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FoodHACCP Newsletter
09/07 2015 ISSUE:668

 

Salmonella Outbreak: How are Cucumbers Contaminated?
Source : https://foodpoisoningbulletin.com/2015/salmonella-outbreak-how-are-cucumbers-contaminated/
By Linda Larsen (Sep 06, 2015)
Cucumbers distributed by Andrew & Williamson Fresh Produce of California, and grown in Baja Mexico, are being recalled in connection with a large Salmonella outbreak in 27 states. But Salmonella bacteria do not occur naturally on cucumbers; that bacteria is usually found on chickens, beef, and pork. Where did it come from?
The Centers for Disease Control and Prevention (CDC) had a meeting with independent industry experts about this outbreak last month. An industry meeting was held on August 26, 2015, with four independent experts from the produce industry. They discussed crop production and distribution practices that may have caused the contamination. These recalled cucumbers were grown on poles in a field.
Most consumers aren’t aware that fresh produce is one of the leading vehicles for pathogenic bacteria. In fact, the pathogen-commodity pair of Salmonella and vine-stalk vegetables (tomatoes, cucumbers) is the third most common combination responsible for outbreaks, according to CDC data.
So how does bacteria get onto cucumbers in the first place? There are several ways this happens.
First, feces in the field can contaminate produce. Wild animals in the field can defecate on plants and deposit bacteria. In the ongoing Cyclospora outbreak linked to cilantro grown in Mexico, investigators found human feces and toilet paper in the fields.  People can be carriers of Salmonella bacteria without showing any symptoms.
Second, irrigation water can be contaminated with bacteria. Large feedlots, or concentrated animal feeding operations (CAFOs) create tons of manure full of pathogenic bacteria that can get into the ground water. When that water is used to irrigate farm fields, it can contaminate fruits and vegetables.
Third, unsanitary conditions in the packing sheds and distribution channels can contaminate produce. If trucks, containers, washing equipment, conveyer belts, or buildings are not sanitary and regularly cleaned with disinfectant, the produce can be contaminated. Many of these buildings used to clean and pack produce can be open to birds and wildlife, which can also contaminate the product.
These are all reasons why it is critically important that consumers, retailers, and restaurants handle produce so it is safe to eat. All produce should be thoroughly washed with clean running water before it is prepared or eaten. Produce with crinkled or rough surfaces, such as cantaloupes and spinach, can be difficult to clean thoroughly. Cooking will kill pathogenic bacteria, but most fresh produce is eaten raw, without a kill step.
If you ate raw cucumbers, either from the grocery store or from a meal at a restaurant, and have experienced the symptoms of Salmonella food poisoning, please see your doctor. These symptoms include diarrhea, which may be bloody, fever, nausea, abdominal cramps, and vomiting. Symptoms usually begin 6 to 72 hours after exposure to the bacteria, and last about a week. But even if you recover completely from this illness without medical attention, you could suffer complications in the future, including reactive arthritis. Your doctor should know about your illness.
The hospitalization rate in the ongoing Salmonella outbreak linked to imported Andrew & Williamson cucumbers is 33%, much higher than the usual hospitalization rate of 20%. Many of those sickened in this outbreak are children, who are more susceptible to complications from this illness. Or the Salmonella Poona bacteria that has sickened patients may be resistant to antibiotics; we don’t know yet.
The cucumbers recalled in connection with this outbreak were sold in Alaska, Arizona, Arkansas, California, Colorado, Florida, Idaho, Illinois, Kansas, Kentucky, Louisiana, Minnesota, Mississippi, Montana, Nevada, New Jersey, New Mexico, Oklahoma, Oregon, South Carolina, Texas, and Utah. They may have been distributed to other states as well.

Salmonella Cucumbers Sold at Red Lobster, Walmart
Source : https://foodpoisoningbulletin.com/2015/salmonella-cucumbers-sold-at-red-lobster-walmart/
By Linda Larsen (Sep 06, 2015)
There is a large Salmonella outbreak linked to cucumbers imported from Mexico by Andrew & Williamson Fresh Produce. Customers of that company are listed on the corporate website. For now, we know that the cucumbers were sold to consumers at Red Lobster restaurants and select Walmart stores. The report from the Minnesota Department of Health lists Red Lobster, and Walmart has posted the recall on their web site.
Other stores and restaurants listed as customers at the Andrew & Williamson site include In-N-Out Burgers, Save Mart Supermarkets, Sam’s Club, The Capital Grille, United Supermarkets, Albertson’s, H-E-B, Safeway, Kroger, Olive Garden, Costco, and Fresh & Easy. The recalled cucumbers may or may not have been sold at those outlets. The cucumbers were not sold at Whole Foods, according to information from that company.
As of September 3, 2015, 285 people are sick with the outbreak strain of Salmonella Poona in 27 states. The case count per state is: Alaska (8), Arizona (60), Arkansas (6), California (51), Colorado (14), Idaho (8), Illinois (5), Kansas (1), Louisiana (3), Minnesota (12), Missouri (7), Montana (11), Nebraska (2), Nevada (7), New Mexico (15), New York (4), North Dakota (1), Ohio (2), Oklahoma (5), Oregon (3), South Carolina (6), Texas (9), Utah (30), Virginia (1), Washington (9), Wisconsin (2), and Wyoming (3). Illnesses began to be reported on July 3, 2015. More will likely be reported, since the government only has data up to August 26, 2015.
Seventy-three percent of the 80 people interviewed so far reported eating cucumbers the week before they got sick. That is a “significantly higher” proportion than a survey of healthy people, in which just 55% ate cucumbers in the month of July.  Several clusters of ill persons have been identified in different states; a cluster is defined as two unrelated people sickened with the same bacteria strain. Traceback investigation discovered that Andrew & Williamson Fresh Produce of San Diego was a common supplier of cucumbers eaten by people in those outbreak clusters.
Public health officials are collecting leftover cucumbers from restaurants and grocery stores where patients reported eating or shopping to see if they are contaminated with the pathogenic bacteria. The San Diego County Health and Human Services Agency isolated Salmonella bacteria from cucumbers they collected at a visit to the Andrew & Williamson facility.
Andrew & Williamson has recalled all “Limited Edition” cucumbers that were sold between August 1, 2015 and September 3, 2015. They were distributed in Alaska, Arkansas, Arizona, California, Colorado, Florida, Idaho, Illinois, Kansas, Kentucky, Louisiana, Mississippi, Minnesota, Montana, New Jersey, New Mexico, Nevada, Oklahoma, Oregon, South Carolina, Texas, and Utah through retail, food service, wholesalers, and brokers. They may have been sold in other states as well.
If you ate slicer cucumbers, the long green cukes, in July, August, or September of this year and have experienced the symptoms of Salmonella food poisoning,  which include diarrhea that may be bloody, nausea, abdominal cramps, fever, and vomiting, see your doctor. Salmonella is a reportable illness. If you do have it, your doctor will tell health officials about it and you will be added to the case count if your illness was caused by the outbreak strain.
Most cases of Salmonella are never reported to doctors, which can make solving these outbreaks very difficult. In fact, for every case reported, there are at least 30 other cases that are not reported. In other words, this outbreak could have sickened almost 9,000 people at this point.
Pritzker Olsen, the law firm that underwrites Food Poisoning Bulletin, has been contacted by several people sickened in this outbreak. They are preparing to file a lawsuit on Tuesday, September 8, 2015.

Wash. state health official stymied in quest to test farm pigs for Salmonella
Source : http://barfblog.com/2015/09/wash-state-health-official-stymied-in-quest-to-test-farm-pigs-for-salmonella/
By Doug Powell (Sep 06, 2015) 
On July 15, 2015, the Washington State Department of Health notified the feds of an investigation of Salmonella I 4,[5],12:i:- illnesses. The U.S. Department of Agriculture’s Food Safety Inspection Service (FSIS) determined there was a link between whole hogs for barbeque and pork products from Kapowsin Meats and these illnesses.
JoNel Aleccia of The Seattle Times writes the oddly named strain of salmonella, common nationally but never before seen in Washington, now has sickened at least 167 people in 11 counties with confirmed illness since April, health officials said.
People who fell ill consumed whole hogs at private barbecues and at several King County restaurants that served dishes containing the tainted meat. At least 24 people have been hospitalized; several lawsuits have been filed.
Dr. Scott Lindquist, state epidemiologist, wants to knowwhether swine sent to Kapowsin Meats in Graham, Pierce County, were colonized with the strain associated with the outbreak. Officials with the U.S. Department of Agriculture (USDA) issued a public-health alert because of the problem, and Kapowsin has now recalled more than 520,000 pounds of pork products and closed its doors until the issue is resolved.
“What I’m trying to figure out is, did it come from all the farms that fed into Kapowsin? Was this very specific strain in each of those farms, or was it just one? What if all of these farms test negative?” Lindquist said. “It would be helpful for me to know: Are those pigs carrying this specific salmonella strain?”
Agriculture officials in the two states and at the USDA say they don’t have authority to require or refuse testing.
Kirk Robinson, deputy director for the Washington State Department of Agriculture, said it’s not clear how the tests would be conducted or who would give the go-ahead to begin.
‘’What would be the protocols around doing that testing?’’ he asked.
“We really don’t have jurisdiction to go on the farm and do some sampling.’’
He added, however, that department officials would be happy to work with farmers and other agencies once any decision is made.
In Montana, a spokesman for Dr. Gregory Holzman, the state’s new medical officer, said his department has broad authority to investigate sources of illness and that Holzma is considering the issue, although there’s no timeline for an answer.
The move by Lindquist also is drawing concern from pork-industry representatives in Montana and at the national level. Montana’s state veterinarian said he has no authority to agree to on-farm testing and he doesn’t think it’s necessary.
“We want to assist the public-health agencies in finding the cause and prevent future incidents. Unfortunately, sampling farms for salmonella will not accomplish this goal,” Dr. Martin Zaluski, state veterinarian with the Montana Department of Livestock, said in an email. “Sampling farms is of limited value to confirm what we already know.”
Dr. Liz Wagstrom, chief veterinarian for the National Pork Producers Council, and Anne Miller, executive director of the Montana Pork Producers Council, sent Washington health officials letters raising questions about the value of on-farm testing. There are no consistently effective methods to control salmonella on farms, Wagstrom noted.
“The main reason for sending the letter was to ask WADOH (Washington State Department of Health) to reconsider its intent to conduct on-farm testing, which in my scientific opinion would produce no demonstrable benefit to public health,” she wrote in an email to The Seattle Times.
Lindquist said he plans to vigorously pursue the testing, despite any opposition.
“I am here to protect the public’s health,” he said. “It’s the information coming off the farm that’s going to be the key to solving this.”

Will FDA’s New Food Import Programs Make Food Safer?
Source : http://www.foodsafetynews.com/2015/09/will-fdas-new-food-import-programs-make-food-safer/#.VezlPhEViUm
By Brandon Neuschafer (Sep 04, 2015)
Opinion
First, the statistics. At the time that President Obama signed the Food Safety Modernization Act (FSMA) into law in 2011, the United States imported about 15-20 percent of its domestic food supply, and as many as 70 percent of the food importers were small companies. Since FSMA was passed, the amount of food imported on an annual basis has increased more than 10 percent.
At the same time, numbers developed by the Centers for Disease Control and Prevention and cited by the Food and Drug Administration (FDA) indicate that 48 million people (one in six) get sick each year from foodborne illnesses and that 128,000 are hospitalized and 3,000 die from such illnesses. FDA believes that many of these cases of illness and death are preventable.
When one combines these illness numbers with the expanding market for food imports, the concern for safety becomes more pronounced. Current import rules generally only require that a foreign facility, where food is manufactured, processed, packed or held, be registered with FDA, that prior notice of the food import be provided to import officials, and that the product otherwise comply with U.S. laws, such as labeling laws. A gap can be created, though, where there is difficulty in effecting the monitoring and inspection of foreign facilities.
Accordingly, FSMA requires FDA to create several new food import programs. These include a verification program for importers to ensure that foreign suppliers have sufficient controls, a third-party certification program for foreign facilities to ensure compliance with U.S. laws, and a voluntary program to provide for expedited review and entry of food imports. In 2013, FDA began implementation of a Foreign Supplier Verification Program for importers and a rule on the accreditation of third-party auditors. Finalization of these programs is expected this year.
FDA has spent the summer further fleshing out the programs it is creating to implement FSMA’s import requirements.
In June, FDA published draft guidance on the Voluntary Qualified Importer Program. This voluntary program will create an expedited import review process for qualifying food importers. To qualify, importers will need to establish a quality assurance program that demonstrates a “high level of control over the safety and security of supply chains.” Foreign facilities where the food to be imported is manufactured, processed, packed or held must be accredited pursuant to the third-party certification program also being developed. Importers will also need to show that they have at least three years of experience importing food products and that there is no history of noncompliance with food safety regulations by either the importer or other entities in the supply chain. Importers pay a fee to participate and, in return, FDA will expedite entry into the U.S. for all foods included in the approved application.
In July, FDA proposed a rule creating user fees for the accreditation of third-party auditors. The accreditation program, originally proposed by FDA in 2013, is a program whereby FDA will recognize accreditation bodies, which will, in turn, accredit third-party auditors who are qualified to conduct food safety audits and issue food and facility certifications. The certifications issued by accredited auditors and certifying bodies then will be used by FDA to assist FDA in deciding whether to admit imported food into the country.
The fee proposal outlined by FDA in July provides for fees to be paid by accreditation bodies, as well as third-party auditors and certification bodies, when applying for and maintaining their relevant status with FDA. The fees are based on FDA’s analysis of costs and manpower associated with the review of various status determinations and range from about $35,000 for initial recognition of an accreditation body or direct accreditation of a third-party auditor or certifying body down to an annual fee of about $2,000 for a third-party auditor or certifying body accredited by an accreditation body (in addition to fees paid to the accreditation body).
Also in July, FDA issued a draft guidance document that establishes model standards on the qualifications for third-party auditors and certification bodies, which can include foreign governments or private companies that would conduct food safety audits of relevant facilities.  This document was guided by, but will take precedence over, ISO/IEC standard 17021 on the requirements for bodies providing audit and certification management systems. Standards established by the rule include those relating to the education, training and competence of personnel, availability of resources and equipment to conduct audits, the ability to communicate with regulated companies and regulatory authorities, and the ability to identify and avoid conflicts of interest. The guidance even allows accreditation bodies to analyze the management capabilities and “skills, personal attributes and behaviors” of audit agents and managers. Auditors will then be required to submit reports of audited facilities to FDA and to the accreditation body.
So, after considering all of these new processes and controls, the question remains: Will our food supply be safer? FDA certainly thinks so. For instance, FDA has stated that “[p]articipation in the third-party accreditation program will facilitate food safety protections, benefit trade, improve efficiency of FDA oversight of imported foods, and increase efficiency and reduce costs for importers with a high level of control over the safety and security of their supply chains.”
The proposed import rules are consistent with FSMA’s heightened focus on prevention through identifying and correcting food safety risks throughout the supply chain. This increased scrutiny of process risks will have obvious positive impacts on food safety and hopefully help lead to increased transparency in the supply chain process. There are outstanding questions, though, regarding how the FSMA obligations will increase food costs on the consumer and how they will open up the chain of liability when something goes wrong. It is clear that these rules will impact agreements food companies have with their suppliers and customers, but the legal world is still trying to ascertain exactly what those impacts look like.
One thing that is for certain is that it will be years before these programs are fully implemented and incorporated into the business practices of food companies around the world. There is no question that there will be increased controls on food production and distribution, as well as increased opportunity to demonstrate and verify safe production and distribution practices. Just as important, there will also be increased opportunity under FSMA to hold food companies accountable. Hopefully, five years from now, I’ll be writing another article about how the new FSMA import programs have resulted in a significant decrease in those illness statistics with which I opened this one.

Poultry Science: Food Safety, Bird Health, Management Stress
Source : http://www.thepoultrysite.com/poultrynews/35685/poultry-science-food-safety-bird-health-management-stress/
By thepoultrysite.com (Sep 03, 2015)
US - The 2015 Poultry Science Association Annual Meeting last month in Louisville, USA included studies on food safety, enteric health, respiratory health, and management stress.
Research evaluated Diamond V Original XPC™ and AviCare™ efficacy:
•Analysis of the gut microbiome response of broilers fed diets containing combinations of Original XPC and salinomycin via an Illumina MiSeq platform. Stephanie Roto, Si Hong Park, Steven Ricke (University of Arkansas)
•Original XPC decreases Salmonella Typhimurium and Enteritidis populations and alters fermentation acid profiles in chicken in vitro caecal incubations. Peter Rubinelli, Steven Ricke (University of Arkansas)
•Effects of feeding XPC to broilers challenged with infectious laryngotracheitis virus (ILTV) following different vaccination methods. Donald McIntyre, Jonathan Broomhead (Diamond V), John Rosenberger, Milos Markis (AviServe LLC)
•Effect of induced stress on turkey hen performance provided with and without AviCare and Original XPC. Brooke Bartz, Jesse Grimes, Samantha Black, Ilana Barasch (North Carolina State University), Don McIntyre (Diamond V)
Original XPC in poultry feed supports intestinal health and integrity with multiple modes of action to balance the immune system, support the intestinal microbiome, and optimise intestinal structure.
AviCare in poultry drinking water is designed for use before and during production challenges such as fasting, transport, and other atypical situations. AviCare also can be used continuously in the drinking water, along with Original XPC in the feed, during all life stages.
For research details and results, contact a Diamond V Poultry Advisor (http://www.diamondv.com/experts/species/poultry/).
To subscribe to PoultryAdvisor with monthly ‘Research Update’, visit www.diamondv.com

 

 

 


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Study says foodborne illnesses cost $77 billion a year
Source : http://barfblog.com/2015/09/study-says-foodborne-illnesses-cost-77-billion-a-year/
By Doug Powell (Sep 03, 2015)
The first step in solving any problem is to recognize that a problem exists.
From rehab to the National Rifle Association, the phrase is thrown around like candy at Halloween, yet it doesn’t change or even influence behavior: those steps are harder.
The food safety world is inundated with reports recognizing the problem, but little changes.
A new report by the American Association for Justice (formerly known as Association of Trial Lawyers of America) concludes that the food industry’s drive for profits over safety has fueled a series of illness outbreaks and that the civil justice system remains consumers’ last and best line of defense.
“American consumers expect and deserve safe food. Yet, time and again, food producers have cut corners on food safety knowing full well that tainted products cause serious illness or even death. Cutting corners puts profits over people and that’s unforgivable when it comes to our food supply. Parents should never have to be worry about the safety of the peanut butter or ice cream they feed their children,” said Larry Tawwater, President of AAJ. “Because regulators are underfunded and understaffed, it is the civil justice system that provides the accountability necessary to safeguard our food supply.”
Every year, 48 million people fall sick, 128,000 are hospitalized, and at least 3,000 die from foodborne illness, costing the nation approximately $77 billion. Recalls in 2015 have surged compared to 2014 rates. In one of the most recent high-profile outbreaks, three people died after consuming Blue Bell ice cream contaminated with listeria. The company reportedly knew as early as 2013 that it had listeria in one of its plants. The outbreak is the most recent of the “ten worst outbreaks” chronicled in the new report.
problem.2“If your food supply begins with corporate run factory farms, it begins in a system that prioritizes corporate profits over public health,” Jessica Culpepper, food safety & health attorney for Public Justice, said on today’s call.
Are not small growers charging ridiculous amounts for boutique food with dubious health claims also profit-driven?
AAJ Researcher David Ratcliff said what’s so surprising is how often outbreaks of foodborne illnesses occur, adding, “We’re focused on so many other things when it comes to food – gluten, calories and GMOs (genetically modified organisms),” he said. “There’s a sense it won’t happen to us.”

Korean Scientists Report Second ‘Kill Step’ for Salmonella in Peanut Butter
Source : http://www.foodsafetynews.com/2015/09/korean-scientists-suggest-second-kill-step-for-salmonella-in-peanut-butter/#.VezmjhEViUl
By News Desk (Sep 02, 2015)
American consumers lost their innocence about peanut butter when manufacturers of such well-known brands as Peter Pan, Great Value, King Nut, and Organic Trader Joe’s Salted Valencia all failed to remove the Salmonella contamination from their once-trusted products.
Peanuts are grown in fields, along with manure and mud and other materials, so the presence of Salmonella is always possible. But consumers who knew anything about it knew enough to assume that those peanut roasters with their temperatures set to reach 300 degrees F killed any bug that was present.
Then came ConAgra, Peanut Corporation of America, and Sunland — the manufacturers that somehow let Salmonella find its way back in their peanut butter after the peanuts were roasted and before the products were shipped. Three outbreaks in 10 years have caused plenty of thinking about what needs to be done to kill Salmonella in peanut butter and prevent it from coming back.
The latest voices come from Seoul National University scientists Won-Jae Song and Dong-Hyun Kang. In the February 2016 edition of Food Microbiology, Song and Kang report on their experiments to inactivate Salmonella Senftenberg, Salmonella Typhimurium, and Salmonella Tennessee in peanut butter by subjecting it to 915 MHz microwave heating.
Highlights of their work include:
•Peanut butter inoculated with Salmonella was treated with 915 MHz microwave system.
•Six kW microwave heating effectively reduced Salmonella in peanut butter.
•No significant change of color, acid and peroxide value was observed.
•Microwave heating can be used as a control method for peanut butter pasteurization.
“This study evaluated the efficacy of a 915 MHz microwave with 3 different levels to inactivate 3 serovars of Salmonella in peanut butter. Peanut butter inoculated with Salmonella enterica serovar Senftenberg, S. enterica serovar Typhimurium and S. enterica serovar Tennessee were treated with a 915 MHz microwave with 2, 4 and 6 kW and acid and peroxide values and color changes were determined after 5 min of microwave heating. Salmonella populations were reduced with increasing treatment time and treatment power,” according to the researchers’ abstract.
“Six kW 915 MHz microwave treatment for 5 min reduced these three Salmonella serovars by 3.24–4.26 log CFU/g. Four and two kW 915 MHz microwave processing for 5 min reduced these Salmonella serovars by 1.14–1.48 and 0.15–0.42 log CFU/g, respectively. Microwave treatment did not affect acid, peroxide, or color values of peanut butter. These results demonstrate that 915 MHz microwave processing can be used as a control method for reducing Salmonella in peanut butter without producing quality deterioration,” they wrote.
Since those three Salmonella outbreaks linked to peanut butter occurred, processors have focused on fixing leaky roofs and addressing basic pest control and sanitation issues. Some possible interventions, such as irradiation, cannot claim to leave peanut butter without changes in color or odor. If microwaving leaves no trace, as reported by the Koreans, it’s an intervention that might attract some attention. However, there is no indication the authors are suggesting that consumers microwave their peanut butter at home.
The Korean study found in Food Microbiology is available through ScienceDirect on either a pay-per-view basis or by subscription to a participating scientific publication.

Pritzker Olsen Clients Speak Out on Food Safety
Source : https://foodpoisoningbulletin.com/2015/pritzker-olsen-clients-speak-out-on-food-safety/
By News Desk (Sep 02, 2015)
The American Association for Justice held a press conference today on the importance of litigation in food safety. The civil justice system is one of the last resources consumers have to protect themselves against contaminated foods put into commerce by big business. Lawsuits are “sometimes the only mechanism for deterring negligent behavior and rooting out systemic problems in the food chain,” according to the report, Food Safety and the Civil Justice System.
In June of 2012, John McKissick ate soft cheese that was imported into the United States from Italy. He got very sick with listeriosis and was hospitalized for months. For most of that time, he was unconscious and suffered from hallucinations and sepsis.
Various types of cheeseHis wife Pat contacted Pritzker Olsen law firm, which underwrites Food Poisoning Bulletin, to represent the family. At the press conference, Pat said, “John was unconscious, intubated, his blood pressure spiked, he had small strokes, and sepsis. We hired Pritzker Olsen in June 2012. Fred Pritzker and Brendan Flaherty carried John and me through these months of fear.
“They found out through their investigation how John got sick, and where the contamination happened. Fred Pritzker himself knew more about Listeria than anyone in the medical field and anyone we came into contact with. We faced mounting medical costs, and our quality of life completely changed. We faced an uncertain future. We are grateful that we had a good lawyer on our side, and we decided that we would go forth with the lawsuit in September 2012. We are glad we did.
“After the settlement, our efforts have involved issues of food safety. We have been to FDA meetings, interviewed, and have been quoted in articles in journals. We are busy trying to contact members of Congress to move quickly to fund FDA and what they are trying to do in the line of prevention of our food safety. This is a matter of national security.”
Noted attorney Fred Pritzker said, “The system of food regulation in this country is cumbersome and antiquated. It’s also underfunded. And there’s too much deference given to food companies at the expense of consumer safety. In too many outbreak cases, the fault of the processor is often abetted by the systemic failures of our food safety system. I can’t tell you how many times I’ve heard ‘We have the safest food in the world.’ Tell that to the tens of thousands of people sickened and killed each year by food poisoning.”
Brendan Flaherty, one of the experienced attorneys who represented the McKissicks, said, “What the McKissick’s case shows is that regulatory gaps and loopholes have a very real human cost.  By litigating their case and speaking out about their story, they are pushing policy makers to make our food supply better and safer.”
Unfortunately, most consumers do not know the full scope of food poisoning issues in this country. According to the American Association for Justice report released today, 48,000,000 Americans are sickened with food poisoning every year. Of those, 128,000 are hospitalized, and at least 3,000 people die from these infections. For every reported case, dozens more go unreported. The conservative cost estimate for these illnesses is $77 billion a year. Civil litigation is the most important way to expose the problems in our food industry and may be the only way to help solve this issue.
David Ratcliff, researcher at AAJ, said in the press conference that most businesses are not regularly visited by inspectors. Inspections happen most often after an outbreak occurs. Litigation helps uncover inside information about the workings of these huge corporations. Holding them accountable in court helps promote food safety.
Jessica Culpepper, a food safety and health attorney with Public Justice, said in the conference that the way animals are being raised in concentrated animal feeding operations (CAFOs) is part of the problem. Horrific conditions, too much crowding, and too much waste makes animals sick, and then “the diseased product ends up in the consumer production line.”
She also said that companies profiting from this system maximize their profits by passing costs on to the consumer. And the problem goes well beyond crowded feedlots. For instance, contaminated manure ends up in the groundwater, then it contaminates the lettuce you may eat for dinner. More regulation is needed at plants and at factory farms to address this issue.
Food Poisoning Bulletin asked if there was a way to make this issue, which affects all Americans, more prominent in the coming national elections. Mr. McKissick said, “one of the issues is making sure FDA has adequate funding for implementation of FSMA. The law is in place, but if extensive testing isn’t carried out, or the government doesn’t have the muscle to make producers get into line, it doesn’t work. Candidates should be challenged to discuss what they are doing for food safety.
“This affects everyone. Something has to be done to make sure that we don’t leave ourselves vulnerable to this. We are all vulnerable because we all eat.
“When we [the McKissicks] were at the FDA in April, we heard so much about the dangers of imported foods and things we all consider safe, such as imported cheeses from Italy. There needs to be more money spent on food safety.”
The FDA and USDA share oversight of our food system, which is woefully inadequate. President Obama has requested $109 million for funding the Food Safety Modernization Act for FY 2016. Congress is approving only $40 million.
Ms. Culpepper added, “The press needs to be involved. This issue is presented as the responsibility of the consumer to protect themselves. Why is industry maximizing profit over public health?”

Seven Have Died in Quincy IL Veterans Home Legionnaires’ Outbreak
Source : https://foodpoisoningbulletin.com/2015/seven-have-died-in-quincy-il-veterans-home-legionnaires-outbreak/
By Linda Larsen (Sep 02, 2015)
The Illinois Department of Public Health reports that as of Tuesday, September 1, 2015, seven people have died in the Legionnaires’ Disease outbreak at the Veterans Home in Quincy. At least 39 people are sickened in that outbreak. That is an increase of three deaths and 10 more cases since the weekend.
Legionella bacteria causes Legionnaires’ Disease. It grows in warm water systems, such as cooling towers, fountains, and the plumbing systems of large buildings. The bacteria causes the illness when it is inhaled in mist or vapor. People can also aspirate contaminated water; it gets into the lungs and causes this pneumonia-like illness. This disease is not transmitted person-to-person.
The incubation period of Legionnaries’ Disease is two to fourteen days, but most often about five days. Symptoms begin with a high fever of at least 102°F, chills, muscle pains, and headache. A serious cough, which may produce mucus or blood, follows. Chest pain, shortness of breath, and diarrhea can follow. This disease is very similar to pneumonia, and diagnosis may be difficult.
If your loved one has been sickened with Legionnaires’ Disease at the Quincy, Illinois Veterans Home, call our experienced attorneys for help.
Those who are most susceptible to Legionnaries’ Disease include current and former smokers, anyone who is over the age of 50, those with chronic lung diseases, and those with suppressed immune systems. Most cases are successfully treated with antibiotics, but up to 30% of those who get Legionnaries’ Disease die.
This is the third major outbreak of Legionnaires’ Disease this summer. One outbreak, linked to the Opera House Hotel in the South Bronx, New York City, killed 12 people and sickened 124. Another outbreak at the San Quentin state prison in California may have sickened up to 57 people.
Legionnaires’ Disease outbreaks are more common in the spring and fall. A diagnosis requires specific laboratory tests that need to be specially requested. Routine lab tests will not identify this bacteria.

A Taste of 20 Years of Washington E. coli Lawsuits
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/a-taste-of-washington-e-coli-outbreaks/#.VeznsREViUl
By Bruce Clark (Sep 2, 2015)
Washington has had its fair share of E. coli Outbreaks and resulting lawsuits in the last 20 years.
•Cozy Valley Raw Milk E. coli Outbreak Lawsuit – Washington State (2011)
•Dee Creek Farm E. coli Outbreak Lawsuits – Washington & Oregon (2005)
•Dole Spinach E. coli Outbreak Lawsuits – Nationwide (2006)
•Finley Elementary School E. coli Outbreak Lawsuit – Washington (2001)
•Interstate Meat E. coli Outbreak Lawsuits – Oregon, Washington & Idaho (2007)
•Ixtapa Mexican Restaurant E. coli Outbreak Lawsuits – Washington (2008)
•Jack in the Box E. coli Outbreak Lawsuits – Western States (1993)
•Odwalla E. coli Outbreak Lawsuits – Western States (1996)
•Parsley E. coli Outbreak Lawsuit – Washington & Oregon (2005)
•Robinswood Pointe Senior Living Facility E. coli Outbreak Litigation – Washington (2005)
•Romaine Lettuce E. coli Outbreak Lawsuits – Washington State (2008)
•Spokane Produce E. coli Outbreak Lawsuits – Washington, Oregon, Idaho (2002)
E. coli: Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. coli outbreaks and hemolytic uremic syndrome (HUS). The E. coli lawyers of Marler Clark have represented thousands of victims of E. coli and other foodborne illness infections 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 E. coli lawyers have litigated E. coli and HUS cases stemming from outbreaks traced to ground beef, raw milk, lettuce, spinach, sprouts, and other food products. The law firm has brought E. coli lawsuits against such companies as Jack in the Box, Dole, ConAgra, Cargill, and Jimmy John’s. We have proudly represented such victims as Brianne Kiner, Stephanie Smith and Linda Rivera.
If you or a family member became ill with an E. coli infection or HUS after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark E. coli attorneys for a free case evaluation.

Seattle E. coli Outbreak Linked to Los Chilangos Food Truck
Source : https://foodpoisoningbulletin.com/2015/seattle-e-coli-outbreak-linked-to-los-chilangos-food-truck/
By News Desk (Sep 02, 2015)
An E. coli outbreak that has sickened at least six people and hospitalized three, including at least one child, has been linked to Los Chilangos food trucks operating in Washington state. King and Snohomish county public health officials are investigating this outbreak.
The food truck visited seven farmers’ markets in King and Snohomish counties and in Issaquah and Sammamish counties as well. The Los Chilangos food trucks were shut down by King County officials on August 21, 2015.
The report states that the vendor was shut down because they were holding potentially hazardous foods at unsafe temperatures, did not properly cool potentially hazardous foods, and did not protect food from cross contamination. In addition, there were inadequate facilities to control temperature of potentially hazardous food and cold holding. The report also states that continued operation of the facility constitutes an imminent health hazard, and that there is an ongoing investigation of a possible foodborne illness outbreak.
Officials have interviewed the six people who have been infected with the same strain of E. coli bacteria. They all ate food prepared by Los Chilangos. Los Chilangos serves food at seven farmers markets, operates two food trucks, and caters events. The kitchen they use is the Eastside Commercial Kitchen, which is a shared use, or commissary kitchen, used by several vendors.
Inspectors found that the condition of that kitchen deemed it an “imminent health hazard“. The commissary kitchen was issued a cease and desist order on Thursday, August 27, 2015. All food vendors that use that kitchen were told to stop operations.
The symptoms of an E. coli infection include diarrhea that may be watery and/or bloody, severe abdominal cramps, and a mild fever. If the infection progresses, it can develop into hemolytic uremic syndrome (HUS), which can cause kidney loss and death. The symptoms of HUS include fever, lethargy, irritability, low or no urine output, skin rash, easy bruising, pale skin, and jaundice. If these symptoms are present, immediate medical attention is critical and necessary.
If you ate at any Los Chilangos truck or outlet and have experienced these symptoms, see your doctor as soon as possible. If E. coli infections are treated with antibiotics, they are more likely to develop into HUS.
E. coli infections are contracted from eating or drinking something contaminated with fecal matter, through person-to-person contact, or from eating or drinking something prepared by an ill person. Contact with animals is also a risk for this infection.
Officials are still trying to determine the source of the pathogenic bacteria. Los Chilangos has been cooperating with officials to help solve the outbreak.

State budget cuts jeopardize food safety testing, agriculture commissioner says
Source : http://www.al.com/news/index.ssf/2015/09/alabama_budget_cuts_could_put.html
By Dennis Pillion (Sep 02, 2015)
Alabama Commissioner of Agriculture John McMillan said Wednesday that proposed budget cuts to his department could jeopardize food safety testing in the state and have negative economic impacts on the agriculture industry, which he said contributes more than $70 billion a year to the state's economy.
"Our scope of work is large and varied, from inspecting the small scales at the grocery store to regulating the pesticide companies that provide termite inspection and treatment," McMillan said in a news release. "The department's laboratories are among essential services that budget cuts would jeopardize.
"These include a broad array of vital services, from testing for pesticide residue to thousands of tests performed by the department's diagnostic labs on Alabama poultry and livestock."
McMillan said the budget passed by the Alabama Senate in the first special session this summer would decrease his department's appropriation out of the general fund from $9.6 million to $5.3 million.
The department labs test blood samples, including tests for avian flu, taken from every poultry flock produced in Alabama, as required by the U.S. Department of Agriculture. McMillan said the cuts could force him to close three of four poultry inspection labs around the state, which could disrupt the poultry industry.
The cuts would also jeopardize the department's meat processing inspection services and seed lab, which would negatively affect agriculture operations in the state. 
"Any further cuts will damage our ability to operate effectively," McMillan said. "We live with austerity and practice it every day, but the deeper the cuts to our appropriation, the more we will be forced to curtail essential services."
The Department of Agriculture is just one state agency facing the possibility of significant funding cuts, as the Alabama legislature struggles to put together a budget that is facing a $200 million shortfall.
So far, based on the most recent special session budget passed by the senate:
•The Alabama Law Enforcement Agency has said all but four drivers license offices in the state would close.
•State Parks director Greg Lein said all 22 Alabama state parks are in danger of closing.
•The forensics lab and morgue in Huntsville could be shut down, forcing north Alabama county coroners to send bodies to Montgomery for autopsy.
•The Alabama Department of Environmental Management would be forced to either double the amount it charges to issue permits, or turn water pollution permitting in the state over to the EPA.
•Alabama's prison system still has problems.
Some budget proposals also included drastic cuts to Medicaid, which hospital officials warned could jeopardize millions more in federal matching funds, close rural hospitals and hurt quality of care for everyone in the state.
Gov. Robert Bentley has called a second special session to begin on Sept. 8 to draft a budget by the beginning of the 2016 fiscal year on Oct. 1.

Seven Have Died in Quincy IL Veterans Home Legionnaires’ Outbreak
Source : https://foodpoisoningbulletin.com/2015/seven-have-died-in-quincy-il-veterans-home-legionnaires-outbreak/
By Linda Larsen (Sep 02, 2015)
The Illinois Department of Public Health reports that as of Tuesday, September 1, 2015, seven people have died in the Legionnaires’ Disease outbreak at the Veterans Home in Quincy. At least 39 people are sickened in that outbreak. That is an increase of three deaths and 10 more cases since the weekend.
Legionella bacteria causes Legionnaires’ Disease. It grows in warm water systems, such as cooling towers, fountains, and the plumbing systems of large buildings. The bacteria causes the illness when it is inhaled in mist or vapor. People can also aspirate contaminated water; it gets into the lungs and causes this pneumonia-like illness. This disease is not transmitted person-to-person.
The incubation period of Legionnaries’ Disease is two to fourteen days, but most often about five days. Symptoms begin with a high fever of at least 102°F, chills, muscle pains, and headache. A serious cough, which may produce mucus or blood, follows. Chest pain, shortness of breath, and diarrhea can follow. This disease is very similar to pneumonia, and diagnosis may be difficult.
Bad Bug Law Team
If your loved one has been sickened with Legionnaires’ Disease at the Quincy, Illinois Veterans Home, call our experienced attorneys for help.
Those who are most susceptible to Legionnaries’ Disease include current and former smokers, anyone who is over the age of 50, those with chronic lung diseases, and those with suppressed immune systems. Most cases are successfully treated with antibiotics, but up to 30% of those who get Legionnaries’ Disease die.
This is the third major outbreak of Legionnaires’ Disease this summer. One outbreak, linked to the Opera House Hotel in the South Bronx, New York City, killed 12 people and sickened 124. Another outbreak at the San Quentin state prison in California may have sickened up to 57 people.
Legionnaires’ Disease outbreaks are more common in the spring and fall. A diagnosis requires specific laboratory tests that need to be specially requested. Routine lab tests will not identify this bacteria.
Our Food Safety System Needs a Fully Funded FSMA
Source : http://www.foodsafetynews.com/2015/09/our-food-safety-system-needs-a-fully-funded-fsma/#.VezmEREViUl
By Jeff Almer (Sep 02, 2015)
Lung cancer and a brain tumor didn’t kill my mother — Salmonella-contaminated peanut butter did.
My friends and family mourned her passing, but we resolved to try to fix the system that ultimately allowed irresponsible food manufacturers to ship tainted peanut products nationwide, sickening more than 700 people and killing nine.
In February 2009, I testified before Congress to call attention to the crimes committed by Peanut Corporation of America (PCA) executives. It is the government’s job to protect us from these deliberate misdeeds. Families and individuals whose lives were forever changed by foodborne illness helped pass the U.S. Food and Drug Administration’s (FDA) groundbreaking food safety law, the Food Safety Modernization Act (FSMA) — a critical first step toward the kind of food safety oversight that could have protected my mother and hundreds more from the PCA executives who be sentenced on Sept. 21.
FSMA shifts FDA’s focus from reaction to prevention and makes growers and food producers fully responsible for the safety of their products. As I write this, one of the law’s powerful, prevention-based oversight rules is being finalized and released: preventive controls for human and animal foods. The preventive controls rule requires that companies put in place measures to minimize contamination and risk — and FDA can levy fines or stop contaminated products from ever reaching a grocery shelf. Under FSMA, if FDA uncovers a problem (including rodent and mold infestations) at a food processing facility — as they did at one PCA plant — the agency can shut that facility down. For the first time, the new law requires that every food facility be subject to more frequent FDA inspections. Finally, FDA now has the authority to require a company to recall potentially unsafe products.
The preventive controls rules are just one piece of the law. FSMA also includes re-tooled safety standards for fresh produce and imposes stricter guidelines for imported foods. These efforts are critical to keep pace with a food production and regulatory system that has evolved and become much more complex in the past 50 years.
I firmly believe that if FSMA had been in place in 2009, my mother would still be with us — and so, food safety advocates like me have worked for years to make FSMA a reality. It turns out that it’s not that simple. Today, we have a law — signed by the president more than four years ago — but the law does not have the robust funding required to do all that we need it to.
The House and Senate agriculture appropriations bills for fiscal year 2016 award the FDA $41 million and $41.5 million, respectively, for FSMA implementation. FDA had asked for $109.5 million — almost three times as much as what lawmakers are proposing.
Sadly, this is nothing new. Each year, Congress acknowledges FSMA’s importance by granting some funds to implement the law. But each year, these funds fall far short. For FY 2014, FDA got $53 million for FSMA. For FY 2015, it was only $27.5 million. The reality is that without full funding, the law that we toiled day and night to pass — the law that might have saved our friends and loved ones’ lives — cannot meet its potential. Congress must give FDA the funds it needs to protect our food supply and prevent PCA-like abuses in the future.
In Albany, GA, later this month, I will stand in a courtroom with other families that have been impacted and witness the sentencing of convicted former PCA employees. But our day in court won’t solve everything — and it certainly won’t bring my mother back.
We need a fully implemented and fully funded FSMA to fix the food safety system. It’s what we need, deserve and have fought for up till now — and I know that my mother would want me to keep fighting.

Listeria and Corn
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/listeria-and-corn/#.Vezm6REViUl
By Andy Weisbecker (Aug 31, 2015)
Bonduelle USA Inc. of Brockport, NY is recalling 9,335 cases of frozen corn because it has the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.
The frozen cut corn was distributed to stores in the following states: New York, New Jersey, Pennsylvania, Vermont, Massachusetts, Indiana, Ohio, Kentucky, Maryland, Virginia, North Carolina, Florida, Mississippi and Louisiana.
The affected frozen cut corn was distributed in poly bags under the following labels and codes:
•WYLWOOD Super Sweet Whole Kernel Corn, NET WT. 16 OZ (1 LB), UPC 051933002401, Codes: Best By June 2017 K51564 and K51574;
•MARKET BASKET Cut Corn, NET WT. 16 OZ. (1 LB.), UPC 049705693414, Code: Best By June 2017 K51574;
•Bountiful Harvest WHOLE KERNEL CUT CORN, NET WT. 40 OZ. (2.5 LBS.), UPC 822486120597, Code: Best By June 2017 K51574;
•WEST CREEK FROZEN VEGETABLES Cut Corn, NET WT. 2.5 LBS., UPC 00806795285239 Code: Best By June 2017 K51574.
The company has not received any complaints in relation to this product and is not aware of any illnesses associated with the product to date.
The recall was the result of product being tested at retail by the State of Tennessee which had tested positive for Listeria monocytogenes. The company has ceased distribution of the product, and the company and US Food and Drug Administration (FDA) continue their investigation as to what caused the problem.

Legionnaires’ Outbreak at San Quentin State Prison
Source : https://foodpoisoningbulletin.com/2015/legionnaires-outbreak-at-san-quentin-state-prison/
By Linda Larsen (Aug 31, 2015)
A Legionnaires’ Disease outbreak at the San Quentin State Prison has forced that facility to shut off the water. There are six confirmed cases, and at least 51 other possible cases. Those prisoners who have been diagnosed with the illness have been transferred to hospitals for treatment. The possible cases are under observation at the prison’s medical unit.
If your relative has been diagnosed with Legionnaires’ Disease at the San Quentin State Prison, contact our experienced lawyers for help.
Portable toilets are being brought in for the prisoners’ use. The kitchen has stopped producing meals; inmates are eating boxed meals. The prisoners who may be sick live in all areas of the prison. The Marin County Health Department is investigating the outbreak.
No visitors have been allowed in the facility since the outbreak began. No prisoners can be transferred in or out of the facility as well. Inmates are being told they cannot drink the water and should not touch it.
The prison receives water from the Marin County Municipal Water District. It is stored on a tank on the prison property. Stored water has an increased risk for contamination from Legionella bacteria, especially if the tank is not disinfected often.
The symptoms of Legionnaries’ Disease are like pneumonia, including high fever, cough, and chills. Other symptoms may include diarrhea, nausea, and vomiting. The illness is not spread person-to-person, but is contracted from breathing contaminated mist or water vapor.
Prisons are responsible for the health and well-being of inmates. These facilities are often at high risk for food poisoning and other disease outbreaks because of crowded conditions. Minimum safety standards must be met in these facilities.

Food safety after a power outage: What to discard and what to keep
Source : http://www.vancitybuzz.com/2015/08/food-safety-fridge-power-outage/
By Vancity Buzz Staff (Aug 30, 2015)
Following Saturday’s massive windstorm, some households and businesses in the Lower Mainland will not have their electricity return until the early morning hours of Monday. For some, that could mean perishable food items stored in their fridges and freezers have been without power for up to 36 hours.
So what does that mean for food safety following a protracted power outage? According to Health Canada, any thawed that has been left at room temperature for two or more hours should be discarded, and it goes without saying this is the case for anything that has an unusual colour or odour.
“A full freezer will keep food frozen for about 48 hours,” reads the federal government’s advice. “A freezer that is half full will keep food frozen for about 24 hours. An unopened refrigerator will keep food cold for about 4 hours.”
Health Canada’s American counterpart, the U.S. Department of Health and Human Services, has compiled a list of what foods should be discarded if it has been held at a temperature above 4.4°C for over two hours:
Refrigerated perishable foods that should be discarded
•Raw or leftover cooked meat, poultry, fish, or seafood; soy meat substitutes
•Thawing meat or poultry
•Salads: Meat, tuna, shrimp, chicken, or egg salad
•Gravy, stuffing, broth
•Lunchmeats, hot dogs, bacon, sausage, dried beef
•Pizza – with any topping
•Canned hams labeled “Keep Refrigerated”
•Canned meats and fish, opened
•Casseroles, soups, stews
•Soft Cheeses: blue/bleu, Roquefort, Brie, Camembert, cottage, cream, Edam, Monterey Jack, ricotta, mozzarella, Muenster, Neufchatel, queso blanco, queso fresco
•Shredded Cheeses
•Low-fat Cheeses
•Milk, cream, sour cream, buttermilk, evaporated milk, yogurt, eggnog, soy milk
•Baby formula, opened
•Fresh eggs, hard-cooked in shell, egg dishes, egg products
•Custards and puddings, quiche
•Fresh fruits, cut
•Opened mayonnaise, tartar sauce, horseradish (discard if above 10°C for over 8 hours)
•Fish sauces, oyster sauce
•Opened creamy-based dressings
•Spaghetti sauce, opened jar
•Refrigerator biscuits, rolls, cookie dough
•Cooked pasta, rice, potatoes
•Pasta salads with mayonnaise or vinaigrette
•Fresh pasta
•Cheesecake
•Pastries, cream filled
•Pies – custard, cheese filled, or chiffon; quiche
•Vegetables: Greens, pre-cut, pre-washed, packaged
•Vegetables, cooked; tofu
•Vegetable juice, opened
•Baked potatoes
•Commercial garlic in oil
•Potato salad
•Casseroles, soups, stews
Not part of this ‘discard list’ includes breakfast foods (such as bagels, pancakes and waffles), raw uncooked vegetables, bread, rolls, cakes, muffins, basic condiments, opened juices, uncut fresh fruits, butter, margarine and hard cheeses. According to the U.S. health agency, these foods can sustain warmer temperatures for longer periods.
It should also be noted that food should never be tasted to determine its safety. Fortunately, temperatures in Metro Vancouver have cooled down significantly ahead of the windstorm.
As of 4 p.m. Sunday, approximately 180,000 customers in the Lower Mainland and elsewhere in the South Coast were still without power – down from 500,000 customers during the peak of the outage.
B.C. Hydro’s latest estimates indicate power will be restored to all affected Lower Mainland areas by no later than 1 a.m. Monday.

 

 

 

Internet Journal of Food Safety (Operated by FoodHACCP)
[2015] Current Issues

Vol 17.25-31
Combined Effect Of Disinfectant And Phage On The Survivality Of S. Typhimurium And Its Biofilm Phenotype
Mudit Chandra, Sunita Thakur, Satish S Chougule, Deepti Narang, Gurpreet Kaur and N S Sharma

Vol 17.21-24
Quality analysis of milk and milk products collected from Jalandhar, Punjab, India
Shalini Singh, Vinay Chandel, Pranav Soni

Vol 17.10-20
Functional and Nutraceutical Bread prepared by using Aqueous Garlic Extract
H.A.R. Suleria, N. Khalid, S. Sultan, A. Raza, A. Muhammad and M. Abbas


Vol 17.6-9
Microbiological Assessment of Street Foods of Gangtok And Nainital, Popular Hill Resorts of India
Niki Kharel, Uma Palni and Jyoti Prakash Tamang


Vol 17.1-5
Assessment of the Microbial Quality of Locally Produced Meat (Beef and Pork) in Bolgatanga Municipal of Ghana
Innocent Allan Anachinaba, Frederick Adzitey and Gabriel Ayum Teye


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