FDA Warning Letters: Florida Seafood Processor and French Butter Producer
Source : http://www.foodsafetynews.com/2015/11/fda-warning-letters-florida-seafood-processor-and-french-butter-producer/#.Vk0wlY2heUl
By News Desk (Nov 09, 2015)
In the latest batch of posted warning letters from the U.S. Food and Drug Administration (FDA), the Gourmet Classic Salads seafood processing facility in Lake Wales, FL, was cited for “serious violations” of the seafood Hazard Analysis Critical Control Point (HACCP) regulations.
FDA stated that the company’s ready-to-eat seafood salad products were considered adulterated “in that they have been prepared, packed, or held under insanitary conditions whereby they may have been rendered injurious to health.”
The company’s HACCP plan for “Ready to Eat Seafood Salads” did not list the critical control points of processing/mixing and blending for distribution/shipping, FDA’s letter noted.
There were also problems with some of the plan’s monitoring procedures and the frequency for each critical control point, and Gourmet Classic didn’t follow the monitoring procedures/frequencies of metal inclusion for all trays listed in their HACCP plan, the letter added.
Flechard S.A.S., located in La Chapelle-d’andaine, France, was cited for misbranding issues with its Pure Butterghee (33 pounds), Butter Ghee Natural Milk (56 ounces), Butter Ghee Natural Milk (28.2 ounces), Frentel Bueurre Demi-Sel, and Bessofier unsalted butter products.
These issues included failing to declare milk as an allergen, selling products as butter without conforming to the statutory definition of butter, fabricating products from two or more ingredients without declaring the common or usual name of each ingredient on the label, failing to use the appropriate statements to identity butter products made with lactic starter cultures, failing to label nutrition facts information in an appropriate format, failing to translate all required information on the labels into English, and failing to include the place of business of the manufacturer, packer, or distributor on labels.
Recipients of FDA warning letters have 15 working days from receipt to outline specific steps they have taken to come into compliance with the law.
Why Is Chipotle Having So Many Food Safety Issues?
Source : http://www.buzzfeed.com/venessawong/why-is-chipotle-having-so-many-food-safety-issues#.soe1Bbl2k
By Venessa Wong (Nov 05, 2015)
The burrito chain has been linked to outbreaks of norovirus, salmonella and E. coli in recent months.
It has been a difficult year for Chipotle. The burrito chain’s obsession with serving high-quality, fresh ingredients — one of its fundamental marketing strategies — has ended up causing it one headache after the other.
Just as Chipotle recovered from a months-long carnitas shortage – the chain pulled pork off menus when a supplier failed to follow animal welfare standards – it was soon linked to three cases of foodborne illness: a norovirus outbreak in Simi Valley, California in August, cases of salmonella in Minnesota traced back to tomatoes shortly after, and – just last week – E. coli in the Pacific Northwest. The chain’s 43 restaurants in Washington and Oregon have been closed since Friday.
“Having three outbreaks over the course of two to three months is highly unusual,” food poisoning attorney Bill Marler told BuzzFeed News. “I think corporate leadership needs to step back at look at their food safety culture.”
Chipotle does have vulnerabilities. In its discussion of risks to its business in its most recent annual report, the company warned: “We may be at a higher risk for food-borne illness outbreaks than some competitors due to our use of fresh produce and meats rather than frozen, and our reliance on employees cooking with traditional methods rather than automation.”
In other words, the chain’s biggest strengths can also become big-time weaknesses.
Few answers were available by Wednesday about the 35 people sick with E. coli linked to eating at possibly eight Chipotle restaurants in Washington and Oregon. The source of the contamination might have been produce, although it was still not clear as health officials continued their investigation. “We are not going to speculate about what may have caused this while the investigation is ongoing,” Chipotle spokesman Chris Arnold said in an email.
It is facing lawsuits from sickened customers, two in Minnesota and one in Washington.
Is something wrong at Chipotle?
Chipotle is certainly not the only chain to experience such problems. The strain of bacteria affecting Chipotle’s Northwest stores now, E. coli O26, previously had been tied to raw clover sprouts at Jimmy John’s Restaurants in 2012.
In recent years, the number of foodborne outbreaks traced back to fast food restaurants has increased, according to the Centers for Disease Control and Prevention.
Still, the recent string of events at Chipotle raises questions about whether there are shortcomings in its food safety practices or supply chain, or whether it has simply been the victim of some serious bad luck. The chain was also connected to a norovirus outbreak in 2008 that sickened 450 people.
Chipotle has hired two food safety consulting firms to assess its standards and has been commended for taking broad action by closing restaurants in the area and cooperating with the investigation.
For now, it is conducting environmental testing in Washington and Oregon restaurants, and is working with consultants to assess and improve its food safety standards systemwide. “We are just beginning this work [with the consulting firms] and aren’t going to speculate about outcomes of that effort,” said Arnold
The Snack Attack and Finger Food Flu
Source : http://www.foodsafetynews.com/2015/11/the-snack-attack-and-finger-food-flu/#.Vk0wvo2heUl
By Sydney Ross Singer (Nov 4, 2015)
(This article was originally posted here on Nov. 2, 2015, and is reposted with permission.)
We all connect with the world around us with our hands, touching all sorts of objects, surfaces, and other hands, which is why diseases are often transmitted by hand contact. Of course, dirty hands can be washed. The problem is when we don’t wash them and use our dirty hands to deliver pathogens into our bodies by rubbing our eyes, scratching our nose, and then picking up food with our fingers.
Finger food is an American favorite. While forks and knives keep our fingers clean of food and the food clean from our fingers, there are lots of favorite foods we happily eat with our fingers. From sandwiches, hamburgers, hotdogs, and fried chicken to chips, nuts, cookies, fruit, and candy, there is usually nothing between the food and your hands, making this a common way for pathogens to enter your body as you eat.
All the food preparation safety in the world cannot stop you from getting sick from eating if you use dirty fingers to hold your food. This makes eating finger food a risky behavior, especially during flu season.
Sometimes, you have no choice but to use your hands to eat. For example, airlines often serve snacks, such as peanuts or potato chips or small sandwiches, and you are expected to use your hands to eat them. However, after being in pathogen-rich environments like airplanes, finger food becomes a vector of disease.
Some snack packaging allows you to avoid touching the food, as with a small box of raisins. You can lift the box to your mouth and pour the food in. But some snack items are pure finger food. For example, how can you eat potato chips without touching the chips with your hands? How can you eat a pickle or hold a hotdog or hamburger without using your hands?
Sandwiches are often eaten with dirty hands. The outer covering of bread seems like a wrapper keeping our hands clean of the food inside. But dirty hands can deliver pathogens to the bread and from there to your body.
Clean utensils are the best way to avoid food contamination from hand contact. But finger foods are made to be eaten without utensils. How can we have our cake and eat it too without utensils?
Here are some suggestions:
Wash your hands before eating. If soap and water are not available, use hand sanitizer.
Hold the food with the wrapper if possible.
For foods such as potato chips, where you can’t just pour the product from the package into your mouth, the food manufacturer can attach a sanitary hand wipe packet to the food package.
If you are really hungry and have no practical way to clean your hands to eat a sandwich, try holding the sandwich in one place only and discard that part.
Don’t forget to wash your hands after eating as well since food left on the hands can feed pathogens and make your hands an even greater threat to your health the next time you eat.
Finger food is fine if your fingers aren’t filthy. A little common sense and good hygiene can help you avoid foodborne illness.
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UK Businesses With Food Safety Violations Now Getting Mapped
Source : http://www.foodsafetynews.com/2015/11/uk-businesses-with-food-safety-violations-now-getting-mapped/#.Vk0w742heUl
By News Desk (Nov 04, 2015)
The United Kingdom’s Food Standards Agency (FSA) has come up with a response to all those who say that publishing restaurant inspections is just a “moment in time” report — it is mapping the entire rap sheet for businesses successfully prosecuted for any food standard, food hygiene or food safety-related violations.
The entire database for these prosecutions in England, Wales, and Northern Ireland are being made public via a searchable live map.
According to FSA, the database gives details of local authority food hygiene and food safety prosecutions and outlines where and how food businesses have breached regulations. These data are supplied on a voluntary basis by local authority officers. The new map is also being published to highlight the number and type of successful fines levied.
“We want businesses to understand how important it is not to flout the rules which are there to protect public health. If they do, then both we and local authorities will take action against them,” said Rod Ainsworth, FSA’s director of regulatory and legal strategy.
He said that publication of this information also lets local authorities share intelligence to get a better understanding of where and how food hygiene and safety breaches occur.
“This information will also be useful to consumers and businesses when choosing suppliers,” Ainsworth added. “General Food Law is there to keep consumers safe. Like our Food Hygiene Rating scheme, we want the prosecutions database to empower consumers and businesses alike to vote with their feet and avoid those that are not following rules.”
From information going back to April 1 of this year, FSA stated that there have been 419 prosecutions in total. A little more than 1 in 4 food law breaches (26 percent) were related to offenses where food enforcement officers found there was a failure by businesses to keep premises or equipment clean. Other common food law breaches included unfit food on the premises, a lack of hand-washing facilities and food safety training, as well as pest control issues.
Warning Against Eating Crabs in Central and Northern California
Source : https://foodpoisoningbulletin.com/2015/warning-against-eating-crabs-in-central-and-northern-california/
By Linda Larsen (Nov 04, 2015)
The California Department of Public health advised consumers not to eat Dungeness and Rock crabs caught in waters between the Oregon border and the southern Santa Barbara county line because of dangerous levels of domoic acid. This naturally occurring toxin can cause food poisoning.
Test results have shown “persistently high levels” of domoic acid in these shellfish. The levels are over the state’s action level for the crab’s body meat as well as the viscera, which is also known as crab butter. These crabs pose a “significant risk to the public” if they are eaten. Domoic acid is related to a bloom of a single-celled plant called Pseudo-nitzschia. Conditions that support the growth of this plant are not possible to predict, so food safety experts rely on continuous testing to check if these shellfish are safe to consume or not.
Sampling will continue to monitor the toxin levels. When the levels go down and do not exceed the action level of 30 ppm in the viscera and 20 ppm in the, the advisory will be lifted.
The symptoms of domoic acid poisoning include vomiting, diarrhea, abdominal cramps, headache, and dizziness. The symptoms usually appear within 30 minutes to 24 hours after eating contaminated seafood.
Some people may become more seriously ill, and experience symptoms such as trouble breathing, confusion, disorientation, cardiovascular instability, seizures, permanent loss of short term memory (otherwise known as Amnesiac Shellfish Poisoning), and excessive bronchial secretions. Some people may become so ill they lapse into a coma and may die. There have not been any reported illnesses to date in connection with the consumption of these products.
EPA May Ban Insecticide Over Water Quality Issues, Not Food
Source : http://www.foodsafetynews.com/2015/11/epa-may-ban-insecticide-over-water-quality-concerns-not-food/#.Vk0xUI2heUl
By News Desk (Nov 04, 2015)
The U.S. Environmental Protection Agency (EPA) says there are no risks to humans from exposure to the common insecticide chlorpyrifos from food, but the agency has nonetheless asked for public comment on a proposal to revoke all food residue tolerances for the insecticide, which is mostly used on fruits, vegetable and nut crops. The proposed ban will not affect the 2016 growing season.
EPA acted by an Oct. 31 deadline imposed by the Ninth U.S. Circuit Court of Appeals for the agency to respond to a petition from the Natural Resources Defense Council and the Pesticide Action Network North America over chlorpyrifos in drinking water.
EPA wanted to conduct more analysis, but the San Francisco-based appeals court said that the agency either had to deny the petition, start the revocation process, or go with a final revocation rule.
EPA kicked off the 60-day public comment period to revoke the insecticide’s use not because of the risk to food but over concern that its use in certain watersheds could pose a risk from “potential aggregate exposure.” And because the agency was unable to make a safety finding based on “the science as it stands currently,” it did not deny the petition from the environmental groups.
“EPA is not issuing a final revocation rule because we have not proposed it and have not completed our refined drinking water assessment, leaving certain science issues unresolved,” the agency said in a statement. “Therefore, as we are informing the court, we have proposed to revoke all chlorpyrifos tolerances based on the science as it stands. Issuing a proposed revocation provides an opportunity for public input prior to any final decision.”
Members of the public have been invited to comment until the end of the year on both a completed hazard assessment and the completed drinking water analysis prior to EPA issuing a final rule. The agency is currently performing additional analysis related to its hazard assessment in order to make certain that any final decision protects infants and children. Once completed, if warranted, the analysis would inform a final tolerance revocation rule.
The petition filed by the environmental groups sought a a national ban on chlorpyrifos. California fruit and vegetable growers are among the largest users of the insecticide, which is not permitted for home use and requires no-spray and buffer zones around sensitive areas, such as schools. Alternatives to chlorpyrifos are more costly and less effective, according to growers.
There are reports that the insecticide, introduced in 1965 by Dow Chemical Company, has sickened farmworkers, and there are concerns that residues of chlorpyrifos found in waterways threaten the health of fish.
Food companies, step it up: US multistate foodborne outbreaks, 2010-2014
Source : http://barfblog.com/2015/11/food-companies-step-it-up-us-multistate-foodborne-outbreaks-2010-2014/
By Doug Powell (Nov 04, 2015)
Multistate outbreaks cause more than half of all deaths in foodborne disease outbreaks despite accounting for only a tiny fraction (3 percent) of reported outbreaks in the United States, according to a new U.S Centers for Disease Control report.
fact-sheet-vs-final-thumbnail-page-3_cropRecent outbreaks of foodborne illness linked to tainted cucumbers, ice cream and soft cheeses show the devastating consequences when food is contaminated with dangerous germs before it reaches a restaurant or home kitchen.
Highlights from the report on multistate foodborne outbreaks during 2010-2014 include:
• An average of 24 multistate outbreaks occurred each year, involving two to 37 states.
?Salmonella accounted for the most illnesses and hospitalizations and was the cause of the three largest outbreaks, which were traced to eggs, chicken and raw ground tuna.
?Listeria caused the most deaths, largely due to an outbreak caused by contaminated cantaloupe in 2011 that killed 33 people.
?Imported foods accounted for 18 of the 120 reported outbreaks. Food imported from Mexico was the leading source in these outbreaks, followed by food imported from Turkey.
The report recommends that local, state, and national health agencies work closely with food industries to understand how their foods are produced and distributed to speed multistate outbreak investigations. These investigations can reveal fixable problems that resulted in food becoming contaminated and lessons learned that can help strengthen food safety.
The report highlights the need for food industries to play a larger role in improving food safety by following best practices for growing, processing, and shipping foods. In addition, food industries can help stop outbreaks and lessen their impact by keeping detailed records to allow faster tracing of foods from source to destination, by using store loyalty cards to help identify what foods made people sick, and by notifying customers of food recalls.
“Reacting to problems isn’t sufficient in today’s food system, nor is it the best way to practice public health,” Dr. Kathleen Gensheimer, director of FDA’s Coordinated Outbreak Response & Evaluation Network, said in a teleconference.
Gensheimer stressed that in the past, food safety has been focused on reacting to outbreaks, but new regulations set to take effect in 2016 will require companies to take a science-based approach to building safety controls into food production.
“Industry is a very critical partner,” she said.
For example, although it is still not clear what caused the E. coli outbreak at Chipotle, Gensheimer said on the call that the company has shared “all of their records and is working with us in any way possible to give us information about their suppliers.”
Gensheimer also said after the current investigation ends, the company expressed interest in meeting with FDA and the CDC to work out ways to prevent future outbreaks.
CDC Director Dr. Tom Frieden said state-of-the-art disease tracking tools, and the introduction of gene tools, are helping to quickly track down the source of food-borne outbreaks in collaboration with state and national partners.
Frieden said disease detectives are “cracking the cases much more frequently than in past years because we have this new DNA fingerprinting tool being used increasingly,” but many cases still go unsolved.
He said companies are also stepping up to help, noting new requirements at Wal-Mart Stores Inc for food suppliers that set new control for suppliers to reduce contamination and the wholesaler’s Costco’s use of membership card lists to notify customers about recalled foods.
The leading causes of multistate outbreaks – Salmonella, E. coli, and Listeria – are more dangerous than the leading causes of single-state outbreaks. These three germs, which cause 91 percent of multistate outbreaks, can contaminate widely distributed foods, such as vegetables, beef, chicken and fresh fruits, and end up sickening people in many states.
“Americans should not have to worry about getting sick from the food they eat,” said CDC Director Tom Frieden, M.D., M.P.H. “Top-notch epidemiology and new gene sequencing tools are helping us quickly track down the source of foodborne outbreaks – and together with our national partners we are working with the food industry to prevent them from happening in the first place.”
Introduction: Millions of U.S. residents become ill from foodborne pathogens each year. Most foodborne outbreaks occur among small groups of persons in a localized area. However, because many foods are distributed widely and rapidly, and because detection methods have improved, outbreaks that occur in multiple states and that even span the entire country are being recognized with increasing frequency.
Methods: This report analyzes data from CDC’s Foodborne Disease Outbreak Surveillance System to describe multistate foodborne outbreaks that occurred in the United States during 2010–2014.
Results: During this 5-year period, 120 multistate foodborne disease outbreaks (with identified pathogen and food or common setting) were reported to CDC. These multistate outbreaks accounted for 3% (120 of 4,163) of all reported foodborne outbreaks, but were responsible for 11% (7,929 of 71,747) of illnesses, 34% (1,460 of 4,247) of hospitalizations, and 56% (66 of 118) of deaths associated with foodborne outbreaks. Salmonella (63 outbreaks), Shiga toxin-producing E. coli (34), and Listeria monocytogenes (12) were the leading pathogens. Fruits (17), vegetable row crops (15), beef (13), sprouts (10), and seeded vegetables (nine) were the most commonly implicated foods. Traceback investigations to identify the food origin were conducted for 87 outbreaks, of which 55 led to a product recall. Imported foods were linked to 18 multistate outbreaks.
Conclusions: Multistate foodborne disease outbreaks account for a disproportionate number of outbreak-associated illnesses, hospitalizations, and deaths relative to their occurrence. Working together, food industries and public health departments and agencies can develop and implement more effective ways to identify and to trace contaminated foods linked to multistate outbreaks. Lessons learned during outbreak investigations can help improve food safety practices and regulations, and might prevent future outbreaks.
MMWR November 3, 2015 / 64(Early Release);1-5
Samuel J. Crowe, PhD1,2; Barbara E. Mahon, MD2; Antonio R. Vieira, PhD2; L. Hannah Gould, PhD
Chipotle Hires Safety Consultants to Cope With Health Scare
Source : http://www.bloomberg.com/news/articles/2015-11-03/chipotle-hires-food-safety-consultants-to-cope-with-health-scare
By Nick Turner, Craig Giammona (Nov 04, 2015)
Chipotle Mexican Grill Inc., which closed 43 restaurants over the weekend after an E. coli outbreak, has hired food-safety consulting firms and is testing ingredients in an effort to defuse the health scare.
After shutting restaurants in Seattle and Portland, Oregon, Chipotle is doing a deep cleaning of the locations, the company said in a statement Tuesday. Twelve people in the Portland area and 25 in Washington state became ill after eating at Chipotle restaurants, according to health officials in the two states. There have been no deaths, but at least 12 of those affected have been hospitalized.
Health officials haven’t yet found a cause of the outbreak, Denver-based Chipotle said on Tuesday. The company said it continues to work with authorities. Only eight of the shuttered restaurants have drawn concern, but it closed the others “out of an abundance of caution,” Chipotle said.
The company is working with Seattle-based IEH Laboratories & Consulting Group to resolve the matter, as well as conducting environmental testing in restaurants and distribution centers. Chipotle also is replacing all the food in the closed locations.
“We work with a number of very fresh ingredients in order to serve our customers the highest-quality, best-tasting food we can,” co-Chief Executive Officer Steve Ells said in the statement. “If there are opportunities to do better, we will push ourselves to find them and enhance our already high standards for food safety. Our deepest sympathies go out to those who have been affected by this situation and it is our greatest priority to ensure the safety of all of the food we serve and maintain our customers’ confidence in eating at Chipotle.”
Funky Fish: Is Ciguatera Fish Poisoning on the Rise?
Source : http://www.foodsafetymagazine.com/magazine-archive1/octobernovember-2015/funky-fish-is-ciguatera-fish-poisoning-on-the-rise/
By Elizabeth G. Radke, Ph.D., M.P.H.
Ciguatera fish poisoning is a foodborne illness resulting from the consumption of contaminated tropical and subtropical saltwater fish, particularly those from coral reefs. Implicated fish are generally large, carnivorous species such as barracuda, grouper, amberjack and snapper. Illness can be severe, with acute gastrointestinal symptoms as well as neurologic issues (paresthesias, weakness, pain, temperature reversal, memory/concentration problems, among others) that can persist for months or longer. Ciguatoxins are the cause of illness, and they originate from Gambierdiscus species dinoflagellates (microalgae) as precursor toxins called gambiertoxins. As these toxins move up trophic levels to larger fish, they are biotransformed and become the potent poison that causes an estimated 50,000–500,000 illnesses per year worldwide.[2,3]
Because algae growth is impacted by temperature, it is believed that the incidence and geographical range of ciguatera and other harmful algal blooms will be affected by climate change. Growth rates for Gambierdiscus species dinoflagellates are highest in warm temperatures (optimum 29–30 °C), and thus with warming waters, it is possible that we will start to see them move into areas that have historically been too cold. Some studies have observed positive associations between seawater temperature and ciguatera incidence,[4–9] but more evidence is needed to show whether this relationship will actually result in increased incidence. It can be difficult to obtain complete epidemiologic information on ciguatera, particularly looking at long-term trends, as the existence and quality of surveillance programs vary widely between areas and over time. Even when surveillance programs are operational, underreporting is a significant issue. The rest of this article will review recent studies on this issue in the U.S. Virgin Islands and in Florida.
Research in the U.S. Virgin Islands
As with many island communities in the Caribbean and South Pacific, ciguatera is endemic in St. Thomas. “Fish poisoning” is a well-known health concern among islanders and fishermen. A multidisciplinary research group from several institutions selected this location to dig deeper into the factors influencing ciguatera and to better understand each step of the pathway from algae to human illness. The team (Project CaribCATCH) included clinical and epidemiologic studies (University of Maryland, Baltimore; University of Florida), environmental studies (University of the Virgin Islands; Woods Hole Oceanographic Institution), climate studies (Florida State University) and toxin studies (U.S. Food and Drug Administration). While much of the work is still underway, some results are already available.
Two islandwide random-digit-dial telephone surveys were performed in 2010 and 2011. They included questions on demographics, fish consumption, history of ciguatera episodes in the participant and their household, and ciguatera awareness. A medical record review of emergency department visits was performed for 1995–2011 (2000–2001 and 2006 were missing) to determine the number of visits for ciguatera. These results were compared with similar data from St. Thomas in 1980.
Eight hundred seven residents participated in the telephone surveys (response rate 25%). Of the participants, 186 (23%) reported that they had ever had ciguatera, and there were 339 total episodes reported. The average annual incidence was estimated as 12 per 1,000 (95% CI 10–21) from the survey. In the 1980 survey, the incidence among adults was approximately 14 per 1,000, so no increase was observed, counter to expectations. Similar results were observed in the emergency department data. In exploring reasons for this lack of increase, it was observed that frequency of fish consumption, socioeconomic status and age distribution had changed on the island over this period. Since illness was associated with lower education levels (OR 0.3, 95% CI 0.2–0.5 for some college or more; OR 0.5, 95% CI 0.3–0.8 for high school graduate vs. some high school or less), higher levels of fish consumption (OR 2.2, 95% CI 1.4–3.5 for eating fish at least three times a week vs. fewer than three times a week) and having previous episodes of ciguatera (OR 4.2, 95% CI 1.9–9.5), population shifts from 1980 to 2010 in these factors could have helped compensate for rising seawater temperatures.10 More research is needed to identify and characterize the factors associated with ciguatera in this region.
Other Research in St. Thomas
There are several other important projects still being analyzed from this research effort. Clinical studies include a longitudinal analysis of diagnosed cases of ciguatera on the island, with visits at 0, 3 and 12 months after onset to better characterize the illness and quantify rates of chronicity. Thus far, 62 cases have been followed, with 56 percent having dermal and neurologic symptoms 3 months after onset and 13 percent continuing to have vague neurologic complaints after 1 year. Environmental studies include extensive monitoring of four sites around the island. Data include environmental parameters (seawater temperature, salinity, precipitation, wind speed), Gambierdiscus populations, coral species composition/health, macroalgal cover/composition, nutrients and the toxicity of dinoflagellate field samples and fish. Toxin studies include working to optimize detection of toxin in fish and developing methods for diagnosing disease in patients. Climate studies include correlating weather patterns, particularly the Atlantic Warm Pool, with Gambierdiscus population and disease incidence data.
Research in Florida
While St. Thomas is well within the typical geographic range for ciguatera, Florida represents a different opportunity for research. The state lies on the edge of the geographic range—ciguatera is reported fairly commonly in South Florida, but is much less common farther north. This makes it a useful location for observing the impact of climate change, as northern movement would be expected. In addition, there is already public health surveillance in place, which is useful for measuring trends over time. However, underreporting is substantial and unquantified, and historical data for comparison are limited. An analysis of reports to the Florida Department of Health (FDOH) from 2000 to 2011 was combined with a survey of recreational fishermen to estimate incidence by adjusting for underreporting, evaluate catch locations for illness-causing fish and identify high-risk demographic groups and fish types.
Floridians are not as familiar with ciguatera as U.S. Virgin Islanders are. Members of the general public are likely to have not heard of it at all, while fishermen in South Florida may have some limited knowledge. Because of this, a survey of the general population was not considered a good approach for estimating incidence. Instead, recreational saltwater fishing license holders were surveyed by email. Home addresses were obtained for all 2011 licensees from the Florida Fish and Wildlife Conservation Commission, and the survey was sent to all who provided an email address (311,799; approximately 10% were undeliverable). There were 5,352 participants. They were asked whether they had ever received a diagnosis of ciguatera (likely cases) or experienced a list of symptoms after eating saltwater fish (possible cases), as well as the type of fish, where they caught it and medical attention sought.
Reports to FDOH served as the base incidence rate. Annual incidence averaged 0.2 per 100,00 statewide, 1 per 100,000 in Miami-Dade County and 3 per 100,000 in Monroe County (Florida Keys). Survey data were used to estimate underreporting and adjust those rates. Three types of underreporting were considered: (1) affected persons who do not seek medical attention for their illness [in the survey, 57% (95% CI 52–63) of likely and possible cases sought medical attention for their illness]; (2) persons who seek medical attention but whose illness is not appropriately diagnosed [most cases in the survey (88%, 95% CI 19–40) were diagnosed (i.e., were likely vs. possible)]; and (3) persons who received a diagnosis that was not reported to FDOH. Cases who stated they received a diagnosis in Florida and were willing to provide identifiers were matched to FDOH records. Only 7 percent (95% CI 0–18) were reported to FDOH. Based on these levels of underreporting, incidence estimates were increased by a factor of 28, to 5.6 per 100,000 statewide, 28 per 100,000 in Miami-Dade County and 84 per 100,000 in Monroe County. A comparable historical rate was not available except for in Miami. Before adjusting for underreporting, an estimate in 1980 was 5 per 100,000 compared with 1 per 100,000 in this study.
Fishers reported catching the majority of implicated fish in the Bahamas (34%) and Florida Keys (20%). Cuba and Palm Beach County were the next most common, each with 5 percent, followed by Miami-Dade County with 4 percent. Toxic fish were only sporadically caught north of Palm Beach. This was consistent with data from 1954 to 1992, although that study did not include fish caught outside Florida. There was a higher percentage of implicated fish north of South Florida in the cases identified through the email survey than in the FDOH reports. This could indicate a bias in reporting due to better physician awareness in South Florida, or it could be a result of illnesses unrelated to ciguatera. Overall, there was little evidence that the geographic range or incidence had increased over time. However, these data provide a solid baseline for future comparisons, and this area should be monitored closely in the future.
In looking at demographics, Hispanic ethnicity was an important risk factor. Hispanics had a relative risk of 3.4 compared with non-Hispanics. Fish consumption may play a role in that difference. Illness among Hispanics was more likely than in non-Hispanics to have been caused by barracuda (Table 1).
The types of fish consumed by all cases were consistent with past research. Grouper was most commonly reported (31%), followed by barracuda (18%), amberjack (8%), snapper (8%) and hogfish (7%). However, after adjusting for total commercial and recreational landings as a proxy for consumption, hogfish and barracuda looked to be particularly high risk.
While the studies in the U.S. Virgin Islands and in Florida did not find evidence of an increase in incidence or geographic range of ciguatera over time, past research has shown strong evidence of a relationship between seawater temperature and growth of the toxin-producing algae. There are many reasons why it may not have been observed in these studies. Some possibilities: changing demographics and risk behaviors (fish consumption), increased awareness of risk, differences in current data versus historical data, other environmental influences (including coral reef health), changes in Gambierdiscus or the toxin or changes in fish populations. It is also possible that more time is needed for the increase to become measurable. In any case, as our seawaters continue to warm as a result of climate change, it is critical to continue research on this issue.
While ciguatera continues to be a public health concern, the best way to prevent illnesses is to increase awareness in at-risk populations. There is no accurate way to detect the toxin in fish without extensive laboratory testing, and it cannot be cooked or frozen out of the meat. So it is important for public health and food safety authorities to educate the public on high-risk fish species. Many of the fish species (e.g., grouper, snapper) implicated are very commonly eaten without issue and thus do not need to be avoided altogether (though eating smaller fish will reduce risk). Others such as barracuda are high-enough risk that messaging should recommend complete avoidance. For all of these fish, it is useful for people to be aware of the risk so that they can take action if they become ill—seek medical attention, let their provider know that they ate saltwater fish and, if possible, keep some of the fish in the freezer for confirmatory testing.
Among the outstanding researchers contributing to Project CaribCATCH: J. Glenn Morris Jr. (principal investigator, University of Florida Emerging Pathogens Institute), Lynn Grattan and Sparkle Roberts (University of Maryland, Baltimore), Tyler Smith (University of the Virgin Islands), Don Anderson and Mindy Richlen (Woods Hole Oceanographic Institution), Alison Robertson (U.S. Food and Drug Administration) and Vasu Misra (Florida State University). I was an epidemiology doctoral student working on this project. My Florida study collaborators were J. Glenn Morris Jr. and Andrew Reich.
Elizabeth G. Radke, Ph.D., M.P.H., is the communicable disease epidemiologist for the Arlington County (VA) Public Health Division. She previously worked as the Arbovirus Surveillance Coordinator for the Florida Department of Health. She received a Ph.D. in epidemiology from the University of Florida and an M.P.H. in epidemiology from the University of Pittsburgh.
1. Friedman, MA, et al. 2008. Ciguatera fish poisoning: Treatment, prevention and management. Mar Drugs 6:456–479.
2. Fleming, LE, et al. 1998. “Marine seafood toxin diseases: Issues in epidemiology and community outreach,” in Harmful Algae, eds. B Reguera, J Blanco, ML Fernandez and T Wyatt (Galicia: Xunta de Galicia and Intergovernmental Commission of UNESCO), 245–248.
3. Dickey, RW and SM Plakas. 2010. Ciguatera: A public health perspective. Toxicon 56:123–136.
4. Hales, S, et al. 1999. Ciguatera (fish poisoning), el Nino, and Pacific sea surface temperatures. Ecosystem Health 5:20–25.
5. Chateau-Degat, ML, et al. 2005. Seawater temperature, Gambierdiscus spp. variability and incidence of ciguatera poisoning in French Polynesia. Harmful Algae 4:1053–1062.
6. Llewellyn, LE. 2010. Revisiting the association between sea surface temperature and the epidemiology of fish poisoning in the south Pacific: Reassessing the link between ciguatera and climate change. Toxicon 56:691–697.
7. Tester, PA, et al. 2010. Ciguatera fish poisoning and sea surface temperatures in the Caribbean Sea and the West Indies. Toxicon 56:698–710.
8. Skinner, MP, et al. 2011. Ciguatera fish poisoning in the Pacific islands (1998 to 2008). PLoS Negl Trop Dis 5:e1416.
9. Gingold, DB, et al. 2014. Ciguatera fish poisoning and climate change: Analysis of national poison center data in the United States, 2001–2011. Environ Health Perspect 122:580–586.
10. Radke, EG, et al. 2013. Ciguatera incidence in the US Virgin Islands has not increased over a 30-year time period despite rising seawater temperatures. Am J Trop Med Hyg 88:908–913.
11. Morris, JG, et al. 1982. Ciguatera fish poisoning epidemiology of the disease on St. Thomas, U.S. Virgin Islands. Am J Trop Med Hyg 31:574–578.
12. Grattan, LG, et al. 2013. “Ciguatera fish poisoning in St. Thomas, USVI: Exposure, symptoms, and recovery,” (Proceedings: 7th Symposium on Harmful Algal Blooms in the U.S.), 45.
13. Radke, EG, et al. 2015. Epidemiology of ciguatera in Florida. Am J Trop Med Hyg 93:425–432.
14. Lawrence, DN, et al. 1980. Ciguatera fish poisoning in Miami. JAMA 244:254–258.
15. Desylva, DP. 1994. Distribution and ecology of ciguatera fish poisoning in Florida, with emphasis on the Florida-Keys. Bull Mar Sci 54:944–954.
Outbreaks Bring Downward Pressure on Chipotle Stock
Source : http://www.foodsafetynews.com/2015/11/foodborne-illness-outbreaks-bring-downward-pressure-on-chipotle-stock/#.Vk0yII2heUl
By Dan Flynn (Nov 03, 2015)
Food poisoning outbreaks involving Chipotle Mexican Grill outlets are eroding its overall stock value, which last summer hit a per-share high of $756. The company’s shares closed Monday at $624, a drop of 2.5 percent.
Traded under the symbol “CMG” on the New York Stock Exchange, the “fast casual” restaurant chain has recently experienced three consecutive outbreaks involving three separate pathogens. It briefly closed a restaurant in Simi Valley, CA, in August after 82 customers and 17 employees were sickened by Norovirus. Then, in September, 22 Chipotle locations in the Minneapolis area were associated with a Salmonella Newport outbreak in which 64 people were sickened.
Another 43 Chipotle restaurants in Oregon and Washington state have now been closed since Oct. 31 because the chain has been associated with an E. coli outbreak in the Pacific Northwest.
The two-state investigation is now looking at what came into those restaurants that may have spread the contamination. Lettuce is high on the suspect list, according to Lane County, OR, environmental health staffer who commented on the investigation to Food Safety News.
Meanwhile, Jonathan Modie, a spokesman for the Oregon Public Health Division, confirmed Monday that investigators are focusing in on contaminated produce.
“We are looking at everything, but our epidemiology investigation is guiding us toward produce,” Modie said. “Chipotle has meat products, but based on things we heard from people who got sick … it seems like the most common denominator is some kind of vegetable course.”
Currently the closures in Oregon and Washington state account for only about 2 percent of Chipotle’s 1,931 locations nationwide. It is not known when those restaurants will reopen.
Health officials in the two states have tallied 22 cases of E. coli infection, including eight people who have been hospitalized. The illnesses since Oct. 14 have involved people ranging from 11 to 64 years old.
Northwest health officials say the number of people sickened by this outbreak is likely higher than that because it not uncommon for people affected with Shiga toxin-producing E. coli to go without seeing a doctor or other health care provider. They are anticipating that the outbreak numbers will increase as Chipotle customers in the affected areas learn about it and seek care.
People who should seek medical treatment and tell their doctor about the outbreak are those who dined at any of the Chipotle restaurants in the impacted counties between Oct. 14 and 23, 2015, and who subsequently became ill with vomiting and bloody diarrhea.
The targeted Chipotle locations are located in the Portland metropolitan area, including Oregon’s Clackamas and Washington counties, and Clark, King, Skagit, and Cowlitz counties in Washington state.
Most people infected with E. coli develop watery and/or bloody diarrhea and abdominal cramps within 1-10 days, with the average being 3-4 days. Most illnesses resolve on their own within 7 days. Most people recover within a week but, rarely, some develop a severe type of kidney failure that can begin as the diarrhea is improving and is most common in children younger than five years old and the elderly.
The Oregon Health Authority, Washington State Department of Health, U.S. Food and Drug Administration (FDA) and U.S. Centers for Disease Control and Prevention are working with the county health departments on the outbreak.
Until the recent outbreaks, analysts viewed Chipotle’s finances as strong, with the company focused on expansion to Canada and Europe and creation of a new Asian brand. The 22-year-old fast casual brand known for using locally sourced, responsibly raised and organic ingredients expanded its locations in the U.S. from 1998-2006 when McDonald’s was the majority owner of the Denver-based company. McDonald’s sold its Chipotle stock in 2006.
Study: Food Pantries Have ‘Room for Improvement’ in Food Safety
Source : http://www.foodsafetynews.com/2015/11/study-food-pantries-have-room-for-improvement-in-food-safety/#.Vk0zBI2heUl
By Lydia Zuraw (Nov 03, 2015)
Food-donations_406x250The food safety of food pantries is a fairly new arena for researchers, but with 14 percent of American households insecure about food at some point during 2014, it’s drawing more attention.
The latest bit of research on the subject finds that there is “much room for improvement,” particularly when it comes to recalls. The report was published online Sunday in the Journal of Food Protection.
“Populations of lower socioeconomic status are suspected to experience greater rates of foodborne illness, although this is difficult to demonstrate,” wrote study authors Ashley Chaifetz of the University of North Carolina at Chapel Hill and Ben Chapman of North Carolina State University. Also, those who rely on food pantries often have less access to healthcare in the event that they are infected with a foodborne pathogen.
They studied the standard operating procedures and interviewed managers at 105 food pantries from 12 North Carolina counties. The “snapshot” of the state’s food pantries compared differences between independent pantries and those partnered with a food bank, metropolitan versus rural, and pantries in which the managers did and did not receive any food safety training.
Many of the food safety procedures Chaifetz and Chapman encountered were informal. Nearly all pantries did a good job of limiting opportunities for cross-contamination and providing adequate hand-washing facilities, but safe food handling training and knowledge about recalls were lacking.
Managers at 77 pantries received some food safety training, and those at pantries partnered with a food bank — a warehouse that stores and distributes food obtained from producers, retailers, federal commodity programs, and the food industry to food pantries — rather than at independently run pantries were more likely to have received training. Only 41 percent of the volunteers at all the pantries were reported to have gone through training, including but not limited to, food safety.
Only 64 percent of pantry managers said they had up-to-date information regarding recalls, and 60 of the 67 pantries with recall information partnered with a food bank.
“That most pantry managers lacked information on food recalls is a public health failure,” Chaifetz and Chapman wrote.
Some of their other findings regarding recalls were that:
•“Ten pantry managers assumed the food bank would remove any recalled items before distribution or that the food bank would contact them in the event of a recall, even though it had never done so.”
•“Twenty-nine managers had never pulled nor searched the pantry for a recalled product, but 13 pantry managers explicitly remembered that they had to search for or pull peanut butter during its most recent recall.”
•“[S]ix pantry managers currently post information for clients, seven additional pantries would tell the clients if they learned of a recall (but had never done so), and 15 pantry managers responded that they would not tell the clients, either because they were unable to do so or because they made the assumption that recalled food would not reach the client.”
Chaifetz and Chapman emphasized in their report that there are limitations in stating that their findings are representative of other states, but they offered some recommendations for things any food pantry could do to improve food safety.
These include emphasizing regular hand-washing, obtaining more regular information on recalls, creating strict rules for what foods they will and will not distribute, and having set procedures on repackaging items, from glove use to packaging and labeling. Producing a written set of Standard Operating Procedures would also help pantry staff and volunteers understand the reasons for, and importance of, food safety tasks.
There is a lot more research still to be done regarding emergency food operations, but this study has already been used by officials with North Carolina Cooperative Extension to develop a set of free educational resources for food pantries.
Food Safety and the Perception of Risk
Source : http://www.foodsafetynews.com/2015/11/food-safety-and-risk-perception/#.Vk0yV42heUl
By Omar Oyarzabal (Nov 03, 2015)
In the latest issue of Food Safety Magazine published Nov. 3, 2015, there is an article about the terms “hazard analysis” and “risk assessment.” I wrote that article to highlight the fact that these terms, which have different origins but may have similar meanings, are not really the same and do not produce the same results.
Briefly, hazard analysis is the assessment of the hazards that may be associated with a food commodity in a particular food processing establishment, with the final output of finding out which hazards are “significant” and have to be addressed in a HACCP (hazard analysis critical control points) plan. Risk assessment is more complex and requires the use of more sophisticated data analysis to characterize the risk for a given pathogen/food commodity combination. These are just very brief distinctions in concepts, but these terms have been stretched to mean a few other things. Yet the results are different. Here I would like to further explain my reasoning and emphasize that the use of technical terms can be confusing because basic terms, such as “hazard” and “risk,” are sometimes not clear in our minds.
There are large differences in the way the public and scientists look at and interpret risk. There are topics that consistently polarize opinions, and people tend to end up with extreme views. Keep in mind that I am referring to issues that are under the realm of science and are part of current scientific efforts or endeavors. There are some good examples of these topics and the division in the opinions between scientists and the public in the survey report published in January 2015 by the Pew Research Center. This survey included the public and scientists who are members of the American Association for the Advancement of Science. For instance, from the group of scientists surveyed, 87 percent thinks that climate change is due to human activities, while only 50 percent of the public surveyed thinks the same. When it comes to genetically modified organisms (GMOs), 88 percent of the scientists thinks they are safe to eat, while only 37 percent of the public thinks the same. There are no proven cases of any human getting sick or dying because of the consumption of commercial GMOs foods, yet we still have a high annual incidence of Salmonella associated with the consumption of food. Why do we ignore the basic science behind hazards in foods (e.g., bacteria), pay too much attention to perceived hazards, and choose to consume high-risk foods at all costs (e.g., uncooked burgers)? These contradictions and the lengths people go through to justify risky decisions have always fascinated me.
This large variation in the interpretation of risk among all of us applies to almost any field or topic, but I am careful in addressing hazards in foods. Whenever I have the chance, I make sure food processors understand that addressing hazards in foods is more in-depth than what we think it is. I mainly refer to “biological” hazards (bacteria, parasites, viruses, etc.), whose appearance is difficult to predict and distributions difficult to exactly mimic with the current probability models. Yet we have made important progress over the years. This progress is in part due to the application of HACCP, in which the first principle is to conduct a “hazard analysis,” and thanks to “risk assessment,” which is the science component of the risk analysis model applied to foods.
Over the past few years, I have included a dice game in my HACCP classes to explain the differences between hazard, a harmful event, and risk, the probability of an event occurring. I also make sure the definition of hazard includes the words “known” and “concrete” to frame the discussion. I try to make sure food processors understand that we are talking about known, concrete hazards so these processors address the most probable hazards (significant) associated with their products that can make people sick.
Interestingly enough, most processors still consider chemical hazards and GMOs to be the most important. Pesticides are definitely used in food production, but the cases of pesticide intoxication due to approved pesticides in the U.S. are related to the handling of the actual chemicals and not to the consumption of foods that were treated with appropriate, approved pesticides following appropriate application practices. These processors also underestimate Salmonella, and some really believe that we have controlled it already. In my experience, the words Campylobacter and Norovirus are almost unknown words to most processors. Borrowing from the studies on the psychology of risk perception, it is the “unknown knowns”— those hazards which we intentionally refuse to acknowledge that we know, or we ignore them altogether — which are the most significant hazards in food safety. Perceived but not real hazards and our belief that we are less likely than other people to experience negative events (optimism bias) are really a bad recipe for food safety.
I also make sure that the concept of risk, when referring to food safety, is associated to “a harmful, concrete event,” a “negative” event, if you will, to emphasize that we are not talking about events with “positive” results. In some cases, one may risk giving money and can end up wealthier — winning the lottery, for instance. In most cases, I also remind class participants of the risk formula by Peter Sandman, in which risk = hazard + outrage, with special, big emphasis on the word “outrage”: the driving force in risk perception.
As an educator, I wonder why we don’t explain simple terms, such as hazard and risk, which are usually not clear and sometimes are considered synonyms in people’s minds. Nobody can build up on the understanding of complex technical terms if basics terms are not well-defined. That is also fascinating.
In the recently released Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food from the U.S. Food and Drug Administration, the concepts are to perform a “hazard analysis” to identify foreseeable hazards and to perform a “hazard evaluation,” and then apply “risk-based preventive controls” to control hazards. The term “risk-based” appears at least once per page in the first 30 pages of the document. I also emphasize that there is no standard, consistent definition of “risk” when applying this term to food safety, and this is the reason I intentionally include words such as “concrete” when defining hazards and “negative” when defining risk. Again, the intention is to frame the discussion to focus on actual hazards. Understanding the basic definitions of hazard, risk and risk perception allow food processors to later understand what are the components of risk-based food safety programs. These programs are based on science and not on perception, and I try to make sure that food processors understand their own perceptions and understand how to recognize their customers’ perceptions.
We all have our own perceptions of hazards in foods. Some of us take it as a life crusade to right what we think is wrong, and sometimes we decide what is right or wrong based on perceptions. Yet we keep ignoring those preventable “unknown knowns” that bring a tremendous burden to our public health system, a public health system that is suffering from federal and state budget cuts that impact our ability to deal with even well-known hazards.
Sometimes I am told that food safety is boring. Isn’t that fascinating as well?
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