As explained in a comprehensive report issued by the USDA’s Economic Research Service:
Salmonella contamination occurs in a wide range of animal and plant products. Poultry products and eggs are frequently contaminated with S. enteritidis, while beef products are commonly contaminated with S. typhimurium. Other food sources of Salmonella may include raw milk or other dairy products and pork. Salmonella outbreaks also have been traced to contaminated vegetables, fruits, and marijuana.
Another study went into even greater detail in explaining the prevalence of Salmonella and the sources of human infection, stating as follows:
A food item was implicated in 389 (46%) outbreaks of S. Enteritidis infection from 1985 through1999; in 86 (22%) of these, more than one food item was implicated. Of the 371 outbreaks for which information was available, 298 (80%) were egg associated. This proportion ranged from 10 (71%) of 14 in 1985 to 19 (95%) of 20 in 1997. Of outbreaks caused by a single vehicle for which information was known, 243 (83%) of 294 were egg-associated, as were 55 (71%) of 77 outbreaks in which more than one food item was implicated.
Among single foods implicated in egg-associated outbreaks, 67 (28%) of 243 were foods that contained raw eggs (e.g., homemade ice cream, Caesar salad dressing, tiramisu, egg nog). Sixty-five (27%) of the outbreaks implicated traditional egg dishes such as omelets, French toast, pancakes, and foods that use egg batter, such as crab cakes, chile rellenos, egg rolls, and Monte Cristo sandwiches. Sixty-three (26%) outbreaks implicated dishes known to contain eggs, such as lasagna, ziti, and stuffing, which would have been expected to have been fully cooked but probably did not reach temperatures sufficient to kill S. Enteritidis. Thirty-six (15%) outbreaks implicated egg dishes that were “lightly cooked” (e.g., hollandaise sauce, meringue, cream pies). The food vehicles in 12 (5%) outbreaks were reported to contain eggs but could not be classified because information on how the dishes were prepared was not provided.
Seventy-three (20%) of the 371 confirmed outbreaks for which information was provided involved vehicles that did not contain eggs. Twenty (27%) of these outbreaks were associated with poultry (chicken or turkey), 8 (11%) with beef, and 6 (8%) with foods containing shrimp (3 outbreaks), bologna (1), pork (1), and pepper loaf (1). Other implicated foods included potatoes (3), beans (3), desserts (3), salad (3), macaroni and cheese (1), cheese sauce (1), goat cheese (1), chili (1), and a pureed diet (1). In 22 (30%) of the non–egg-associated outbreaks, more than one food was implicated. In four of these outbreaks, cross-contamination with raw eggs was suspected.
In sum, food remains the most common vehicle for the spread of Salmonella, and eggs are the most common food implicated. As one authority points out, “Studies showed that the internal contents of eggs can be contaminated with [Salmonella], and this contamination has been identified as a major risk factor in the emergence of human illness.” Part of this risk stems from the variety of ways that Salmonella can contaminate an egg. For example, the FDA has documented the following:
Bacteria can be on the outside of a shell egg. That’s because the egg exits the hen’s body through the same passageway as feces is excreted. That’s why eggs are required to be washed at the processing plant. All USDA graded eggs and most large volume processors follow the washing step with a sanitizing rinse at the processing plant. It is also possible for eggs to become infected by Salmonella Enteritidis fecal contamination through the pores of the shells after they’re laid. SE also can be inside an uncracked, whole egg. Contamination of eggs may be due to bacteria within the hen’s reproductive tract before the shell forms around the yolk and white. SE doesn’t make the hen sick.
Chicken is also a major cause of Salmonella. Beginning in 1998, the publisher of Consumer Reports magazine has conducted surveys and tested chicken at retail for Salmonella and Campylobacter. Its 2009 study found 14% of broiler chickens at grocery stores to contain Salmonella. A USDA Baseline Data Collection Program report done in 1994 documented Salmonella contamination on 20.0% of broiler-chicken carcasses. However, in 2009 the same USDA data collection survey showed the prevalence of Salmonella in broiler chickens at 7.5%. Additionally, turkey carries a lower risk with a prevalence of 1.66%.
While Salmonella comes from animal feces, fruits and vegetables can become contaminated. A common source is raw sprouts, which have been the subject of at least 30 reported outbreaks of foodborne illnesses since 1996. The U.S. Department of Health and Human Services cautions against consuming raw sprouts under any circumstances: “Unlike other fresh produce, seeds and beans need warm and humid conditions to sprout and grow. These conditions are also ideal for the growth of bacteria, including Salmonella, Listeria, and E. coli.”
In general, safe cooking and preparation of food can kill existing Salmonella bacteria and prevent it from spreading. Additionally, safe choices at the grocery store can greatly reduce the risk of Salmonella.
•Always wash your hands before you start preparing food.
•Cook poultry until it reaches an internal temperature of 165 ºF.
•Cook beef and pork until they reach 160ºF. High quality steaks (not needle or blade tenderized) can be safely cooked to 145ºF.
•Cook eggs until they reach 160ºF or until the yoke is solid. Pasteurized eggs are available in some grocery stores.
•Do not eat or drink foods containing raw eggs. Examples include homemade eggnog, hollandaise sauce, and undercooked French toast.
•Never drink raw (unpasteurized) milk.
•Avoid using the microwave for cooking raw foods of animal origin. Microwave-cooked foods do not reach a uniform internal temperature, resulting in undercooked areas and survival of Salmonella.
•If you are served undercooked meat, poultry, or eggs in a restaurant don’t hesitate to send your food back to the kitchen for further cooking.
•Avoid cross-contamination. That means that you should never allow foods that will not be cooked (like salads) to come into contact with raw foods of animal origin (e.g., on dirty countertops, kitchen sinks, or cutting boards). Wash hands, kitchen work surfaces, and utensils with soap and water immediately after they have been in contact with raw foods of animal origin.
•Wash hands with soap after handling reptiles, amphibians or birds, or after contact with pet feces. Infants and persons with compromised immune systems should have no direct or indirect contact with such pets.
•Reptiles, amphibians or birds, or any elements of their housing (such as water bowls) should never be allowed in the kitchen.
•Avoid eating in animal barns, and wash your hands with soap and water after visiting petting zoos or farm settings.
•Always wash your hands after going to the bathroom. The hands of an infected person who did not wash his or her hands adequately after using the bathroom may also contaminate food.
Steps for proper hand washing:
•Wet your hands with clean warm running water;
•Rub your hands making lather for 20 seconds. Make sure that you scrub your hands entirely (not just the fingertips);
•Rinse your hands under warm running water;
•If possible, turn the faucet off using a paper towel;
•Dry your hands using paper towels or an air dryer;
•Do not use an alcohol-based (waterless) sanitizer instead of washing your hands when cooking or when hands are visibly soiled. Hand sanitizers are only effective when there is no visible organic matter (like dirt, food, or other matter) on the hands.
New Database of Food Safety Inspections Includes About Half of All U.S. Counties
Source : http://www.foodsafetynews.com/2015/04/new-database-of-food-safety-inspections-includes-about-half-of-u-s-counties/#.VStc3dj9ns1
By Lydia Zuraw (Apr 10, 2015)
If you’ve ever tried to find a recent inspection report for a particular restaurant, you’ll know that the ease of accessing and understanding that information can depend on what city or county you live in.
University of Maryland Economics Professor Ginger Jin and UCLA Associate Professor of Business Management Philip Leslie have been doing research about food safety inspections since the 1990s. Out of that work grew the idea to collect and normalize data from food safety inspections from local government websites.
magnifying-glass-computerAlong with UMD Computer Science Professor Ben Bederson and graduate students Alexander Quinn and Ben Zou, they created a huge database of food service inspections from about half of all counties in the U.S.
The team started with the largest jurisdictions — nearly 20 states that publish data statewide and large metropolitan areas such as New York City — which means their database includes almost 900,000 establishments, almost 7 million inspections, and more than 18 million violations.
The database doesn’t cover every single restaurant in the country because not all local governments publish their data, but Jin estimates that more than half of the restaurants in the country are represented.
“If you need one particular piece of data, it might not be there, but if you use it for the broader kinds of analyses that we think provide the most value, then you’re well-covered,” Bederson says.
The scan is continuous so it’s pretty current and includes information dating back to when the team started scanning sites a few years ago. In addition, some sites had historic data going back to the mid-1990s in some cases, so that was included in the database.
The technology behind the database had two major hurdles to overcome.
The first is that although there is guidance provided by the Food and Drug Administration on best practices for running and reporting food safety inspections, each municipality does things differently. For example, some jurisdictions might have broad categories for problems encountered during inspections while others go into granular detail. It’s the difference between “temperature out of range” and “the temperature in the corner of the refrigerator was between this and that temperature.”
The second is that inspection results are reported online in many different ways. There could be a more human-friendly PDF file or webpage that searchable by restaurant but terrible for a computer to mine, or a computer-friendly database that might be harder for the average consumer to interpret.
The database was built with a couple different customers in mind. One was chain restaurants that don’t want to manually collect data across hundreds of locations. Another was local health departments wanting to understand whether emulating the way a nearby jurisdiction operates could make their own inspections more efficient. The third main target audience was national policymakers who want a big picture of food safety and/or fiscal effectiveness.
Going forward, the team is working on commercializing the database for companies and organizations. They’re also working on developing different tools for different potential users.
Otherwise, it’s about making the database bigger and better.
Jin notes that the team welcomes food safety inspection data from any health department that hasn’t posted their data on the web.
“Our engineers can deal with the technical problem and save them the cost of setting up their own website and tracking data over time,” she says. “If they are not ready to disclose the data to the public yet, we can incorporate their data into our framework and limit the access to their specification.”
They’re also happy to work with local and federal governments on exploring ways that might improve inspections and compliance with food safety regulations.
“The business world has been into ‘big data’ for quite some time and, in my view, the government — especially local governments — have lagged behind in this movement,” Jin says. “I think potentially that big data could be even more useful for local governments themselves because they have collected many of those data.”
For non-commercial use, the database is available free to the public at InspectionRepo.com.
Listeria In Sabra Hummus Prompts Latest Food Safety Recall
Source : http://www.forbes.com/sites/judystone/2015/04/09/listeria-in-sabra-hummus-prompts-latest-food-safety-recall/
By forbes.com (Apr 09, 2015)
Sabra hummus—a staple in many refrigerators, including my own—has just been recalled due to the risk of Listeria infections. No one has been sickened; the recall is precautionary, after contaminated samples were found during a routine grocery inspection.
Listeria has been a common cause of widespread outbreaks. Recently, there was an outbreak in Kansas and Texas, linked to Blue Bell Creameries ice cream. Eight people were hospitalized; three died.
Last year, caramel apples were the source of a multi-state outbreak of Listeria, dampening the Halloween pleasures for many. Thirty-five people became ill and there were several cases of meningitis and miscarriage, as well as seven deaths.
Other Listeria outbreaks have been traced to Mexican or other imported soft cheeses, and there was a large outbreak from cantaloupe. That fruit-related outbreak involved 147 people in 28 states, and led to 33 deaths, mostly in those older than 60.
Listeria causes about 800 infections in the U.S. annually, and 3-4 outbreaks. Commonly implicated foods are unpasteurized cheese and dairy products, deli meats, and hot dogs. Vegetables have been less commonly linked.
Most people eating food tainted by Listeria would not become very ill—rather getting more typical food poisoning symptoms of vomiting or diarrhea. Listeria can cause life-threatening infections in immunocompromised people, however, where it can cause meningitis, or in pregnancy, leading to miscarriage. Elderly and diabetics are at higher risk for serious illness as well.
Only these specific lots (SKU) of Sabra Classic Hummus are affected by this recall:
040822011143/300067 – Sabra Classic, 10 oz. – 3-059/Best before May 11;
040822011143/300067 – Sabra Classic 10 oz. – 3-060/Best before May 15
040822014687/300074 – Sabra Classic, 30 oz. – 3-059/Best before May 11
040822342049/301216 – Sabra Classic Without Garnish, 32 oz. – 3-059/Best before May 11
040822017497/301290 – Sabra Classic, 17 oz. Six Pack – 3-058/Best before May 11
040822017497/301290 – Sabra Classic, 17 oz. Six Pack – 3-059/Best before May 11
040822342209/301283 – Hummus Dual Pack Classic/Garlic – 3-058/Best before May 11
It is important to know that the infection can take up to 2 months before symptoms show, and require different antibiotics (Ampicillin) than are generally used. So keep a note of your exposure, just in case you become ill.
Consumers who have purchased any of these products are urged to dispose of or return it to the place of purchase for a full refund. Consumers with any questions may call toll free 1-888-957-2272.
How can you reduce your risk of Listeria?
Wash fruits and vegetables, even if you will peel or cut them—this avoids spreading bacteria from the outside of the fruit into the flesh. This is especially important with rinds with crevices where bacteria may be lurking. Listeria can continue to grow in refrigerated foods. The CDC recommends a refrigerator temperature 40°F or lower.
Juice from hot dogs or deli meat should be thoroughly cleaned up. Opened packages of hot dogs should be used within a week; deli meats should be stored for only 3-5 days.
Recommendations for those at increased risk—the elderly, immunocompromised, or pregnant—are far more restrictive. Deli meats, cold cuts, and hot dogs should be avoided, unless the latter are heated to 165°F or steaming. Do not eat meat spreads or pâtés from the refrigerated sections or food bars of stores. Refrigerated smoked seafood, such as salmon (lox) should not be eaten unless cooked. Canned seafood is generally safe.
Most importantly—and it can’t be said enough—do not eat or drink unpasteurized dairy products. There are many infections transmitted this way.
So it’s not just Sabra or hummus to be wary of. These general food safety suggestions will hold you in good stead in preventing a variety of food-borne infections.
For more on how food outbreaks are traced and food safety tips, see this week’s World Health Day: #SafeFood post.
Consumer Food Handling Leads to Cross-Contamination
Source : http://foodpoisoningbulletin.com/2015/consumer-food-handling-leads-to-cross-contamination/
By Linda Larsen (Apr 9, 2015)
A new peer-reviewed article by Jeannie Sneed, et al, published in Food Protection Trends says that consumer food handling practices lead to cross-contamination. Although outbreaks that sicken multiple persons are usually linked to mass produced foods or restaurants, about 9 to 15% of most foodborne illnesses occur in the home.
The study looked at the “Food Safe Families” clean and separate messages and to determine the impact of external safe food handling cues. One hundred-twenty-three parents who were between 20 and 45 years of ago, who prepared four or more meals at home each week, and had at least one child less than 13 years old in the home were studied. Two experimental groups were educated about safe food handling; one through traditional food safety messages, the other through Ad Council public service announcements. A control group was not given any education.
They were then videotaped preparing a meal with raw chicken or ground beef inoculated with Lactobacillus case (tracer organism), and a ready to eat fruit salad. The researchers found that, after preparation, about 90% of the salads were contaminated, and 24% were highly contaminated. Bacterial levels were lower for the food safety messages group. And hand washing scores were lower for the control group.
Cloth towels were the most frequently contaminated contact surface. Cell phones should be studied as a source of cross-contamination, especially since the phones were not washed or disinfected when used in the kitchen for looking at recipes. The study found that most of the participants were not able to prepare a salad without contaminating it with the tracer organism.
Another study done at the University of Westminster, published in the March 2015 edition of The Journal of Hospital Infection found that single-use paper towels are the most hygienic way to dry hands after washing at the sink. That study compared air dryers, jet air, and paper towels.
The study also showed that handling raw meat and poultry are a food safety risk in consumer kitchens. Most, or more than 82%, of the participants left meat-originating contamination on the sink, refrigerator, oven, and/or trash cabinet handles.
The researchers conclude that educational methods have some impact on reducing cross-contamination in consumer kitchens, but the impact is inconsistent. The question is “how to best impact food handling behaviors to reduce cross-contamination? Research is needed what motivates consumers to change behavior to reduce the risk of foodborne illnesses and what messages have been effective.
Food safety: Food sources, tips to prevent food poisoning
Source : http://zeenews.india.com/news/health/tips/food-safety-food-sources-tips-to-prevent-food-poisoning_1574240.html
By Salome Phelamei (Apr 9, 2015)
Food safety can be referred to the conditions and practices that preserve the quality of food to prevent contamination and foodborne illnesses.
According to WHO, there are five key principles of food hygiene, they are:
1. Prevent contaminating food with pathogens spreading from people, pets, and pests.
2. Separate raw and cooked foods to prevent contaminating the cooked foods.
3. Cook foods for the appropriate length of time and at the appropriate temperature to kill pathogens.
4. Store food at the proper temperature.
5. Use safe water and raw materials.
Although all foods can become contaminated, higher risk foods include red meats, poultry, eggs, cheese, dairy products, raw sprouts, and raw fish or shellfish. Hence, extra care is needed in handling, storing and preparing these items in order to avoid from severe health hazards.
Below are a few tips to prevent food poisoning:
All milk, yogurt, cheese and other dairy products should have the word "Pasteurized" on the container.
Avoid eating foods that contain raw eggs (such as caesar salad dressing, raw cookie dough, and egg nog.
Do not eat raw honey, and honey should not be given to children under 1 year of age.
Shun eating soft cheeses
Do not eat raw vegetable sprouts
Shellfish that has been exposed to red tides should not be eaten
Make sure that you wash all raw fruits, vegetables, and herbs with cold and running water
Do not eat raw vegetables or unpeeled fruit
Eat only hot, freshly cooked food
Drink only boiled water
Ready to eat: DG health urges increased food safety
Source : http://tribune.com.pk/story/865997/ready-to-eat-dg-health-urges-increased-food-safety/
By Our Correspondent (Apr 8, 2015)
Khyber-Pakhtunkhwa Health Services Director General Dr Parvez Kamal Khan has stressed the need to make food safer for consumption and urged all stakeholders to play their role.
He said relevant legislation was in the works at the provincial level and reiterated his resolve to work with all stakeholders, read a statement issued from the DG Health’s office on Tuesday.
Khan made these remarks during a seminar organised by the K-P Health department in collaboration with the World Health Organization (WHO) sub office in the province to mark World Health Day.
The event was called From Farm to Plate, Make Food Safe and was held at the DG’s office. Agriculture University Peshawar Professor Dr Ziauddin from the department of Human Nutrition explained all aspects of basic food safety and hygiene identification.
World Health Day Stresses Food Safety
Source : http://foodpoisoningbulletin.com/2015/world-health-day-stresses-food-safety/
By Linda Larsen (Apr 7, 2015)
Today is World Health Day. The World Health Organization (WHO) is making the centerpiece of this year’s celebration food safety. New data on the harm caused by food poisoning stresses the global threat caused by contaminated food.
WHO states that there is a need for coordinated, cross-border action across the entire food supply chain. WHO Director-General Dr. Margaret Chan said in a statement, “food production has been industrialized and its trade and distribution have been globalized. These changes introduce multiple new opportunities for food to be contaminated with harmful bacteria, viruses, parasites, or chemicals.” Food that is not safe to eat can contain bacteria, viruses, parasites, and chemical substances. Unsafe food can cause more than 200 diseases.
WHO is releasing the first findings from its analysis of the global burden of food borne diseases. The full research will be released in October 2015. The analysis found that there were an estimated 582 million cases of 22 different food borne enteric diseases around the world in 2010. Those illnesses caused 351,000 deaths. The most common type of food poisoning was from Salmonella Typhi (52,000 deaths), E. coli (37,000 deaths), and norovirus (35,000 deaths.)
The African region had the highest disease burden for enteric food borne illness, followed by South East Asia. And more than 40% of the people suffering from these illnesses caused by contaminated food were children under the age of 5. WHO said, “food borne diseases impede socioeconomic development by straining health care systems and harming national economies, tourism and trade. Food supply chains now cross national borders.”
WHO states that efforts to prevent these illnesses can be strengthened. Governments need to pub robust food safety systems in place. Global and national level measures can be taken, including the joint WHO-FAO International Food Safety Authorities Network to ensure good communication during an outbreak.
The press release also states that the public must play a role in food safety. Consumers must understand safe food practices, and how to cook potentially hazardous foods such as raw chicken. WHO offers the Five Keys to Safer Food manual that all people should read to help increase their understanding of the problem and to keep food poisoning at bay.
After Easter, a Word About Egg Safety
Source : http://foodpoisoningbulletin.com/2015/after-easter-a-word-about-egg-safety/
By Linda Larsen (Apr 7, 2015)
After Easter, most people have hard cooked eggs that they have dyed for the holiday. The FDA wants you to know some food safety tips for handling this food.
Fresh eggs can contain Salmonella bacteria that are in the actual egg itself, not just on the shell. The FDA estimates that 142,000 illnesses are caused by consumers eating eggs that are contaminated with this pathogenic bacteria.
Although there are regulations in place to help prevent contamination on the farm and during shipping, eggs will contain Salmonella. The bacteria is actually in the hen’s ovaries. Consumers are the last measure of defense against food poisoning from eggs.
All cartons of shell eggs that have not been treated to destroy Salmonella bacteria are required to display this safe handling statement: “To prevent illness from bacteria: keep eggs refrigerated, cook eggs until yolks are firm, and cook foods containing eggs thoroughly. Eggs that have been treated to destroy Salmonella — by in-shell pasteurization, for example — are not required to carry safe handling instructions.”
Only eggs that have been heat treated (pasteurized) do not have to carry that statement. If you buy pasteurized eggs, always follow the expiration date on the package to the letter.
Always refrigerate eggs promptly, whether cooked or uncooked. Eggs should always be cooked until both the yolk and white are firm; soft cooked eggs are not safe.
Hard cooked eggs should be refrigerated promptly after cooking, and within 2 hours out of refrigeration. If they were used in an Easter egg hunt and the ambient temperature was above 80°F, you only have one hour to refrigerate the eggs. If any hard cooked eggs were cracked during the hunt, throw them away. Hard cooked eggs should be used within 7 days of cooking.
If you are going to pack hard cooked eggs for lunches, pack with frozen gel packs to keep them cold. Tell your child to throw away any hard cooked egg that is not eaten.
What To Know About How We Deal With Foodborne Illness Outbreaks
Source : http://www.refinery29.com/2015/04/85069/food-safety-world-health-day-2015
By Sarah Jacoby (Apr 7, 2015)
We've got listeria here and salmonella there. Sometimes, it seems like there's a new foodborne illness outbreak every day. So, you might wonder: Who's keeping track of all this stuff? In honor of World Health Day's focus on food safety (and with the help of this new TestTube video), we're happy to tell you.
This can be a confusing subject in the U.S. because more than one government agency is involved. We've got the Food and Drug Administration (FDA), the United States Department of Agriculture (USDA), and — when things get serious — the Centers for Disease Control and Prevention (CDC). Although there's a lot of overlap, TestTube explains that the USDA is mainly focused on agriculture, including animal welfare and food distribution.
The FDA gets to worry about the health impacts of food, as well as those of cosmetics and prescription drugs and many other things. It may be more likely to act on tips from consumers, and it has the power to issue mandatory recalls. However, food companies themselves also do their own inspections and often keep detailed records of what's going on.
If there are so many people working on food safety, why do we keep having outbreaks? For one thing, a recent audit of the FDA suggested that the agency is both underfunded and understaffed. And, we don't necessarily get to see the outbreaks the FDA prevents, because, well, they've been prevented. As for the USDA, it prevents an estimated 25,000 foodborne illness cases per year.
Clearly, though, even with all of these eyes on your food, your own eyes are important, too. For more information on how to choose and prepare safe food, check out the FDA's recommendations.
What a Massive Spinach Recall Teaches Us About Food Safety
Source : http://time.com/3774505/food-safety-spinach-recall/
By Elizabeth Grossman / CivilEats.com (Apr 7, 2015)
Questions remain since the E. coli outbreak in spinach 9 years ago
Over the past two weeks, grocery stores in every region of the United States and Canada have been taking frozen organic spinach—and a host of products ranging from frozen dinners to spinach dip—off their shelves. All the spinach in question, which may have been contaminated with Listeria, comes from a single California-based vegetable processing company.
No illnesses have been reported, but the massive recall has affected about half a dozen companies including Amy’s Kitchen and Rising Moon Organics and major retailers, among them, Target, Costco, Wegmans, and Giant Eagle. For many, it brings to mind the infamous E. coli recall that rocked the U.S. produce industry, killed three people, and sickened 205 in 2006. And it raises the question: Has our food gotten any safer in the past nine years?
“That outbreak was a watershed for the fresh produce industry. Not just leafy greens but all produce,” says United Fresh Produce Association Senior Vice President for Food Safety and Technology, David Gombas.
As leafy greens eaters may remember, in 2006, E. coli O157:H7 was traced to spinach that was grown and bagged in California and then sold all across North America. While scientists and regulators determined that the contamination was caused by animals in the field, the precise source was never definitively pinpointed.
The incident prompted new voluntary food safety guidelines for companies that sell leafy greens in California, the state that produces most of the nation’s lettuce and spinach. It also played a role in the creation of a major piece of federal legislation—the Food Safety Modernization Act (FSMA)—the (underfunded) rules of which the U.S. Food and Drug Administration (FDA) is still finalizing.
At the time, says Gombas, many produce industry leaders came to realize, “that a whole lot of information was missing” about the food we eat. “Not only on leafy greens but for fresh produce in general.”
Traceability—the ability to trace food from kitchen table back to its origins and locate the source of a problem if one occurs—is key to maintaining a safe food supply. And while there have been quite a few measures to improve quick identification of steps in the produce supply chain—who’s sold what to whom and when—some important information is still inaccessible to the food-buying public.
In the case of the current spinach recall, Coastal Green, the company that processed and sold the greens to other companies which turned it into to packaged frozen and ready-to-steam spinach or who used it in ready-to-cook or frozen pasta or dips, has been readily identified. But the grower(s) have not been. Nor is there any information available on where exactly the spinach was grown, not even from the FDA.
While some preventative measures—like basic hygiene for everyone who touches the produce—are relatively simple to achieve, identifying sources of contamination in the field is more difficult, Gombas explains. “By the time you get a positive detection, you’re days away from when the contamination event occurred,” he says.
But when it comes to Listeria, the pathogen in the current spinach recall, the “bug can occur at different points in the system, on the farm or in processing, so you need different precautions,” says Christopher Waldrop, director of the Consumer Federation of America’s Food Policy Institute. And like other food-related bacterial infections, Listeria is of increasing concern given the rise in antibiotic resistance.
“Ideally, as soon as a company finds out it has a problem, they should be letting their customers know and letting the public know. There shouldn’t be a time lag,” says Waldrop. But, he notes, the rules about when a company issues a recall are not dictated by law. “It’s all voluntary,” he says.
While the 2002 Bioterrorism Response and Preparedness Act requires food companies to keep sales records, the FDA’s requirements are not yet finalized. Several “pilot” traceability projects are now underway under FSMA to “explore and evaluate methods to rapidly and effectively identify recipients of food to prevent or mitigate a foodborne illness outbreak.”
Since food companies do their own internal food testing, it’s typically up to food processors and retailers to notify the FDA, which posts recall notices on its website and distributes them via email. The companies are then supposed to notify customers, but there aren’t any specific timeframes required by regulation.
Coastal Green “is conducting this recall voluntarily,” the FDA explained in an email. But the agency also stresses, “a recall action is a voluntary action on the part of the firm, unless mandated by FDA,” which would happen only in an urgent situation—if a serious contamination issue is confirmed—or the company has somehow failed to act.
In the current recall, processors and distributors receiving the spinach quickly notified food companies so products could be pulled from store shelves. “We immediately alerted FDA—it was the same afternoon (Friday, March 20) that we received the notice from Coastal,” says a spokesperson for Amy’s Kitchen.
“We have to follow where every ingredient goes in every product,” says Mark Hubbard spokesman for Twin City Foods, a processing, packing, and distribution company affected by the recall. Thanks to the changes that have occurred over the last decade, companies like his have a system for doing so. Hubbard calls the change, “a good thing.”
John Personeni, president of the Carmel Food Group which owns the Rising Moon Organics brand is not quite so sanguine. He says his company purchased the spinach in question for ravioli in December of last year, but wasn’t notified of a problem until March. “We’re usually notified much sooner. That’s why this is so disturbing,” he says.
The FDA, which is investigating the problem, had no additional specifics to offer in response to our questions. And it’s not clear what—if any—additional information will be available in the weeks to come. Coastal Greens did not respond to requests for information and its website does not list spinach among the company’s products.
The big questions, says Waldrop, are: “How do we prevent this from happening again?” and “Would the [FSMA] rules that are coming out of FDA have prevented it from happening?”
The existing voluntary California leafy greens guidelines and the forthcoming FSMA rules include safety standards for things like irrigation water, manure use, equipment, and facilities. But ensuring food safety at the source also involves training and empowering farmworkers to report problems. Peter O’Driscoll, director of the Equitable Food Initiative, a private-public partnership that aims to improve working conditions on farms, says his organization is doing just that.
“One of the growers we work with instituted something they call red-button moments,” explains Waldrop whose organization is an Equitable Food Initiative member. “Any worker can stop the production line at any time.”
But not all farms have such a policy. And poor working conditions on farms are often associated with food safety issues. For example, Jensen Farms—the large Colorado cantaloupe grower responsible for the 2011 Listeria outbreak that killed 33 people—was fined the very same year for providing their workers with substandard, unsanitary housing.
“The really good news is while the [recall] was widespread,” cases “of illness or problems are nonexistent as far as we can tell,” says Hubbard.
But just how much of that outcome is due to luck, versus the product of recent changes, is still hard to gauge.
UN stresses importance of food safety – from farm to plate – on World Health Day
Source : http://www.un.org/apps/news/story.asp?NewsID=50508#.VStiUtj9ns1
By un.org (Apr 07, 2015)
– With the United Nations health agency highlighting food safety on World Health Day, the Secretary-General today called for unified efforts to ensure that production, distribution, and preparation of food is done safely.
“The health, agriculture, trade, and environment sectors need to work together,” said Ban Ki-moon. “We all have a role to play in keeping food safe – from farm to plate.”
Mr. Ban pointed to the more than 200 diseases that can come from contaminated food and to the constantly evolving threat from new production, distribution and consumption methods, as well as the emergence of resistant bacteria.
“With the food supply chain stretching around the world, the need to strengthen food safety systems within and among countries is becoming more critical,” he said. “That is why, on World Health Day, the World Health Organization (WHO) is calling on countries and all actors to improve food safety from farm to plate and everywhere in between.”
To mark the day, the WHO released new data on the harm caused by foodborne illnesses and the global threat posed by unsafe foods.
“Food production has been industrialized and its trade and distribution have been globalised,” said WHO Director-General Dr. Margaret Chan. “These changes introduce multiple new opportunities for food to become contaminated with harmful bacteria, viruses, parasites, or chemicals.”
The WHO's findings are part of a broader ongoing analysis of the global burden of foodborne diseases, the full results of which will be released in October, and they show that 582 million cases of 22 different foodborne diseases were reported in 2010, with 351,000 deaths from diseases including Salmonella, E.Coli and norovirus.
Most cases were recorded Africa and South-East Asia and 40 per cent of those suffering from food-borne diseases from contaminated food were children under five years-old.
In response, Dr. Chan stressed the need for coordinated, cross-border action across the entire food supply chain to ensure food safety as she launched World Health Day under the slogan 'From farm to plate, make food safe.'
“A local food safety problem can rapidly become an international emergency,” she said. “Investigation of an outbreak of foodborne disease is vastly more complicated when a single plate or package of food contains ingredients from multiple countries.”
The global impact posed by unsafe food was not just found in the health impacts, with the economic impacts also high. Germany's 2011 E.coli outbreak, for example, reportedly caused $1.3 billion in losses for farmers and industries and $236 million in emergency aid payments to 22 European Union Member States.
To counter such emergencies, robust food safety systems are needed that drive Government and public action to safeguard against chemical or microbial contamination of food. The joint WHO-Food and Agriculture Organization (FAO) International Food Safety Authorities Network (INFOSAN) is aimed at ensuring effective and rapid communication during food safety emergencies.
“It often takes a crisis for the collective consciousness on food safety to be stirred and any serious response to be taken,” says Dr. Kazuaki Miyagishima, Director of WHO's Department of Food Safety and Zoonoses. “The impacts on public health and economies can be great. A sustainable response, therefore, is needed that ensures standards, checks and networks are in place to protect against food safety risks.”
Consumers also play important roles in promoting food safety, from practising safe food hygiene and learning how to take care when cooking poentially hazardous foods, like chicken, to reading labels when buying and preparing food. The WHO's 'Five Keys to Safer Food' explain the basic principles that each individual should know all over the world to prevent foodborne diseases.
In his remarks, UN General Assembly President Sam Kutesa said food safety is also a critical element of food and nutrition security and every effort must be made to prevent the prevalence of foodborne diseases, for the well-being of people, families and communities.
“The production of good, quality food will be critical for the achievement of the sustainable development goals (SDGs),” he said, adding that the importance of addressing malnutrition in relation to food security, health and poverty eradication is highlighted in the proposed SDGs which will be the main component of the post-2015 development agenda.
As we UN Member States sought to formulate that agenda, with the eradication of poverty and hunger at its core, we must all commit to ensuring the availability of affordable, diversified, safe and healthy food.
“Coherent policies, coordinated action among different stakeholders and the empowerment of consumers, particularly women, will be critical for ensuring that we meet our food safety and nutrition objectives, both now and in the future,” President Kutesa said.
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Good Consumer Practices Are Necessary to Further Improve Global Food Safety
Source : http://www.foodsafetymagazine.com/magazine-archive1/aprilmay-2015/good-consumer-practices-are-necessary-to-further-improve-global-food-safety/
By Sean Leighton, M.Sc., M.B.A., and William H. Sperber, Ph.D
To a large extent, modern food safety management efforts in the United States and the rest of the world originated in the 1950s and 1960s with the joint development of the Hazard Analysis and Critical Control Points (HACCP) system of food safety management by The Pillsbury Company, the U.S. Army and NASA. Developed to ensure the safety of military and space foods, the HACCP system was applied to consumer food production beginning in 1972. Its growing success in the global food processing industry for two decades led to its codification in 1992 as the global standard for food safety management by the Codex Alimentarius Commission and the U.S. National Advisory Committee on Microbiological Criteria for Foods.[3,4]
It soon became obvious to its practitioners that the HACCP system could not operate in a vacuum. Food safety defects in several production facilities were found to be related, not to failures at specific CCPs, but rather to failures to recognize the importance of Good Manufacturing Practices (GMPs), also known as Good Hygienic Practices, to prevent the contamination of production line equipment with contaminants from other areas of the production facility. The food industry quickly changed its thinking from “Food safety equals HACCP” to “Food safety equals HACCP plus prerequisite programs.”
Food safety practitioners also recognized that HACCP could not be applied to the production of all foods. Only those foods that could be processed with a CCP—a definitive kill or control step within the control of the food manufacturer—such as pasteurization, sterilization, refrigeration, freezing, dehydration or the reduction of water activity or pH, or the use of preservatives, could reliably be managed by an HACCP system. Foods for which CCPs cannot be developed and applied, those that are typically consumed raw or undercooked, for example, fresh produce or raw ground meat and poultry, can never have the assurance of food safety that resides in those foods produced with one or more CCPs. Therefore, additional prerequisite programs were developed to reduce the chance of food safety failures in foods consumed raw or undercooked.
Good Agricultural Practices (GAPs) were developed to reduce contamination of fruits and vegetables as they were grown, harvested and transported to processing plants or retail distribution centers. Good Distribution Practices (GDP), while in their infancy compared with GAPs and GMPs, are being developed as a necessary part of the farm-to-table spectrum to improve and maintain food safety. The remaining prerequisite program to cover the farm-to-table spectrum, Good Consumer Practices (GCPs), is currently underde-veloped with limited awareness of their benefits.[8,9] Therefore, we are organizing this article to emphasize the importance of consumers’ recognition of their roles and responsibilities to protect their families and themselves, and to remind regulators that food safety requires a steady farm-to-table effort, with sufficient emphasis on the “table” part of this spectrum.
The Case for Consumer Education
The food industry and regulatory agencies have both been reluctant to suggest that consumers bear some responsibility for the safe handling of foods. Moreover, the industry is regularly criticized whenever it suggests that simply cooking raw meat, poultry and seafood properly would easily prevent foodborne illnesses. Industry critics are quick to claim that “just cook it” is used to mask inadequate food safety controls during food processing. We first heard the term “Good Consumer Practices” from an industry executive several years ago. Upon further inquiry, the executive said, “We are not promoting the idea of GCPs because we do not want consumers to think that we are trying to shift our responsibility for food safety to them.”
Neither industry critics nor industry executives are willing to sincerely embrace the concept that ensuring food safety is a farm-to-table responsibility. They probably do not realize that a strong system of food safety management has been developed to achieve the goal of safe food for everyone, with each major part of the farm-to-table supply chain being supported by its own prerequisite program. Food growing and production is supported by GAPs, food processing is supported by GMPs, food distribution is supported by GDPs and food consumption will be supported by GCPs—but only once their efficacy is recognized and accepted.
Furthermore, most participants in the food chain do not realize that HACCP cannot be used to provide safety for a particular food when no CCP is available or practical to develop. They also do not recognize or admit that foods typically consumed raw or undercooked can never be produced completely free of pathogens when the only tools available during their production are GAPs, GMPs and GDPs. For that reason, the development and acceptance of GCPs would significantly reduce the occurrence of foodborne illnesses. Barring acceptance of these facts and responsible actions, the only procedure to reduce foodborne illness associated with raw produce, meat, poultry and seafood would be to cook or irradiate all raw foods at the points of production.
Now the good news! The emerging status of GCPs as an important prerequisite program is not as bleak as the above description might suggest. For some time, governmental organizations, consumer advocacy organizations and determined individuals have laid a solid foundation for GCPs by their steady efforts to educate consumers about safe food handling practices. Several prominent examples are:
• Gateway to Federal Food Safety Information
• Partnership for Food Safety Education
• STOP Foodborne Illness
• Center for Science in the Public Interest
• The Center for Foodborne Illness Research and Prevention
• Food-Safe Kitchens
Clearly, knowledgeable consumers already have access to a great deal of useful information to maintain safe food handling practices in the home. They will be able to do even better with the combined support of governmental agencies, consumer advocacy groups, scientists and other educators, and the companies that grow, process and distribute food. The ultimate acceptance of GCPs as an additional prerequisite program, or “management” practice, will prove to be as useful as the development and acceptance over the past 45 years of GAPs, GMPs and GDPs.
Consumer Attitudes and Practices
Every day, over 316 million people consume some form of food in the United States and are demanding more from the food industry than ever before—through improved nutrition and variety to increasingly “natural” ingredients and increased transparency of the supply chain through improved labeling. Along with these increased demands, the consumer’s confidence in food safety is declining. According to the 2014 Food and Health Survey completed by the International Food Information Council Foundation, over the past 3 years, there has been a 24 percent increase in the number of consumers who are “not too confident” or “not at all confident” in the safety of the U.S. food supply. Perhaps it is this declining confidence in the food supply that has led to increased self-education by the consumer in food safety practices.
Despite the development of a number of educational programs, many consumers do not transfer their knowledge of food safety into action. A recent observational study indicates that essential food safety steps, such as washing hands before preparing food and adequately cooking raw chicken, are not commonly practiced in the home even when the observed individuals claim to be knowledgeable of effective food safety practices! Results from this survey suggest that while consumers believe they are educated in proper food handling and preparation practices, they are not actually applying those principles when cooking in the home. Current food safety education programs are available for educating the general population as a whole. These programs are especially effective as sources of information to those consumers who are interested in food safety and want to become more knowledgeable in safe food handling and effective food preparation. However, we believe there is an opportunity for GCPs to become a program that is complementary to existing educational programs.
It has been demonstrated that knowledge is valuable only if it is transferred into action. The GCP program we are proposing is not designed with the objective of educating consumers, but rather at directing them to take appropriate action. GCPs aim to direct the consumer, in real-time, when the consumer is beginning the preparation of the meal. Very few consumers take the time to access an educational program online or refer to a food safety pamphlet concurrently while cooking ground turkey. And over time, it is by the combination of existing educational programs with consistent, standardized, real-time communication that the safe preparation and handling of food will become learned by consumers by rote.
So what exactly are “Good Consumer Practices” and if the solution is so clear, what could be some of the challenges in their implementation?
We will attempt to answer some of these questions with the summary of a stakeholder analysis completed in 2014. To gain a better understanding of attitudes and perceptions of GCPs by the food industry, a survey was conducted targeting food and ingredient processors (n = 39), food “distributors” (restaurants and grocery stores; n = 6), regulatory officers (n = 6), public health officials (n = 4) and scientists and academics (n = 7). The survey was designed to assess perceptions of a GCP program in the following five areas: 1) who will benefit from a GCP program; 2) expectations and goals of a GCP program; 3) unintended consequences or negative impacts of a GCP program; 4) level of influence over the implementation of a GCP program; and 5) intention to participate in a GCP program, should one be developed.
Out of 62 respondents, 98 percent indicated they believe consumers have some responsibility in preparing food safely. Additionally, 84 percent of survey respondents indicated that consumers would benefit the most from a GCP program (followed by suppliers and food manufacturers at 8 percent and 5 percent, respectively). All individuals surveyed indicated that a GCP program would have at least some positive impact on consumer public health. Lastly, 92 percent of survey respondents indicated that they would support the implementation of a GCP program in the food industry (Figures 1–3). While the response to GCPs from representatives of the food industry is largely supportive, the stakeholder analysis did raise some considerations. One of these points that was mentioned by three respondents is the perception that a GCP program could “place the blame” on consumers when foodborne illness occurred. As a result, any GCP program would have to be carefully constructed and mindfully communicated so as not to suggest blame was being placed. Another comment that was received from more than one respondent is that a GCP program shares the food safety responsibility with consumers. Consumers may be wary of why this is the case and so should be a key consideration in designing a GCP program. A second GCP survey, to be submitted exclusively to consumers, has been proposed to gain a better understanding of the perceptions and attitudes of consumers not tied to the food industry.
Further Development of GCPs
Much work has been done toward the development of safe food preparation and storage practices, as presented by various authors and agencies. Marchiony, Sperber and Kowalcyk provide a solid foundation of practices for consumers to follow to reduce the risk of foodborne illness (Tables 1–3). These practices can easily be segregated into a clean-separate-cook-chill framework that can evolve into an actionable list of GCPs—a sort of “mini-HACCP program” for the kitchen. We will then outline GCP implementation for homes, restaurants, institutions, food/farmers markets and other categories where GCPs apply. Finally, we will discuss our proposal to include GCPs on food labels and briefly visit the current legal perspective on GCPs through a high-level summary of product liability law.
“Ahem!”—Establishing the GCP Framework
“If I walked into the kitchen without washing my hands as a kid, I’d hear a loud ‘Ahem!’ from my mother or grandmother. Now I count on other people to do the same.”
— Maya Angelou
At the highest level, GCPs can be summarized by the following four steps:20 1) Clean, 2) Separate, 3) Cook and 4) Chill. These four steps can be used as an effective outline for keeping consumers safe from foodborne illness. In the following paragraphs, each category will be summarized and presented as a preliminary model for the GCP framework.
Handwashing. For centuries, washing of the hands has been considered an important and effective hygienic measure. Hand hygiene has since become known as the primary means to prevent contamination of food during handling and preparation. It has been estimated that proper handwashing could reduce the number of deaths associated with diarrhea by nearly 50 percent! The most detailed descriptions of proper handwashing technique15 include using a nail brush, warm water and clean, paper towels (not cloth towels, for fear of microbe harborage). Additionally, guidelines for washing hands published by the U.S. Centers for Disease Control and Prevention indicate that the effective removal of bacteria and viruses is achieved after washing the hands for 20 seconds with warm water and soap.[24-26]
Cleaning and Sanitizing Surfaces. Surfaces (cutting boards, countertops, etc.) should be cleaned and sanitized both before and after they are used for food preparation. Cooking utensils should be cleaned properly following use and either air-dried or dried with a clean, sanitary (preferably paper) towel.
Washing Produce. A detailed review of proper produce washing has been developed. As a general rule, all fruits, root vegetables, tomatoes, cucumbers and bell peppers should be scrubbed prior to consumption. Other produce items such as leafy vegetables, stem vegetables and floral vegetables should not be scrubbed but rather soaked and/or rinsed with potable, cool water for 15 seconds. Prewashed lettuce, spinach and other leafy greens should not be washed again by the consumer as this may contaminate the produce. Prewashed leafy greens should be consumed “as is” without any further washing!
Raw meat, poultry, seafood and eggs inherently contain some pathogens. By separating these food items (and the surfaces they come into contact with) from ready-to-eat foods, the risk of cross-contamination can be greatly reduced. Different-colored cutting boards have been proposed15 to reduce the risk of cross-contamination during raw food preparation. Another, often-overlooked element of separating foods relates to how and where food items are stored in the refrigerator. Raw meat, poultry and seafood should not be stored above ready-to-eat foods. They should be stored in a condition that will not allow them to drip or cross-contaminate the refrigerator. Plastic containers are best at preventing drips from occurring, but wax-coated or plastic deli paper may also serve this purpose. Raw eggs should also be kept separate from ready-to-eat foods and in a condition that, if an egg were to break, the risk of cross-contamination with other foods is low. Some refrigerators have “egg shelves” with depressions for eggs or a separate bin made specifically for housing eggs in the refrigerator. Either of these is preferable to keeping eggs in the paperboard container they are purchased in. The U.S. Department of Agriculture (USDA) Food Safety and Inspection Service has published a good resource on refrigerator food safety.
Separation of raw meat, poultry, seafood and eggs from ready-to-eat foods is also necessary in the grocery store when consumers place foods in baskets or carts while shopping. Ideally, carts would have a “red” section isolated from the larger section of the cart where raw meats, poultry, seafood and eggs could be placed. Specially marked bags should be used for transporting raw meat, poultry, seafood and eggs. Further research needs to be done to understand the risk of cross-contamination at the point of checkout. Little is published about the sanitary condition of the checkout scanner and conveyor belts.
Are consumers informed of which foods are ready to eat and which foods are not? If this is a component of existing food safety educational material, is this information being retained and applied by the consumer when placing food items in the refrigerator or preparing them to consume? This challenge can be addressed with an updated labeling system as part of the GCP program and will be discussed later in this article.
Cooking raw foods to an internal temperature to ensure safe consumption is a fundamental GCP. The need for additional rigor around safe cooking temperature practice and communication has been demonstrated. In the before-cited observational study, 40 percent of participants undercooked their chicken. And to further support the “education vs. direction” approach, only 29 percent of participants in the same study knew the USDA-recommended cooked temperature of 165 °F for chicken. It will most likely come as no great surprise that cooking thermometers were not widely used in this study—most participants determined if the chicken was “fully cooked” by physical appearance alone. Not only has it been demonstrated that color and appearance alone are not reliable methods for determining if chicken is safe to eat, but for many other foods, it is almost impossible to determine color change. This is an underlying factor associated with recent ground turkey outbreaks—raw turkey does not have a strong pink color the same way chicken does. Relying on color to cook ground turkey is an extremely ineffective food safety practice. As a culture, we need to improve the expectation that thermometers are used for cooking raw, non-ready-to-eat foods. Thermometer availability in stores, sold near the raw meats and seafood sections, could support this effort significantly.
GCPs for cooking foods should also include a reference to avoiding the consumption of raw cookie dough, raw milk, raw commercial juices, sprouts, “medium-rare” or “rare” cooked ground meats and other often-consumed raw foods that have historical links to foodborne illness.
The effective chilling of food touches on two main areas: 1) the chilling of raw foods precooking and/or preconsumption and 2) the chilling of food postcooking. Chilling is effective only when the proper temperature and time are followed.
Defrosting Frozen Foods. With less than half of consumers properly thawing meat in the refrigerator prior to cooking, the chilling of foods prior to consumption presents a significant opportunity for consumers to improve food safety. According to the U.S. Food and Drug Administration (FDA), there are three ways to defrost frozen foods: In the refrigerator, in cold water (preferably placing the food in a watertight plastic bag prior to submerging in water) or using a microwave. Defrosting foods at room temperature is not an acceptable practice, as this allows food to sit at temperatures ideal for microbial growth (40 to 140 °F) for a prolonged time. This same principle can be applied to the marinating of meats and fish. Marinating should occur in the refrigerator, not at room temperature, and in a container to avoid leaks and spills.
Refrigerator Temperature. Improper refrigeration temperature is a practice that has room for improvement. FDA has reported that approximately 23 percent of consumers’ refrigerators are not at the recommended temperature of 40 °F or colder. At the very least, refrigerators should have a temperature display easily accessible by the user to facilitate frequent monitoring of temperature. Ideally, consumers should check refrigerator temperatures with an independent thermometer once every 3 months. This GCP could potentially be communicated on a label inside household refrigerators and in the refrigerator manual.
Postcook Chilling. Prepared foods should be refrigerated within 2 hours of eating or preparation. This practice helps avoid the risk of food sitting at room temperature for too long. Additionally, prepared foods that have been chilled for future consumption should be consumed as quickly as possible. Our recommendation is to consume any leftovers within 48 hours from when they were initially prepared.
While the above dialogue focused primarily on GCPs as they apply to the home kitchen, these same food safety principles can be adopted by retail foodservice (e.g., delis and supermarket seafood departments and meat departments) and restaurants, institutions that prepare and serve food (e.g., hospitals, schools, nursing homes), and farmers markets and food stands where food is commonly prepared and served in an outdoor setting. Each of these food preparation environments has its own unique set of challenges and the individual(s) responsible for the preparation of the meals being served needs to be acutely aware of those risk factors that pertain to his or her environment. FDA has published a report entitled FDA Report on the Occurrence of Foodborne Illness Risk Factors in Selected Institutional Foodservice, Restaurant, and Retail Food Store Facility Types. The report calls for the “enhancement” of managerial controls in institutional food preparation around three areas: 1) Improper Holding/Time and Temperature; 2) Poor Personal Hygiene; and 3) Contaminated Equipment/Protection from Contamination. While the FDA Food Code does effectively address most, if not all, of the risk factors associated with retail and foodservice, we believe there is a further opportunity to improve this effort. The formal implementation of a GCP prerequisite program that is linked back to the food manufacturer’s HACCP plan addresses this opportunity. This linkage can be accomplished through clear, standardized, effective labeling, applied by the food manufacturer, that will direct those responsible for preparing foods to practice proper food safety practices.
Enabling the Consumer: Labeling for Food Safety
Food labeling in the United States generally aims to achieve one of three objectives: fair competition among food companies, provide the consumer with important information and mitigate risks to consumer safety and health. The final two objectives of food labeling—providing the consumer with important information and the mitigation of safety and health risks—appear to be directly in line with the objectives of our GCP framework. Could GCPs be communicated on the labels of at-risk food items in a standard, easily recognizable (i.e., graphical) format to direct the consumer of the appropriate food safety precaution to take? Other industries have seen success with this approach. The European Union has initiated the European Energy Labeling Directive—a program to label all electronic appliances with the “EU Energy Label” (Figure 4) to inform consumers of the energy efficiency of a particular appliance at the point of purchase. This clear, standardized, graphical communication has generated impressive results, as is demonstrated by refrigerator sales in the European Union over the past 10 years. The average energy efficiency of refrigerators sold improved by 26 percent between 1992 and 1999—with over one-third of the impact being attributable to the use of EU Energy Labels. This labeling program has been so successful because it serves as both a push and pull mechanism for driving energy efficiency. It pushes appliance manufacturers to produce more energy-efficient appliances while the consumers pull (buy) efficient appliances due to the desire to have more cost-effective, environmentally favorable products.
These mechanisms could apply to consumer food safety in a similar, but slightly different manner. Consumers could come to demand foods with a “GCP Label” to protect their own health and the health of their families. This would give those food manufacturers that apply the label a competitive advantage and eventually drive more food manufacturers to its use. While direct, regulatory intervention requiring GCP labeling may ensure a quicker implementation of a GCP Label, one can see how regulatory intervention may not be required to ensure, with time, all at-risk foods sold in the U.S. contain a GCP Label.
As with any new idea, the EU Energy Label program is not without room for improvement, but most of these challenges are due to the comparative nature of the labeling program (lack of differentiation in the A class of products due to numerous products populating this class, for example). By most accounts, the informative element of the EU Energy Label program continues to be a vast success, as demonstrated by the increasing market share of the most energy-efficient models. Further, the success of “front of pack” (FOP) nutrition labeling in the food industry has demonstrated the consumer’s willingness and ability to comprehend labels on foods. A study by the International Food Information Council found that FOP nutrition information “aided with decision making and understanding” by the consumer.
We are currently working with several graphic designers to develop a GCP Label that will effectively communicate the prescribed food safety practice the consumer should follow to ensure food safety. The objectives of a GCP Label will be: to communicate food safety information, applicable to the food item it is affixed to, which is understood by a wide range of consumers; to inspire the consumer to take the appropriate food safety action; and to satisfy the GCP prerequisite program in fulfillment of the manufacturing company’s overall HACCP plan.
It is our aspiration that a completed graphic and label will be adopted by the leading food safety companies in an attempt to pilot the program, gauge consumer response and begin GCP implementation.
Conclusion: Putting the “Table” in “Farm-to-Table”
Over the past several years, a number of prerequisite programs have been developed in the realization that traditional CCPs cannot manage the food safety of the “farm-to-table” supply chain alone. These prerequisite programs include GAPs for the farm, GMPs for the manufacturing/processing plant and GDPs for warehousing and distribution. We propose that an additional prerequisite program be developed to address the “table.” This prerequisite program, entitled GCPs, can be linked to the HACCP plan in a manner similar to the other prerequisite programs. Under the GCP program, potentially hazardous foods would be required to be identified via risk assessment and then labeled using a standard, graphical labeling scheme. This label, referred to as a “GCP Label,” highlights the actions the consumer should take to reduce or avoid the risk of the food item causing foodborne illness. These actions or practices (listed in Table 4) will be documented in the manufacturer’s HACCP plan as being communicated to the consumer via a GCP Label. Next steps for this initiative include completion of GCP Label designs, sharing them across the industry and industry working groups to receive feedback and to select the optimal design, and then to pilot the GCP program in partnership with one or more food companies.
Owners of Chicago Sprout Business Sign Consent Degree
Source : http://www.foodsafetynews.com/2015/04/owners-of-chicago-sprout-business-sign-government-consent-degree/#.VStjyNj9ns1
By Dan Flynn (Apr 6, 2015)
A soy products manufacturer that agreed to close its doors last November after Listeria contamination at its Chicago facility was associated with several illnesses last summer has accepted a consent degree outlining conditions it must follow if it ever wants to get back in business.
Julia and Paul Trinh, individually and on behalf of Wholesome Soy Products Inc., along with their Foley & Lardner attorneys Nathan A. Beaver and John L. Litchfield, signed the agreement with the federal government late Friday, April 3.
The agreement does not become binding until a federal judge signs it, which is likely to occur shortly. The agreement outlines in minute detail what the Chicago manufacturer will have to do if it wants to produce sprout, tofu, and soy products in the future.
Earlier Friday, the Trinhs and Wholesome Soy Products Inc. were named as defendants in a complaint charging them with responsibility for shipping adulterated food through interstate commerce. Although the facility is closed down, government attorneys said there was nothing in place to stop the company from resuming production “without taking corrective actions.”
In signing the consent degree, neither the Trinhs individually or through their corporate entity are admitting or denying any of allegations in the government’s complaint. They do, however, accept the government’s conditions should they opt to get back into business.
In accepting the conditions, the Trinhs “represent to the Court” that they are currently shut down and not engaged in receiving, preparing, processing, packing, holding or distributing any type of food at, or from, any location.
If they want to try and resume operations, they must give the U.S. Food and Drug Administration (FDA) written notice 90 days in advance of the date they want to restart any activity. Also, Wholesome Soy Products cannot legally resume without first having its facilities inspected by FDA.
The notice and inspection requirements don’t apply to a corporation in which one or both of the Trinhs are an owner, director, officer, or manager, but each of them must notify FDA in writing within 14 days if they become employed elsewhere in the food industry.
Once signed by a federal judge, the consent degree applies to anyone who might want to use the facility at 1150 W. 40th St. in Chicago for food manufacturing. To reopen will require engaging the services of an independent laboratory to test for Listeria monocytogenes, hiring an independent sanitation and food safety expert, and following other specific steps contained in the 20-page agreement.
Where FDA is involved with the start-up requirements, the manufacturer will pay all of the government costs at rates of $89.35 per hour for inspection work and $107.09 an hour for analytical or review work.
FDA’s concerns about Wholesome Soy Products go back to last August and September when inspections of the facility led to the company’s voluntary recall of mung bean sprouts over Listeria contamination. Five Listeria illnesses earlier last summer were then connected to contamination of the Chicago facility.
What You Need to Know About Salmonella
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/what-you-need-to-know-about-salmonella/#.VStkrNj9ns1
By Bill Marler (Apr 5, 2015)
Salmonella is the second most common intestinal infection in the United States. More than 7,000 cases of Salmonella were confirmed in 2009; however the majority of cases go unreported. The Centers for Disease Control and Prevention estimates that over 1 million people in the U.S. contract Salmonella each year, and that an average of 20,000 hospitalizations and almost 400 deaths occur from Salmonella poisoning, according to a 2011 report.
Salmonella infection usually occurs when a person eats food contaminated with the feces of animals or humans carrying the bacteria. Salmonella outbreaks are commonly associated with eggs, meat and poultry, but these bacteria can also contaminate other foods such as fruits and vegetables. Foods that are most likely to contain Salmonella include raw or undercooked eggs, raw milk, contaminated water, and raw or undercooked meats.
Salmonella is generally divided into two categories. Non-typhoidal Salmonella is the most common form, and is carried by both humans and animals. Most serotypes of Salmonella, such as Salmonella Javiana and Salmonella Enteritidis cause non-typhoidal Salmonella. Typhoidal Salmonella, which causes typhoid fever, is rare, and is caused by Salmonella Typhi, which is carried only by humans.
Symptoms of Salmonella Infection
Symptoms of Salmonella infection, or Salmonellosis, range widely, and are sometimes absent altogether. The most common symptoms include diarrhea, abdominal cramps, and fever.
Typical Symptoms of Salmonella infection: Appear 6 to 72 hours after eating contaminated food and last for 3 to 7 days without treatment.
•Fever of 100 F to 102 F
Typhoid Fever Symptoms: Symptoms of typhoid fever appear between 8 and 14 days after eating contaminated food and last anywhere from 3 to 60 days. They include a fever of 104 F, weakness, lethargy, abdominal pain, coughing, nosebleeds, delirium, and enlarged organs. Typhoid fever is a serious illness that can result in death.
Complications of Salmonella
Complications of Salmonella poisoning are more likely to occur among young children and people age 65 or older. Possible complications include:
•Reactive Arthritis: Reactive arthritis is thought to occur in 2 to 15 percent of Salmonella patients. Symptoms include inflammation of the joints, eyes, or reproductive or urinary organs. On average, symptoms appear 18 days after infection.
•Focal Infection: A focal infection occurs when Salmonella bacteria takes root in body tissue and causes illnesses such as arthritis or endocartitis. It is caused by typhoidal Salmonella only.
•Irritable Bowel Syndrome: IBS is one disorder in a spectrum of common functional gastrointestinal disorders. Symptoms of IBS can include constipation, diarrhea, alternating diarrhea and constipation, abdominal pain, urgency, bloating, straining at stools, and a sense of incomplete evacuation.
Salmonella infections generally last 3 to 7 days, and often do not require treatment. People with severe dehydration may need rehydration through an IV.
Antibiotics are recommended for those at risk of invasive disease, including infants under three months old. Typhoid fever is treated with a 14-day course of antibiotics.
Unfortunately, treatment of Salmonella has become more difficult as it has become more resistant to antibiotics. Finding the right antibiotic for a case of Salmonella is crucial to treating this bacterial infection.
Prevention of Salmonella Infection
These safety measures can help prevent Salmonella poisoning:
•Wash your hands before preparing food and after handling raw meats
•Cook meat and eggs thoroughly until they reach an internal temperature of 160 F (71 C)
•Do not eat foods containing raw eggs or milk, such as undercooked French toast
•Avoid cooking raw meat in the microwave, as it may not reach a high enough internal temperature to kill Salmonella bacteria and may be unevenly cooked
•Avoid bringing uncooked meat into contact with food that will not be cooked (i.e. salad)
•Wash hands with soap after handling reptiles or animal feces
•Always wash your hands after going to the bathroom
Additional Resources for Salmonella
About-Salmonella.com is a comprehensive site with in-depth information about Salmonella bacteria and Salmonellosis.
SalmonellaLitigation.com is a Website that provides information about lawsuits and litigation brought on behalf of victims of Salmonella outbreaks nationwide. The site provides extensive information about sources of Salmonella outbreaks.
Salmonella Blog provides up-to-date news related to Salmonella outbreaks, research, and more.
Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clark have represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $600 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants. The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart.
Is your food safe enough?
Source : http://www.thehindu.com/opinion/open-page/is-your-food-safe-enough/article7074819.ece
By thehindu.com (Apr 7, 2015)
World Health Day on April 7 marks the founding of the World Health Organization, with a theme for each year. This year it is ‘Food Safety’, to ensure that everyone has the answers to a few questions: What is in your meal and where did the ingredients come from?
Were they properly, and safely, handled at every stage, from farm to plate? WHO is asking for action to understand and streamline the supply chain and ask stakeholders to promote food safety.
Funding requirement challenges for cold chains to cut wastage figured in recent debates on foreign direct investment in multi-brand retail. With increasing pressure on groundwater resources and other factors, farm markets have moved towards ‘chemically managed’ crops. The deterioration in the quality of topsoil is an issue. There is a growing awareness of the need to grow food that is ‘natural’ and toxin-free. The organic food industry has spawned a new health awareness. Considering modern lifestyles that promote automation and restrict opportunities to do things manually, the stress on right eating has grown.
A recent news story that mentioned idli and sambar among the healthier and nutritious breakfast options, makes you ponder over the value proposition of traditional diets. Historically these were geography-specific, using locally available raw material and attuned to the seasons. With modern supply chain systems in place, the menu has changed in most homes. There could well be a correlation between the rising incidence of non-communicable diseases such as diabetes and cardiovascular diseases and the growth of the agro-commodity industry. The obesity challenge facing Asian and Middle Eastern countries, with their increasing disposable incomes, has been chronicled.
While these relate to the collateral impact of food and lifestyle, in large parts of India and the rest of the world there is a lack of and disregard for food safety norms. Multiple factors including lack of awareness and training, absence of compliance or plain corruption are responsible. In India there have been instances of mass hospitalisation of children partaking food from publicly sponsored school midday meal schemes. Such episodes, even following wedding receptions, cause concern.
India has stringent food safety standards set in the Food Safety and Standards Act of 2006 and the Food Safety and Standards Rules and Regulations, 2011. Yet, the quality of food remains a concern.
Fitness and good health have more to do with dietary choices than number exercise regimes. On World Health Day, let’s pledge to eat healthy, beat obesity, and stay fit.
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