Florida Dept. of Agriculture Nixes New York Fish

NY Fish Inc. (Brooklyn, NY) has voluntarily recalled four production lots of its I Y NY FISH brand Imperial-European Style Smoked Salmon after the Florida State Department of Agriculture found Listeria monocytogenes in samples of the smoked fish purchased from retail stores in that state.

The recalled items are packaged sliced in 3 oz., 8 oz., 16 oz., or  as whole sides (i.e., not sliced) on aluminum-coated cardboard in clear, plastic vacuum-packed bags. Each package carries a red, black and gold sticker label with gold labeling and a small, white sticker label with the lot number. Lots 513 1340, 514 1340, 515 1340 and 516 1340 are the only lots that have been recalled.

The recalled smoked salmon was distributed to wholesalers and retail food stores in six states - New York, New Jersey, Connecticut, Pennsylvania, Washington, and California. It's clear, however, that at least one more state – Florida – also received some of the recalled fish.

No illnesses have been linked to this recall. But the risk of illness associated with consuming food that contains Listeria monocytogenes should be taken very seriously. The elderly, young children, pregnant women, and people with reduced immunity to disease are very susceptible to life-threatening illness as a result of infection with this pathogen.

Anyone who has purchased the recalled product should return it to the store for a full refund. For more information, contact NY Fish Inc. at (718) 342-4100

The China Syndrome: Cadbury Dodges Bullet, Lipton Less Lucky

Unilever Hong Kong has recalled four batches of Lipton Milk Tea Powders after internal tests carried out by the company detected melamine in the products.

The contaminated batches were distributed in Hong Kong and Macau, and are described as follows:

• Lipton Milk Tea Powder Original: 17g x 20 sachets, best before date 17112009
  
• Lipton Milk Tea Powder Gold: 18.5g x 10 sachets, best before date 17112009
  
• Lipton Milk Tea Powder Gold: 18.5g x 20 sachets, best before date 18112009
  
• Lipton Milk Tea Powder Gold: 18.5g x 20 sachets, best before date 19112009
  

Hong Kong's Centre for Food Safety has indicated that it will sample the products and carry out its own melamine testing. Meanwhile, the agency has asked retailers to withdraw the products from sale and is advising consumers not to drink the implicated Lipton tea powders. 

While Lipton has become enmeshed in the melamine affair, Cadbury appears to have been reprieved. 

We reported yesterday that Cadbury had ordered a precautionary recall of eleven products made in its Beijing, China facility after preliminary tests indicated possible contamination with melamine. The chocolates were exported to Hong Kong, Australia and Taiwan.

But an Associated Press report carried this morning by USA Today indicates that the Centre for Food Safety has not found melamine in the Cadbury chocolates. Why the confusion?

As with many analytical programs, melamine testing is probably carried out in two steps. First, samples can be screened using a rapid test based on an immunoassay. These tests are relatively easy to perform, are less expensive, allow most "clean" products to be identified quickly. Then, samples that test positive using the immunoassay test would be retested using a more accurate "gold standard" method based on chromatography. 

We don't know whether that's what happened with Cadbury, but it's a feasible explanation. The company made an ethically appropriate decision to issue a precautionary recall based on the preliminary result, knowing that its reputation could be damaged. Cadbury management should be applauded for that decision, made in the best interests of its customers.

Hold The Lettuce: Update

The Illinois Department of Public Health has added its voice to the contaminated lettuce alert issued last Friday by the Michigan Department of Community Health.

Six residents of Illinois were infected in late August and early September by E. coli O157:H7. The cluster of illnesses all were caused by the same strain of E. coli O157:H7 and the source was traced epidemiologically to chopped and shredded lettuce distributed by Aunt Mid's Produce Company (Detroit, MI).

The same strain of E. coli O157:H7 also is responsible for 26 illnesses in Michigan – including the outbreak cluster at Michigan State University – and an unspecified number of cases in New York, Ohio and Oregon.

Federal and state authorities are working with Aunt Mid's to trace the source of the contaminated lettuce, which was supplied to restaurants, institutions and food service operations. The company has suspended production and sale of its iceberg lettuce product line until the source of the problem has been found and corrected.

The China Syndrome: Cadbury Recalls Chocolates

Cadbury has announced a recall of eleven chocolate items that were manufactured in its Beijing, China plant and exported to Hong Kong, Australia and Taiwan.

The British chocolate maker did not officially state a specific reason for the recall, saying simply that tests had cast doubt on the safety of its Chinese-made products. But an unnamed Cadbury spokesperson told Associated Press that preliminary tests revealed the presence of an undetermined level of melamine in the chocolates.

The eleven recalled Cadbury products have been identified as follows:

• Dark Chocette, 45g
  
• Dark Chocette, 80g
  
• Eclairs, 180g
  
• Dairy Milk Chocolate, 150g Pumpkin
  
• Dark Chocolate, 40g
  
• Dairy Milk Chocolate Bulk Pack, 5kg
  
• Dark Chocolate Bulk Pack, 5kg
  
• Dairy Milk Hazelnut Chocolate Bulk Pack, 5kg
  
• Dairy Milk Cookies Chocolate Bulk Pack, 5kg
  
• Hazelnut Praline Chocolate, 312g 2008 Chinese New Year pack
  
• Dairy Milk Chocolate, 300g 2008 Chinese New Year pack
  

No recall advisories have been issued yet by Australia or Taiwan food safety authorities. But consumers in those countries should take note of this recall and avoid consuming the chocolates listed above until further notice.

Breaking News: Salmonella Alert – Canada and USA

The Public Health Agency of Canada and the US Centers for Disease Control and Prevention are investigating an outbreak of salmonellosis that straddles the US-Canada border.

The outbreak strain, identified as Salmonella Poona, has been blamed for 48 cases of salmonellosis across the United States and 20 cases in Canada – 14 of them in Ontario. The remaining 6 Canadian cases have been reported by Manitoba, Québec and Nova Scotia. The source of the international outbreak has not yet been determined.

Salmonella Poona was blamed for three consecutive outbreaks of food-borne gastroenteritis in 2000-2002. Those outbreaks, which also affected both the United States and Canada, were traced, eventually to contaminated cantaloupes from Mexico. 

Salmonella infections typically are self-limiting and produce symptoms which include vomiting, diarrhea, stomach cramps, nausea and low-grade fever. Occasionally, some victims may later experience symptoms of arthritis as a result of the infection.

Anyone who has experienced symptoms consistent with Salmonella gastroenteritis should seek medical attention, and should be prepared to provide health authorities with information as to what they consumed in the days preceding the onset of symptoms. 

Salmonella is a reportable disease in both Canada and the United States. Any medical practitioners who examine patients with gastroenteritis should obtain a stool specimen and submit that specimen for lab testing. Salmonella-positive lab results must be reported to the appropriate state or federal health authorities.

The China Syndrome: The Next Recall

We're going out on a limb, here. According to the eFoodAlert crystal ball, the next North American recalls of a food from China will be Lotte Koala biscuits.

The Hong Kong Centre for Food Safety reported yesterday that it had detected melamine in three samples of Lotte Koala biscuits, manufactured by Lotte China Foods Co., Ltd. 

Hong Kong has advised stores to withdraw the following biscuits from sale, and the importer has recalled them.

• Lotte Koala Biscuit Family Pack, Chocolate Filled, Double Chocolate Flavor, Exp. Jan 29, 2010 – 68 ppm
• Lotte Koala's March Chocolate Biscuit Family Pack, Exp. Jan 29, 2010 – 57 ppm
  
• Lotte Koala Strawberry Biscuit Family Pack, Exp. Sep 26, 2009 - 4.3 ppm
  

Lotte Koala biscuits can be purchased easily over the Internet – even through Amazon.com. They also are available in Asian and non-Asian supermarkets in the United States.

It will probably take a few days for the news to percolate through to US and Canadian health authorities. But – just like the Mr. Brown instant coffees and the White Rabbit candies – it will happen.

Please do not consume these biscuits. Please do not feed them to your children. And please think twice before knowingly consuming any food made in China, or containing an ingredient from China, until this mushrooming mess has been cleaned up.

Hold The Lettuce

As we reported on Friday, the probable source of the E. coli O157:H7 outbreak that struck the East Lansing campus of Michigan State University earlier this month has been identified.

The cluster of victims at MSU are part of a larger outbreak that includes 26 cases in Michigan, in addition to an unspecified number of cases in Illinois, New York, Ohio and Oregon. Epidemiological investigations have pointed the finger at shredded and chopped iceberg lettuce distributed in institutional size packages. At least some of the outbreak victims consumed lettuce packaged and distributed by Aunt Mid's Produce Company (Detroit, MI).

According to the Michigan Department of Community Health, lab tests and trace-back investigations are still in progress. Additional wholesalers or distributors of lettuce may also be implicated. 

Meanwhile, Aunt Mid's has suspended processing and sale of its lettuce line, and has called in an independent lab to conduct tests and review the company's processing facility and procedures. Initial checks for E. coli O157:H7 have been negative, but additional tests are still in progress.

Based on the information available so far, the lettuce was sold nationally to institutions and restaurants – not to retail stores. Until the trace-back has been completed, and any remaining product recalled, it would be prudent to avoid shredded or chopped lettuce when eating out.

The Other Powdered Milk Safety Problem

With all the focus on melamine in milk powder and other dairy products and ingredients from China, the international media have largely overlooked an old familiar food safety problem that has reappeared this year – Salmonella contamination of powdered milk.

Last month, Spain's National Reference Laboratory of Salmonella (NRLS) noted an unusually high number of isolates of Salmonella enterica serotype Kedougou – a type of Salmonella that is found rarely in Spain. In all, 29 people – 23 of them under one year old – had been infected with the identical strain of Salmonella Kegoudou. Six of the infants were hospitalized as a result of their symptoms. One of the adult victims was the father of an infected infant.

Spanish authorities were able to determine that at least 19 of the infants had been fed the same brand of powdered milk formula in the week before they began to exhibit symptoms of salmonellosis. The formula was manufactured by Santuri, and sold under the brand names "Confort" and "Natur." Five batches of the implicated milk formula were recalled and an alert was issued through the EU Rapid Alert System for Food and Feed.

Last week, the EU could be pardoned for experiencing a sense of déjà vu. Once again, an outbreak of salmonellosis among infants was traced to contaminated powdered milk formula. The venue was different – this outbreak was in France. The Salmonella serotype was different – Salmonella Give, this time. The manufacturer was different – Novalac. But the story was essentially the same.

The French outbreak isn't quite as large. It consists at the moment of five confirmed cases and six probable cases, which are still under investigation. At least 10 of the 11 victims were fed the same powdered milk formula. The epidemiological data were compelling and, without waiting for lab test results on the powdered milk, Novalac recalled the implicated batch of formula on September 23rd. The company extended its recall to include all batches the following day, because some consumers were having difficulty reading the batch numbers.

Salmonella outbreaks have been traced to milk powder several times in past decades – in the UK, France, Korea, the United States and Canada, and Australia, for example. I talk about some of those outbreaks – their causes and how they might have been prevented – in Food Safety: Old Habits, New Perspectives.

Intentional adulteration of food, such as has been taking place with the addition of melamine to milk and vegetable protein products in China, is unconscionable. But accidental contamination of food by a pathogen such as Salmonella can be just as dangerous. 

While we follow the evolution of the melamine adulteration affair, let's not lose sight of the more mundane, but equally important, food safety issues.

The China Syndrome: Canada Expands Mr. Brown Recall

CFIA has expanded its previous notice advising of the recall of three Mr. Brown instant coffee products. The recall now includes all date codes of the following items:

• Instant Coffee 3 in 1 Mandheling Blend Coffee (UPC 4 710085 122523)
  
• Instant Coffee 3 in 1 Blue Mountain Blend Coffee (UPC 4 710085 200597)
  
• Instant Coffee 3 in 1 Arabica Coffee (UPC 4 710085 122509)
  

The earlier recall notice had been limited to certain date codes. At that time, the product was thought to have been distributed only in Alberta, British Columbia and Manitoba. CFIA now advises that Mr. Brown products are available throughout Canada. 

The Canadian importer of these three products, Thai Indochine Trading Inc. (Markham, ON) has voluntarily recalled them. CFIA is monitoring the effectiveness of the recall.

CFIA has also alerted Canadian consumers that four other Mr. Brown products, which have not been imported into the country officially, may nevertheless be available for sale. These products, which have been recalled by King Car Food Industrial Co. Ltd. (Taiwan), include all date codes of:

• Mr. Brown Caramel Macchiato Instant Coffee (3-in-1)
  
• Mr. Brown French Vanilla Instant Coffee (3-in-1)
  
• Mr. Brown Mandheling Blend Instant Coffee (3-in-1)
  
• Mr. Brown Milk Tea (3-in-1)
  

Consumers should avoid using any of these instant coffee and milk tea products, due to the possibility that they may contain melamine.  

E. coli O157:H7: Grime Scene Investigation at MSU

A combined operation that involved investigators and staff from Michigan State University, Michigan's Departments of Agriculture and of Community Health, the FDA, the CDC and the USDA paid off today when the MSU outbreak was traced definitively to a nationally-distributed shredded and chopped iceberg lettuce.

The investigation was triggered by an outbreak of E. coli O157:H7 among students of Michigan State University earlier this month. The outbreak was linked through genetic fingerprinting of the microbe to 26 cases in 8 Michigan counties, as well as to other cases in Illinois, New York, Ohio and Oregon.

By reviewing epidemiological data obtained from the outbreak victims at MSU and elsewhere, investigators have zeroed in on the source of the pathogen – shredded and chopped iceberg lettuce distributed nationally by Aunt Mid's Produce Company (Detroit, MI).

The report on MSU's web site does not indicate whether or not the outbreak strain was detected in a sample of Aunt Mid's lettuce. We can expect a report to be posted soon on the Michigan Department of Community Health web site. And a nation-wide recall of the contaminated lettuce may be in the works – if Aunt Mid can be convinced to go along with the idea.

Allergy Alert: Patak's Cooking Sauce

On September 4th, FDA advised consumers that ACH Food Companies, Inc. (Memphis, TN) was recalling Patak's® Dopiaza Cooking Sauce due to the undeclared presence of butter in the product.

The recalled items were labeled as Patak's® Rich Tomato and Onion Cooking Sauce Dopiaza (Mild) and Patak's® Dopiaza Curry Cooking Sauce Mild, and carry a Best By date of "on or before February 2010."

The undeclared butter was added to the products as a result of a co-packer error. The correct product formulations do not contain butter.

While no illness reports have been received, individuals who are allergic to dairy products may suffer a severe – possibly life-threatening – allergic reaction after consuming these products. Consumers who purchased one of the recalled items are encouraged to return it to the store for a full refund, or to contact ACH toll-free at 800-726-3648 to receive a coupon.

The China Syndrome: Heinz Recalls Baby Food Batch

The H.J. Heinz Company announced today that it was recalling one batch of baby food after the Hong Kong Centre for Food Safety detected a 1.6 ppm of melamine in the product. All other Heinz products were found by the government's testing lab to be melamine-free.

The product being recalled is identified as:

• Heinz Intelligence Many Many Vegetable Cereal (Product Bar Code: 6901642888480)
  

The prompt action taken by Heinz is in sharp contrast to the reaction of Nestlé after Hong Kong reported finding a similar low level of melamine in Nestlé Dairy Farm UHT Pure Milk 1L (Catering). 

The Swiss-based multi-national has issued two press releases to assure consumers that none of their dairy products were contaminated with melamine. Nestlé made the following statement on September 21st:

"The Hong Kong Government's Food and Environmental Health Department has just released a report declaring that Neslac Gold 1+, which was mentioned in the media reports, is safe and that no melamine was detected in the product."

That statement did not at all address the Dairy Farm UHT Pure Milk, in which melamine was detected by the Hong Kong Government. Nestlé followed up their first press release with a second statement, issued on September 23rd:

"No Nestlé milk products in China and Hong Kong are made from milk adulterated with melamine." 

Perhaps Nestlé should take some lessons in public relations and good corporate citizenship from H.J. Heinz.

The China Syndrome: US issues 1st Melamine Recall Advisory

The US Food and Drug Administration today issued an updated health advisory regarding the possibility of melamine contamination in foods imported from China.

According to today's notice, King Car Food Industrial Co. Ltd., has recalled the following Mr. Brown brand instant coffees and milk tea products due to possible melamine contamination.

• Mr. Brown Mandheling Blend Instant Coffee (3-in-1)
  
• Mr. Brown Arabica Instant Coffee (3-in-1)
  
• Mr. Brown Blue Mountain Blend Instant Coffee (3-in-1)
  
• Mr. Brown Caramel Macchiato Instant Coffee (3-in-1)
  
• Mr. Brown French Vanilla Instant Coffee (3-in-1)
  
• Mr. Brown Mandhling Blend instant Coffee (2-in-1)
  
• Mr. Brown Milk Tea (3-in-1)
  

Readers may remember that the Taiwan government was the first to detect melamine contamination in Mr. Brown products. Canada issued a recall of Mr. Brown products earlier this week.

FDA also is advising US consumers that New Zealand has found melamine in White Rabbit Creamy Candies, and that these candies should not be eaten. Again, Canada already has issued a formal recall notice for these candies.

E. coli O157:H7 In Michigan

The outbreak strain of E. coli O157:H7 that has sickened several Michigan State University students also is being blamed for a number of other cases of illness in the state.

The Lansing State Journal reported yesterday that the strain of E. coli O157:H7 that was recovered from five MSU students matches the genetic fingerprint of the strain that has sickened 13 other people in seven Michigan counties, including five inmates of the Lenawee County Jail.

In addition to the five confirmed outbreak cases at MSU, a further 21 reported illnesses among students at the university are still under investigation. 

The China Syndrome: Canada Recalls White Rabbit Candy

CFIA has announced a nation-wide recall of all White Rabbit brand candy. The agency has advised the Canadian public not to "... consume, distribute or sell..." any flavor or variety of White Rabbit candy, due to the risk that it may contain melamine.

In recent days, government labs in New Zealand, Singapore, and Hong Kong all have detected melamine in White Rabbit Creamy Candies, a made-in-China sweet. CFIA has determined that White Rabbit has been imported into Canada and is available for sale in retail stores across the country.

CFIA has advised retailers to remove all White Rabbit candy from store shelves, and is working with importers to coordinate the product recall.

Allergy Alert: Giant Foods – USA

Giant Food LLC has announced a recall of several baked goods due to the possible presence of nuts that were not declared on the lists of ingredients.

The following Giant Bakery Products – sold on or before September 24, 2008 – have been recalled:

• Giant Rainbow Cake (UPC 210725808991)
  
• Giant Mundel Bread (UPC 201500305590)
  
• Giant Rugalah, Raspberry (UPC 201575808453)
  
• Giant Rugalah, Cinnamon Raisin Nut (UPC 201576000092)
  
• Giant Rugalah, Chocolate Chip (UPC 201575500098)
  
• Giant Hamantashen, Cherry (UPC 201760703297)
  
• Giant Hamantashen, Prune (UPC 201577603292)
  
• Giant Hamantashen, Poppy (UPC 201578001295)
  
• Giant Hamantashen, Apricot (UPC 201576201291)
  
• Giant Hamantashen, Assorted Varieties (UPC 201550003996)
  

The following 8-ounce packages of Grandma Taylor's Gourmet Dipping Cookies Mundel Bread – sold in Giant Bakeshops on or before September 24, 2008 – have been recalled:

• Cinnamon Walnut (UPC 67073-00002)
  
• Cinnamon Raisin (UPC 67073-00003)
  
• Chocolate Chip (UPC 67073-00001)
  
• Chocolate (UPC 67073-00004)
  
• Marble Almond (UPC 67073-00005)
  
• Cranberry Pistachio (67073-00006)
  

Individuals who are allergic to nuts should not consume these products, as they risk suffering a severe – possibly life-threatening – allergic reaction due to the undeclared presence of nuts in the products. 

Customers who have purchased recalled items may return them to the store for a full refund. For more information, contact Giant Foods at (888) 469-4426.

Allergy Alert: Soups and Sauces - UK

The UK Food Standards Agency is advising consumers of two allergy-related recalls today.

Sainsbury's Supermarkets Ltd. has withdrawn packages of its SO Organic Pumpkin & Sweet Red Pepper Soup (600g; Use by 7 October 2008), because some of the packages contain Organic Celeriac & Mushroom Soup instead. This product may be hazardous to individuals who are allergy to celery.

In a separate action, Jenks Sales Brokers have recalled five different sauce sachets, due to the presence of one or more undeclared allergens in the products. No date or product codes have been specified. Individuals who are sensitive to one or more of the indicated allergens should not consume the following five products, due to the risk of a severe – possibly life-threatening – allergic reaction.

• Hammonds Vinegar (8g): gluten from barley
  
• Hammonds Brown Sauce (10g): soya, gluten from wheat, barley, and rye
  
• Hammonds Tartare Sauce (10g): mustard, egg
  
• Hammond Mayonnaise (10g): egg
  
• Hammonds Salad Cream (10g): mustard, egg, and gluten from wheat
  

Allergy Alert: HDH Grillin' Sauce Recalled

CaJohns Fiery Foods Company has recalled 103 bottles of HDH Grillin' Sauce, because the sauce may contain one or more undeclared allergens. The problem was detected during a routine inspection by FDA.

The recalled 16-ounce glass bottles were sold between 01/01/07 and 09/15/08 through retailers, web sites and by mail order throughout the United States. Six lot numbers – marked on the bottom of the bottles – are covered by this recall notice: 249242, 249298, 249304, 249154, 249181, and 249197.

The recalled bottles of sauce may contain undeclared anchovies, soy beans or wheat. Individuals who are allergic to one or more of these items may experience serious – possibly life-threatening – symptoms when eating a food containing the ingredient.

Consumers in need of more information about this recall can contact CaJohns toll-free at: 888-703-3473.

New Recall; Different Company; Same Problem: Listeria monocytogenes

Hygaard Find Foods Ltd. (Sherwood Park, Alberta) has announced a voluntary recall of a series of prepackaged ready-to-eat sandwiches due to the possibility of contamination with Listeria monocytogenes, after the company detected the microbe in an environmental sample.

The following items are included in the recall notice:

• Super Donair/Notre Donair Super (251g)
  
• Mini Pizza Sub/Sous-Marin à la Pizza Mini (140g)
  
• Little John Sub/Sous-Marin Petit Jean (387g)
  
• Hoagie (238g)
  
• Mini Hoagie Family Pack/Paquet Familial de Hoagie Mini (822g)
  
• Mini Pizza Sub/Sous-Marin à la Pizza Mini (156g)
  
• Mini Pizza Sub Family Pack/Paquet Familial de Mini Sous-Marin à la Pizza (798g)
  
• Super Pizza Sub/Notre Sous-Marin à la Pizza Super (380g)
  
• Lumberjack Sub/Sous-Marin Bucherin (312g)
  
• Mini Sub/Sous-Marin Mini (133g)
  
• Salt & Pepper Dry Ribs/Flanc de Porc Sechées Entierment Sel et Poivre (164g)
  
• Super Sub/Notre Sous-Marin Super (165g)
  
• Mini Ham Sub Family Pack/Paquet Familial de Mini Sous-Marin au Jambon (738g)
  
• Philly Steak Sub/Sous-Marin au Philly Bifteck (219g)
  
• Spicy Donair/Donair épicé (155g)
  
• Sausage & Egg Muffin/Muffin avec Saucisse et Oeuf (165g)
  

All of the above-listed items that are identified with Best Before dates of Oct 24 - Nov 16, inclusive are part of the recall. The products were distributed across Canada, except for New Brunswick and Prince Edward Island.

This is the second major precautionary recall of prepared sandwiches by a Canadian manufacturer in less that a week. Last Friday, Smith's Snack Service Ltd. (Norman Cove, NL) recalled its entire outstanding production inventory after CFIA detected Listeria monocytogenes. It doesn't take much stretching of the imagination to deduce that CFIA has instituted a heightened surveillance of all deli meat and ready-to-eat sandwich producers across Canada.

Hygaard uses modified atmosphere packaging technology to extend the shelf life of its packaged sandwiches to 35 days. Their packaging system injects carbon dioxide gas into the packaging to suppress the growth of spoilage bacteria. Unfortunately, Listeria monocytogenes thrives on reduced oxygen/increased carbon dioxide atmospheres. And, unlike many other food-borne pathogens, it multiplies at normal refrigerator temperatures.

As usual, the recall notice does not indicate which grocery chains or convenience stores carry the recalled Hygaard sandwiches. Consumers who want more information can contact CFIA at 1-800-442-2342 during normal business hours.

Listeria in Canada: Touring the Provinces

The Public Health Agency of Canada has confirmed that – as of 4:00 pm today – 48 cases of listeriosis nation-wide are linked to contaminated meat from Maple Leaf's Bartor Road production facility. Another 10 cases are still under investigation. 

Eighteen deaths have been reported for which the outbreak strain of Listeria monocytogenes was the underlying or contributing cause. Three other deaths have been reported in which the outbreak strain did not contribute to the death of the victims. An additional five deaths are still being investigated.

This Listeria monocytogenes outbreak is unprecedented in Canada both in the severity of the illnesses and the geographic distribution of the contaminated food. Here's a breakdown of the outbreak by province, traveling from east to west.

Newfoundland and Labrador

No confirmed or suspect cases of listeriosis.  Last week, Smith's Snacks announced a recall of 31  prepared, ready-to-eat sandwiches and deli meats after CFIA found Listeria monocytogenes for the third time. No illnesses were associated with the recall, and there was no indication that the strain of Listeria monocytogenes was the same as the Maple Leaf outbreak strain.

Nova Scotia

No confirmed or suspect cases of listeriosis associated with the outbreak.

Prince Edward Island

No confirmed or suspect cases of listeriosis associated with the outbreak.

New Brunswick

One fatal confirmed case has been linked to the outbreak. A second case of listeriosis has just been diagnosed. The elderly victim lives in a private residence and was hospitalized as a result of the illness. The strain of Listeria monocytogenes recovered from the patient has been submitted to PHAC's national laboratory for genetic fingerprinting.

Québec

This province had the dubious distinction of coping with a province wide outbreak of Listeria monocytogenes that was simultaneous with, but totally independent from, the national outbreak. Québec reported two confirmed cases associated with the national outbreak strain, including one fatality for which the Listeria monocytogenes infection was not the underlying cause of death. There is also one suspect case still under investigation.

Separately, Québec has reported 30 confirmed cases of listeriosis that have been linked to contaminated cheeses that were manufactured and sold in the province. One of the victims of that outbreak died, and one infant was stillborn. Four of the victims were newborns who were infected in their mothers' wombs, and survived.

Ontario

By far the hardest hit of the provinces, Ontario has experienced 36 confirmed cases, with 7 more cases still under investigation. There were twenty deaths among the confirmed cases; in 14 of them, listeriosis was an underlying or contributing cause of death. There were 6 deaths for which a specific cause was not determined.

Manitoba

This province has experienced five cases of listeriosis so far in 2008. Just one of those cases, reported in August, was caused by the outbreak strain of Listeria monocytogenes. Earlier in September, an infant died from listeriosis. But this infection was caused by a different strain. A new case of listeriosis has just been reported in the Winnipeg area. Lab tests are in progress to determine whether the victim, a woman in her 50's with an underlying medical condition, has been infected by the Maple Leaf outbreak strain.

Saskatchewan

Saskatchewan reported one confirmed case and one death. The death was not directly attributed to the outbreak strain of Listeria monocytogenes.

Alberta

This province has experienced two confirmed cases and one death. The death was attributed to infection by the outbreak strain of Listeria monocytogenes.

British Columbia

This western-most province has reported five confirmed cases of listeriosis linked to the outbreak; a sixth case is under investigation. All five confirmed victims had already-existing medical conditions that might have contributed to their susceptibility to serious illness. The outbreak strain of Listeria monocytogenes was an underlying or contributing cause of two deaths.

Allergy Alert: Mom's Foods and Fine Land Corp. – USA

FDA has announced two separate recalls today due to the presence of undeclared allergens in certain foods.

Mom's Food Products, Inc. (Ft Worth, TX): Mom's has recalled all Tuna Salad sandwiches, Pimento Cheese sandwiches and potato salad, because the salad dressing may contain eggs. The salad dressing supplier made a change in the salad dressing ingredients without advising Mom's of the new formulation.

The following items have been recalled:

• Mom's Pimento Spread 5.0 oz black wedge (UPC 83898 00114)
  
• Race Trac Pimento Spread 5.0 oz black wedge (UPC 83898 00114)
  
• Crosby Food & Vending Pimento Spread 5.0 oz black wedge (UPC 83898 00114)
  
• Outtakes Pimento Spread 4.0 oz black wedge (No UPC)
  
• Mom's Tuna Salad 5.0 oz black wedge (UPC 83898 00108)
  
• Race Trac Tuna Salad 5.0 oz black wedge (UPC 83898 00108)
  
• 2 Podner's Tuna Salad 5.0 oz Clam shell (UPC 83898 00108)
  
• Canteen (Outtakes) Tuna Salad Croissant 4.5 oz Poly Sealed (No UPC)
  
• Mom's Big Sub with 4.0 oz Potato Salad round opaque container (No UPC)
  

The recalled items were sold through retail stores and by direct delivery in Texas. Consumers who purchased the recalled products are encouraged to return them to the store for a full refund. For more information, contact Mom's Food Products toll-free at 1-800-743-0010.

Fine Land Corp. (Brooklyn, NY): Ying Feng Foodstuffs Brand Pumpkin Seeds have been recalled due to the presence of undeclared sulfites. The problem was detected during routine testing by New York State Department of Agriculture and Markets.

The recalled pumpkin seeds – a product of China – are sold nationally in 10 ounce, clear plastic packages, identified with the code EXP 03 25 2010. Consumers can contact the Fine Land at 718-714-1850 for more information on this recall.

Individuals who suffer from allergies to egg or sulfites may experience severe – even life-threatening – reactions after consuming a food item that contains the allergen to which they are sensitive. Fortunately, no illnesses have been reported in conjunction with either of these recalls.

Allergy Alert: Ready-To-Eat Seafood Meals – UK

The UK Food Standards Agency is advising consumers that two ready-to-eat seafood meals sold at ASDA stores and at some smaller retailers contain undeclared allergens – nuts and ghee (milk).

The recalled products, which have a Best Before date of September 2009 are:

• Secrets of the Sea Prawns Pulao, 285g
  
• Secrets of the Sea Prawns Biriyani, 285g
  

The manufacturer has advised FSA that it is relabeling the recalled meals and has sent point-of-sale notices to retailers.

Individuals who are sensitive to either of these allergens should not consume the seafood meals.

What's New at MSU?

State and county health officials are working with Michigan State University to trace the source of an outbreak of E. coli O157:H7 that has sickened at least seven students, and possibly as many as 23. 

As of today, the outbreak strain of E. coli O157:H7 was isolated from three of the students; genetic fingerprinting results are pending on four more. The remaining 16 cases are under investigation.

The outbreak began "officially" the week of September 8th, when 10 students reported experiencing symptoms of gastroenteritis. It appears to have run its course quickly. No new cases have been reported since September 13th.

In reaction to the outbreak, MSU has decided to suspend serving all cooked turkey products. While noting that turkey has not been determined to be the source of the outbreak, the university has declared it an "item of interest" – without specifying why that is so.

Investigators also have not ruled out the possibility that the source of the outbreak was a food handler. According to a report in the Lansing State Journal, one of the confirmed outbreak victims worked as a food handler. And another food handler is among the 16 cases still awaiting lab confirmation.

Today's MSU update suggested that the outbreak might be part of a larger problem. The campus outbreak strain matches a strain of E. coli O157:H7 that has been recovered from nine other people in the southern part of Michigan's Lower Peninsula, and from two individuals in another state. Federal officials are examining the possibility that all of these cases might linked to a common source.

The China Syndrome: Canada Recalls Non-Dairy Creamer

CFIA and Thai Indochine Trading Inc. have issued a recall notice for Mr. Brown 3-in-1 instant coffee products.

Three products, all sold in 450g packages containing 30 x 15-gram bags, have been recalled. The items were distributed in Alberta, British Columbia and Manitoba, and are described as follows:

• Instant Coffee 3 in 1 Mandheling Blend Coffee: UPC 4 710085 122523; Produced 2008/04/09 to 2008/09/12 inclusive; Expiry 2010/04/09 to 2010/09/12 inclusive
  
• Instant Coffee 3 in 1 Blue Mountain Blend Coffee: UPC 4 710085 200597; Produced 2008/04/09 to 2008/09/12 inclusive; Expiry 2010/04/09 to 2010/09/12 inclusive
  
• Instant Coffee 3 in 1 Arabica Coffee: UPC 4 710085 122509; Produced 2008/04/09 to 2008/09/12 inclusive; Expiry 2010/04/09 to 2010/09/12 inclusive
  

The Taiwan government detected melamine in samples of these non-dairy creamers, and announced a recall of the items on the weekend. Thai Indochine, the Canadian importer, initiated this voluntary recall after being informed by the manufacturer of the Taiwan findings. No associated illnesses have been reported.

CFIA has issued an updated consumer advisory on the melamine situation, and is continuing to monitor the Canadian marketplace for other potential melamine-contaminated products.

The China Syndrome: Where Will It End?

Four Mainland Chinese babies are dead, and close to 53,000 other babies and toddlers have been diagnosed with kidney stones. Nearly one-quarter of them  are still in hospital – 104 in serious condition. The head of China's food safety watchdog agency has resigned. And that's not all.

Two Hong Kong youngsters – a three-year old girl and a four-year old boy – also have been diagnosed with kidney stones. Fortunately, neither child is in any danger of serious illness. 

Hong Kong has systematically been testing all dairy products in its local market that originated in mainland China, or that were made using ingredients from the mainland. And it has found several melamine-contaminated foods, including a milk-based dessert product that also was exported to Canada. Singapore has reported finding melamine in White Rabbit Creamy Candy, a popular Chinese sweet. And Taiwan has detected melamine in several products containing vegetable-based, non-dairy cream substitutes.

In addition to torpedoing China's attempts to repair its tarnished food safety reputation, this scandal threatens to damage the names of some multi-national companies; notably Nestlé and Fonterra –whose Chinese subsidiary, Sanlu, was the first dairy implicated in the melamine adulteration.

Fonterra has been accused of being slow to blow the whistle on its Chinese subsidiary. The New Zealand company learned about the melamine contamination in early August, but elected to try to work through the "system" rather than go public with its information. When Fonterra finally advised the New Zealand government of the melamine health risk in early September, New Zealand pressured Chinese authorities to initiate a public recall.

Hong Kong reported finding a low level of melamine (1.4 ppm) in a sample of Nestlé Dairy Farm Pure Milk, imported from mainland China. The Swiss multi-national responded to the finding by stating its confidence that no Nestlé products were made using melamine-contaminated milk.

The next can of worms to be opened will be the presence of melamine in vegetable proteins from China. Taiwan's report is just the leading edge of that typhoon.

Allergy Alert: Québec Recall of Prepared Meals

MAPAQ has issued an allergy alert and recall notice for a variety of cooked dishes sold under the name Les Coquineries, as the dishes contain one or more undeclared allergens, including milk, wheat, eggs, soy, sulfite and sesame.

The recall includes products available for sale up to and including September 19th, at Les Coquineries, 995 avenue Bergeron, Saint-Agapit, QC. Following is a translated list of recalled products, and the undeclared allergen(s) contained in each one:

• Beef with Jamaica pepper: soy
  
• Pork meatballs with cranberry: soy, wheat
  
• Stuffed crepes: soy
  
• Pork with teriyaki sauce: sesame
  
• Pig's feet stew: soy, milk, wheat, eggs, sulfite
  
• Pork meatball stew: sesame, wheat, soy
  
• Green pepper sauce: soy, wheat, sesame
  
• Pickled garlic sauce: soy, wheat, sesame
  
• Pork cassoulet: soy, wheat, sesame
  
• Pork and beans: soy, wheat, sesame
  
• Pork terrine with chestnuts: soy, wheat, sesame
  
• Spaghetti sauce with pork: soy, wheat, sesame
  
• Pork terrine with hazelnuts: soy, wheat, sesame
  
• Butcher's soup (soupe repas): soy, wheat, sesame
  

Individuals with allergies to one or more of the undeclared ingredients should avoid consuming these items. 

Australia Sliced Meat Recall: Listeria monocytogenes

Coles Group Ltd. has recalled a single production batch of Coles branded sliced chicken breast 2 x 50g in plastic twin packs due to the possible presence of Listeria monocytogenes. The recalled meat bears a Best Before date of 07/10/08.

The products were sold in Coles, BI-LO, and Pick 'n Pay stores in New South Wales, Victoria, South Australia and Queensland. Consumers should return the recalled merchandise to the store for a full refund.

Listeria monocytogenes causes mild flu-like or gastrointestinal symptoms in most of its victims. But the very young, the elderly, people with compromised immune defenses, and pregnant women are at heightened risk of serious – even life-threatening – disease. Listeria monocytogenes may trigger premature births and stillbirths, and can infect infants in the womb.

Anyone with questions about this recall can contact Coles at 1800 061 562.

The China Syndrome: Canada Recalls Imported Dessert

CFIA and Regent Long Marketing and Distribution Ltd. have announced that all date codes of Nissin Cha Cha Dessert sold in a 440g package (2 packs of 220g) bearing UPC 4 897878 550005 are potentially contaminated with melamine and are being recalled. The dessert is distributed in Ontario, Alberta and British Columbia.

The milk-based dessert was manufactured in Hong Kong using Yili Pure Milk, one of the milk products in which the Hong Kong Centre for Food Safety detected melamine.

The Centre for Food Safety issued a recall notice for this product in Hong Kong on September 19th. The Canadian action came after Regent – the Canadian importer – was advised of the recall by its supplier, Nissin Foods Company.

There have been no reported illnesses linked to this recalled product. Nevertheless, consumers who have purchased Nissin Cha Cha Dessert bearing the indicated UPC number should either discard the product or return it to the store for a refund.

The China Syndrome: Is Nestlé Being Straight With Consumers?

Hong Kong's Centre for Food Safety has reported finding melamine in a sample of Nestlé Dairy Farm Pure Milk. The one-liter package, sold for use in catering, was found to contain 1.4 ppm melamine (1.4 mg of melamine per Kg). The melamine-contaminated milk was produced by Nestlé Qingdao Limited, in Qingdao, China.

Nestlé's corporate offices released a statement in response to the reports. The company expressed confidence "... that none of its products in China is made from milk adulterated with melamine." The press release goes on to say that the lowest concentration of melamine that can be detected by common lab tests is 2 ppm, and that, based on a 2 ppm level, "... a three-year old child would have to consume over 40 litres of milk every day to exceed ... safety limits." 

The safety limits referred to in the Nestlé statement are so-called "tolerable daily intake" levels of 0.5 mg of melamine per Kg body weight/day in the EU, and 0.63 mg/Kg in the US. Does the arithmetic make sense?

• 2 ppm represents 2 mg of melamine per liter or kilogram of milk
  
• 40 liters of milk x 2 mg represents a total of 80 mg of melamine
  
• at a "tolerable daily intake" of 0.63 mg/Kg, a person would need to weigh 80 ÷ 0.63, or 127 Kg to tolerate 80 mg of melamine per day
  

Swiss 3-year old children might weigh 127 Kg (unlikely though it seems), but it's highly doubtful that Chinese children way one-tenth as much. In fact, even if one assumes that a 3-year old child weighs 15 Kg, the "tolerable daily intake" would be 15 x 0.63, or 9.45 mg of melamine. At 2 ppm, this still represents more than 4.7 liters of milk, but it's a far cry from the 40 liters claimed in the Nestlé statement. Younger children weigh less, of course, and would have a lower tolerance.

In any event, Nestlé's argument is specious. There is no excuse for melamine in milk. Instead of trying to minimize the problem, Nestlé should get busy checking on its Chinese operations. It will do this multinational company no good to be associated with China's adulterated milk scandal.

The China Syndrome: Won The Battle, Losing The War

China's food safety reputation is slipping away at a pace that would leave a nuclear meltdown in the dust.

The country's leaders promised that food served in the Olympic village and at the various venues would be safe. And they delivered. Now that the games are over, China finds itself the focus of an international food adulteration scandal.

Four infants have died, more than 40,000 have been taken to hospital for examination or treatment, and 12,892 of them remain hospitalized – 104 in serious condition. Melamine has been detected in powdered milk, fluid milk and other dairy products manufactured and sold by China's largest dairy companies, including Yili, Mengniu and Sanlu.

Melamine is an industrial chemical that is high in nitrogen. Standard food lab analytical methods to determine protein content simply measure the amount of nitrogen present in a sample. Therefore, food that is adulterated with melamine appears to have a high protein content. Special tests are needed to determine whether the apparent protein content is real, or is due to the addition of melamine.

The ripples from China's melamine adulteration scandal have spread well beyond the country's borders. Hong Kong, a semi-autonomous territory of China, has reported one confirmed illness in a 3-year old child who had been fed Yili brand high-calcium, low-fat milk for the past 15 months. Taiwan also has found melamine – in instant coffee, milk tea, and chicken-and-corn soup, all of which contain non-dairy creamer.

As melamine is detected in an increasing range of products, more countries are closing their borders to foods from China, and are removing Chinese foodstuffs from store shelves. Taiwan, Hong Kong, Macau, Malaysia, Myanmar, and Singapore, have all announced bans and recalls. The United States, Canada, the United Kingdom and the Philippines are among those countries that have alerted their Asian communities to the problem, and are taking precautionary steps – including random sampling of retail products – to ensure that no suspect foods are available for sale.

The Chinese government has been in damage-control mode – both internally and internationally – since the melamine adulteration problem became public. Arrests, dismissals and resignations have been announced, government leaders have visited sick babies in hospital, and the government has instructed that no expense be spared in treating hospitalized victims.

Ironically, Beijing is playing host this coming week to the China International Food Safety & Quality Conference, and Bill Marler is one of the invited speakers. Marler reported receiving an email from the conference organizers the other day. The message read, in part,

"As a reminder, all speakers are expected to exercise diplomacy during your presentation. The CIFSQ Conference is intended to encourage healthy constructive dialogue and information exchange amongst industry players, government regulators and the scientific community to enhance food safety for consumers."

Perhaps the Chinese government should have invited the parents of some of hospitalized infants to join their constructive dialogue.

Cholera and Diarrhea by the Numbers – Iraq and Elsewhere

Everyone seems to agree that there is – or was – an outbreak of cholera in Iraq. But that's where the agreement ends.

The International Society for Infectious Diseases, in an unusual move, incorporated five different reports on Iraq's cholera outbreak into its September 15th "Cholera, Diarrhea and Dysentery Update." The official, government-provided data reported 5 deaths and 68 confirmed cases of cholera. But the Chairman of Iraq's Parliamentary Health Commission claimed that more than 1,000 people had died, and unnamed members of parliament have said that more than 10,000 people have been hospitalized with the disease.

To add to the confusion at the national level, a member of the Governorate Council of the province of Babil has accused Iraq's leaders of hiding the magnitude of the outbreak and has demanded that the province's Health Director be dismissed for mishandling the crisis. According to the report in the Al-Zaman newspaper (available on RedOrbit), Babil has suffered more than 15 deaths from cholera, and there are 50 victims hospitalized in two hospitals, alone.

Political considerations aside, it's understandable that officials at various levels can't agree on the scope of the outbreak. We saw reporting lags and misunderstandings in the United States during the Salmonella Saintpaul outbreak, and in Canada's recent Listeria monocytogenes outbreak, even though both countries maintain sophisticated reporting systems. Some of the reporting discrepancies in Iraq are probably due to logistic and bureaucratic delays; others may be due to confusion between "confirmed" and "suspect" cases of the disease. It will take some time before the true impact of this year's Iraqi cholera epidemic is known.

Iran, Bahrain and Kuwait are watching the situation in Iraq with unease. Iran has warned its citizens who are making pilgrimages to Iraq for Ramadan to take special precautions to guard against infection. So far, no Iranians who traveled to Iraq have developed cholera. Bahrain is monitoring food products and travelers entering the country from Iraq. And Kuwait has banned the import of foodstuffs from Iraq.

Meanwhile, cholera is carrying on its usual activities in other parts of the developing world.

Zimbabwe

A recent cholera outbreak in the Harare region (Chitungwiza) claimed 11 lives and sickened 80 more. That outbreak has been contained, in part thanks to the efforts of UNICEF. 

But the risk of new outbreaks is ever-present, due to the deteriorated water and sewage infrastructure in and around the country's capital city. According to the chairman of the Harare residents association, the population is "... sitting on a time bomb that can explode anytime as a result of the unavailability of a reliable source of water, the flow of raw sewage in residential areas and piling of uncollected garbage around Harare and surrounding areas." The Zimbabwe Health Minister, however, said that the situation was under control.

Guinea-Bissau

UNICEF representatives have been working with the local government in Guinea-Bissau to control and especially stubborn cholera outbreak. But the outbreak has resisted all efforts at containment and has spread to all 11 regions of the former Portuguese colony.

At least 6,461 people have contracted cholera since the outbreak began in May of this year. As of September 16th, the death toll stood at 122 – more than double the 59 deaths that had been reported as of August 21st. 

Health officials blame the difficulty in controlling the epidemic on "... rains, the lack of basic sanitation and the population's stubbornness in not following the authorities' instructions..." 

Nepal

Flooding has triggered an outbreak of infectious diarrhea in the southeastern part Nepal, claiming 3 lives and sickening at least 22 people in the Susari district. The Saptari district, in southern Nepal has been hit even harder; cholera, pneumonia and fever have claimed 11 lives and sickened more than 13,000 victims living in a temporary camp.

Kenya

The Kenya Broadcasting Corporation reported on September 12th that cholera was responsible for 23 deaths in the Bungoma and Homabay districts. As is so often the case, the outbreak was blamed on contaminated river water that is used by local residents for drinking, washing and cooking.

Separately, about 50 cases of infectious diarrhea – not confirmed as either cholera or dysentery – were reported in the Tana Delta District. The Tana river apparently changed its course, drying up the reliable water supply for approximately 40,000 people. 

Tanzania

Cholera has reappeared in northern Tanzania; 180 cases have been reported in two districts. Four people in the Tarima district, which borders Kenya, have died. The government has responded by sending medical personnel and medicines to the area and by arresting some individuals who violated health regulations.

Bangladesh

Dhaka has been experiencing an increase in cases of diarrhea, now that flood waters are receding. During the rainy season, the rate of admission to the "cholera hospital" of patients with diarrhea was 400-450 per day. That number has risen to as high as 600 in a single day. The hospital has erected tents in the parking lot to increase its capacity to treat diarrhea patients.

Indonesia

An unchecked outbreak of cholera has killed at least 291 members of a Papuan tribe since April. Human rights organizations are expressing concern that, if left unattended, the outbreak may spread beyond the confines of Papua and trigger an international epidemic – as happened in 1961.

Philippines

The Dagupan City Health Office is taking steps to prevent future outbreaks of cholera and other forms of infectious diarrhea in that northern Philippines city. Health officials are conducting education campaigns, and sanitation teams are sampling raw and treated water. The new campaign was triggered by reports of three new cases of cholera in the area.

Hong Kong

The Centre for Health Protection (CHP) has confirmed an isolated case of cholera. The victim is a 25-year old man from Tuen Mun. He is in hospital in stable condition. There is no obvious explanation for the man's illness. He has not traveled recently, and has not been in contact with anyone who was suffering from the disease. This is only the second confirmed case of cholera in Hong Kong in 2008.

Also this week, CHP issued a reminder to Hong Kong residents to pay attention to personal hygiene and hand washing, after receiving 19 reports of dysentery – 18 locally-acquired and one imported – so far this month. Five of the victims had eaten at a local fast-food restaurant. Shigella, the microbe that causes dysentery, has no known animal reservoir. It is spread human-to-human through fecal contamination of food, water or utensils. Dysentery is best controlled by scrupulous attention to sanitation and personal hygiene.

Hendricks Farm and Dairy Back In the Raw Milk Business

We reported one week ago that Pennsylvania had suspended the raw milk sales permit of Hendricks Farm and Dairy (Telford, PA) following an outbreak of Campylobacter gastroenteritis in the state. Raw milk produced by the dairy was recalled after it was linked to the outbreak.

Yesterday, the Pennsylvania Department of Agriculture reinstated Hendricks' raw milk permit after the farm passed an inspection and a series of samples taken over several days tested negative for Campylobacter. The Department will continue to test raw milk samples from the Dairy during the next three weeks as a precaution.

This small outbreak was another reminder that consuming raw milk – or dairy products made from unpasteurized milk – carries with it a microbiological risk. Under no circumstances should raw milk be consumed by individuals with compromised immune systems, by young children, or by pregnant women. 

Canada's Listeria Outbreaks: The Week In Review

Maple Leaf announced earlier this week that its Bartor Road production plant has been disassembled, was cleaned and sanitized multiple times, and has been tested repeatedly for Listeria monocytogenes. No trace of the pathogen remains, according to Michael McCain, the company's President and CEO.

The plant has been put back together – a feat that Humpty Dumpty never accomplished – and was scheduled to resume production on September 17th. The company is beginning with test runs under close scrutiny from CFIA. No products will be shipped until both the regulatory agency and Maple Leaf are satisfied that the company's enhanced food safety protocols are working as planned.

The plant's shutdown was prompted by a national outbreak of listeriosis traced to ready-to-eat deli products manufactured and packaged at Bartor Road. The outbreak – not yet officially over due to the long incubation period that Listeria monocytogenes is known for – has claimed at least 18 lives in six provinces (an additional 7 deaths are still under investigation). And it has sickened 48 or more people in seven provinces (9 more cases are suspected, but not yet confirmed). Many of the victims were elderly, living in an institution, or already in hospital when they developed their symptoms.

In the face of these statistics, it's easy to complain that CFIA and Maple Leaf are locking the barn door far too late. Had the company or federal inspectors been more rigorous in their surveillance, the outbreak might have been prevented. Had the Ontario Ministry of Health Laboratories been equipped to run genetic fingerprint analyses of Listeria monocytogenes cultures, the outbreak might have been detected much sooner. Instead, Ontario relied on the national lab, based in Winnipeg, MB for the genetic analysis.

Whatever Maple Leaf's past sins of omission and commission might be, the company is trying very hard to regain the confidence of Canadian consumers. Maple Leaf has posted pictures and descriptions of its clean-up operation on its web site. It also has emphasized to the public its commitment to food safety. Maple Leaf is talking a very good game. Whether the company maintains its follow-through will only be revealed over the next year or two.

Québec, too, is coming to the end of its own Listeria monocytogenes outbreak, traced to contaminated cheeses. Twenty-nine confirmed cases have been recorded so far, and one elderly victim died as a result of his/her infection. The contaminated cheeses were distributed through approximately 300 retail stores, where they were cut, packaged and sold. This distribution system resulted in the pathogen being transferred to other cheeses in the stores, greatly complicating both the epidemiological investigation and the recall process.

Not unexpectedly, the outbreaks have triggered political aftershocks. The opposition party in Québec has called for the province's Minister of Agriculture to initiate an internal inquiry into the conduct of his department. The federal opposition – and the families of some victims – have demanded the resignation of the Canadian Minister of Agriculture. 

Canadian Prime Minister Stephen Harper has announced an independent inquiry into the national outbreak. Whether or not this will happen – and what form the inquiry will take – will be determined by who wins Canada's federal election, scheduled for October 14th. 

Allergy Alert: Margaritaville Tortilla Chips

El Matador Enterprises (Grand Rapids, MI) has recalled 13-ounce bags of Margaritaville Island Lime Tortilla Chips, because an undeclared ingredient – whey – was present in the spice blend used to coat the chips. The affected bags are labeled with a Best Before date of December 6, 2008 and a UPC of 647671310122.

Whey is a milk protein, and may cause a severe allergic reaction when consumed by an individual who is allergic to milk. The Tortilla Chips are not harmful to persons who do not suffer from a milk allergy.

Anyone who purchased the recalled product may return it to the store for a full refund. Consumers with questions about this recall should contact Carol Bahri at (877) 791-6767.

Allergy Alert: Undeclared Ingredients In Canadian Products

CFIA has issued two separate allergy recall alerts – one affecting Québec and New Brunswick and the other affecting Ontario.

Cuisine Malimousse Inc. (Saint-Augustin, QC) has recalled all Best Before dates up to and including 2008 DE 02 (December 2, 2008) of Oceania Duo Mousse Lobster with tomatoes & basil / Smoked Salmon & pesto due to improperly declared milk. The product is sold in Québec and New Brunswick in 130 g packages identified with UPC 7 72643 02600 5. 

Cuisine Malimousse agreed to the voluntary recall after it was found that milk was declared as an ingredient on the French portion of the label, but not on the English portion. Individuals who are allergic to milk protein may suffer a severe reaction after consuming a product that contains milk.

Baltic Bread Products Limited (Hamilton, ON) has recalled the following products due to undeclared egg, milk and soy. The recalled items were distributed only in Ontario.

• Babka European Style Coffee Cake, 400 g (UPC 0 64292 00221 0): contains undeclared milk
  
• The Best Apple Pie, 450 g (UPC 0 64292 10212 5): contains undeclared egg and milk
  
• Danish Pastries, 250 g (UPC 0 64292 10219 4): contains undeclared soy
  

Individuals who are allergic to milk, egg, or soy should avoid consuming the indicated products, as they may trigger a severe reaction in sensitive individuals. For more information on these recalls, please call CFIA at 1-800-442-2342.

It's A Wrap: Québec's Salmonella Outbreak - Final Report

It was one of those textbook-style outbreak investigations – the kind that epidemiology lecturers dream of. Quickly noticed. Quickly traced. Quickly over. Here's what happened.

In late August, the Québec Ministry of Health (MSSS) noticed an unusual cluster of salmonellosis reports, all caused by a single genetic strain of Salmonella Enteritidis. An epidemiological traceback pointed to cheeses manufactured by Fromages La Chaudière Inc. The implicated cheeses – available for sale between July 24th and August 24th – were recalled on August 29th.

The outbreak lasted approximately 3 weeks. The 111 confirmed victims reported onset of their symptoms between August 7th and August 26th, with most of the victims falling ill during the August 10-15 time period. No additional outbreak-associated illnesses were reported after the August 29th recall. 

The Salmonella-contaminated cheese claimed one life – an elderly person; at least 40% of the victims required hospitalization. 

Salmonella Enteritidis is a very common serovar in North America, and often has been associated with eggs and egg products. Twenty years ago, before genetic fingerprinting of outbreak strains became readily available, an outbreak of this size might not have been detected. Or, if detected, tracing the source would have been more difficult.

By their ability to spot the illness cluster and trace its source rapidly, Québec Ministry of Health investigators were able to prevent a much larger outbreak. Perhaps the Ontario government, which was forced to send its Listeria monocytogenes isolates to Winnipeg for genetic fingerprinting, should take notice. And take action.

How Many MSU Students Stricken With E. coli O157:H7?

The public relations staffer at Michigan State University who put together today's news release must have failed Communications, Math 101, or both. It's almost impossible to tell how many students may be victims of the E. coli O157:H7 strain that has sent seven students to hospital.

The first report of the campus outbreak indicated that ten students were suffering from "infectious diarrhea" and seven of the ten had been hospitalized. Three of the students were confirmed to have been infected by the same strain of E. coli O157:H7.

According to the update issued today by MSU, all seven of the hospitalized students have been released. The number of lab-confirmed outbreak cases has increased to six. That's straightforward.

But it's difficult to tell how many "probable" cases are still under investigation. The MUS news release refers, in one paragraph, to "... another 13 people who, because they all had cases of bloody diarrhea, are thought to be "probable" victims, although none of these nine students needed to be hospitalized." And in a later paragraph, to "... the additional 17 cases that are in the "probable" category, but not yet confirmed."

So, are there 17 "probable" victims in addition to the six confirmed cases, or 13 "probable" victims, or 9 "probable" victims? Maybe the next update will be more clear. As best we can tell, there may be as many as 23 students who have been affected by this outbreak.

MSU is still conducting an investigation, in cooperation with USDA and the Ingham County health department, to find the source of the E. coli O157:H7 that has invaded its campus. The health department has not asked that any of the campus dining halls be shut down, claiming that the information gleaned so far does not indicate a need to close these down.

MSU continues to ask any students who experience symptoms of gastroenteritis – especially bloody diarrhea – to contact the county health department at (517) 887-4308.

Additional Cheese Recalls In Québec

The Québec Ministry of Agriculture, Fisheries and Food (MAPAC) has announced two additional voluntary cheese recalls today – one due to inadequate pasteurization and the other after Listeria monocytogenes was detected in a sample.

Ferme écologique coopérative d'Ulverton (Ulverton, QC) has agreed to recall cheese produced at their facility because of the risk of Listeria monocytogenes contamination. The cheese was sold in variable weight packages under the brand names "Chèvre des Vallons"  and "Ulvertom" at the company's service counter. None of the recalled cheese was distributed through retail stores. Cheeses purchased on or before September 4, 2008 are included in this recall.

Fromagerie La Voie lactée inc. (L'Assomption, QC) has agreed to recall the following six items:

• L'Apprenti Sorcier (150 g)
  
• Le Funambule (150 g)
  
• Le Grand Manitou (320 g and 1.2 Kg)
  
• L'Ange gardien (180 g)
  
• Le P'tit Dernier (110 g)
  
• Le Petit Portage (1.2 Kg)
  

The voluntary recall includes all of the above-mentioned cheeses sold up to and including September 19th. The recalled cheeses were sold in retail establishments, but the identity and location of the retail outlets has not been revealed.

MAPAC advises that none of the recalled items have been linked to any illnesses. Consumers with questions can contact the Québec government, toll-free, at 1-800-463-5023.

Ike's Aftermath

While the news media are full of stories about the wreckage wrought by Hurricane Ike, especially in and around Galveston, the Texas Department of State Health Services has been doing its best to ward off outbreaks of water-borne and food-borne illness in the aftermath of the hurricane.

The Texas DSHS yesterday warned residents of Galveston Island to leave the area, if they had not already done so, in order to avoid the possibility of contracting an infectious disease. Health authorities reminded residents that:

• There is no running water.
  
• There are no wastewater services.
  
• Toilets have not been flushed in almost a week.
  
• There is limited or no electrical power.
  
• The only medical care available is temporary urgent care.
  

Under these conditions, people who choose to remain in the area risk:

• water-borne disease due to a lack of potable water and an inability to boil water in the absence of electrical power;
  
• food-borne disease due to the lack of refrigeration of perishable foods and the possibility that food might have become contaminated with untreated wastewater; and 
  
• the absence of medical care in the event of a health emergency
  

In a second warning, issued today, Texas warned residents of the state "... not to use any food, drugs, medical devices or cosmetics that have been discarded by stores or pharmacies ..." as these items may have become contaminated during the hurricane, or as a result of flooding after the hurricane, or may have become damaged as a result of exposure to contaminated water, high temperatures, or high humidity.

People who fled the hurricane's path, and those who opted to remain in their homes should heed these warnings. Please wait until DSHS announces that it is safe to return home before doing so. Your health is more important than your home.

Allergy Alert: Albacore Tune Salad Hoagie

Derringer Foodservices Inc. (Cincinnati, OH) has recalled Albacore Tuna Salad Hoagies with an expiration date of 09/17/08. The sandwiches contain egg, which is not mentioned on the ingredient list. The hoagies, which are sold in food vending machines in the region, are packaged in 7-ounce black plastic packages.

The egg is a component of "reduced fat mayonnaise" used to prepare the tuna salad. Sensitive individuals may develop an allergic reaction as a result of eating an egg-containing food. The oversight was due to a temporary ingredient substitution during manufacture. 

For more information about the recall, consumers can contact Derringer at 1-800-537-0156.

China's Adulterated Milk - How Far Did It Travel?

China's melamine-adulterated milk scandal keeps growing larger. The chemical adulterant has been detected in fluid milk, ice cream and yogurt, in addition to milk powder. 

Countries that have imported dairy products from China are scrambling to determine whether those products are adulterated.

• Hong Kong found melamine in eight dairy products manufactured by Yili – one of the two largest dairies in China, and one of the 22 dairies implicated in the melamine investigation – and has ordered a recall of all Yili dairy products in the Territory. The Centre for Food Safety announced that it was testing infant milk powder available for sale in the former British Crown Colony even though government authorities had been assured that the milk powder sold in Hong Kong contained no ingredients from the mainland.
  
• Singapore's Agri-Food and Veterinary Authority has ordered all Yili dairy products removed from store shelves, and is testing samples of Yili products and those from another Chinese dairy company.
  
• Bangladesh has initiated testing of milk powder imported from China. The government indicated that it would impose a ban milk imports from China if melamine is found in any of the samples.
  
• The UK Food Standards Agency issued an advisory to consumers, stating that there is "... currently no evidence that any of the affected milk, milk powder or powdered infant formula has been imported into the UK." The Agency added that it would continue to monitor the situation.
  
• CFIA issued an advisory to Canadians to avoid purchasing infant formula manufactured in China, which may be found in some ethnic food stores. Canadian inspectors are checking retail stores for the imported baby formula, and CFIA has initiated a border watch. The advisory also indicated that Health Canada had contacted Canada's four major infant formula manufacturers to confirm that none of them had used ingredients from China. T&T Supermarket, a major Chinese supermarket chain, announced that it was removing two yogurt drinks manufactured by Mengniu – one of the large Chinese dairy companies implicated in the melamine probe – from its store shelves. T&T has stores in British Columbia, Alberta and Ontario. 
  
• FDA issued a Health Advisory to US consumers, warning that infant milk powder formula available in some ethnic stores might contain melamine. The federal agency urged consumers to avoid using the imported infant formula. Milk powder from China is not an approved ingredient for infant formula produced in the United States. 
  
• New Zealand has begun a random sampling of milk-containing products from China sold in Asian supermarkets.
  

There's bound to be more repercussions as the scope of China's adulterated dairy scandal becomes more clearly defined.

It's Mainly Because of the (Deli) Meat...

Canadian old-timers might remember the Dominion Store ad jingle. It would appear that, as far as Listeria monocytogenes is concerned, there is an extra layer of meaning in that old slogan.

On May 14th, Smith's Snacks Service, Ltd. (Norman Cove, NL) recalled a single production lot of its Small Sub sandwiches, after CFIA detected Listeria monocytogenes in a sandwich sample. 

One week later, the company recalled a second sandwich – Chicken Club Twister – for the same reason. Both sandwiches carried a Best Before date of JUN/08/08, and both were distributed in Newfoundland and Labrador.

After the second recall, Smith's halted production, arranged for microbiological analysis of its stock of sandwich ingredients,  and carried out an extensive clean-up and sanitation. The company vice-president acknowledged to CBC News that they should have shut down after the initial finding, but pleaded inexperience with the problem.

But Listeria monocytogenes is a poltergeist and SHE'S BAAAAAACK!

Late yesterday, Smith's announced a recall of all date codes of its entire outstanding product line - 31 different products. Once again, Listeria monocytogenes has been given as the reason for the recall. The following products (UPC codes begin with 623858) have been recalled:

Deli Lean Ham, Blackforest Ham, Breakfast Ham, Turkey Breast Roast, Chicken Breast Roast, Roast Beef, Large Sub, Large Pizza Sub, Twin Pack, Small Sub, Chuckwagon, Pizza Sub, Chicken Sub, Double Burger, Bacon Egg Cheese, Bacon Cheese Dog, Club Sub, Deli Deluxe, Deli Twister, Hungry Human, Turkey & Dressing, Turkey, Hot Club, Beef & Cheddar, Ham & Cheddar, Egg Salad, Chicken Club Twister, Ultimate Club, Apple Turnover, Blackforest Cake, and Cherry Cream Cheese Turnover.

The recall announcement does not specify whether Listeria monocytogenes was found in a finished product, in an ingredient, on a piece of equipment, or elsewhere in the production environment (e.g., a floor drain) in the Norman Cove facility. But the breadth of the recall would point to the likelihood of an environmental or equipment contaminant.

There have been no retail-level recall announcements as yet. We'll report those if and when they take place. For now, consumers in Newfoundland and Labrador should avoid consuming any Smith's Snacks products.

Allergy Alert: Mut Gung Sweetened Ginger

K-Fat Inc. has recalled 150-gram clear plastic containers of Mut Gung Sweetened Ginger, due to the presence of undeclared sulfites. The recalled item was sold nationally through retail stores and by mail order.

The recall was initiated after the New York Department of Agriculture and Markets detected sulfites at a level of 94.5 mg per serving. Sulfites can cause serious – even life-threatening –allergic reactions in sensitive individuals, especially those who suffer from asthma.

Consumers who purchased the recalled product can return it to retailer for a full refund.

Allergy Alert: Ralston Recalls Instant Oatmeal

Ralston Foods announced earlier this week that it was recalling 14,664 cartons of Western Family Variety Pack Instant Oatmeal cereal bearing a "Best if used by" date code of DEC0409N. A small number of cartons contain an undeclared milk ingredient.

Individuals who are allergic to milk may suffer severe – possibly life-threatening – reactions upon consuming this product. Other consumers may eat the oatmeal without risk of adverse reaction.

Ralston initiated the recall after learning that "fruit and cream" instant oatmeal packets had been accidentally included in some variety pack cartons. Consumers who purchased the recalled cereal can return the product to the store for a full refund.

Bimbo Bakeries Recalls Oroweat

Bimbo Bakeries issued an allergy alert to its customers earlier this week and has recalled Oroweat 100% Whole Wheat bread, which was baked in its Denver plant. The affected packages sport red, blue or tan closure tabs labeled with a Best Buy date of 9/22, 9/23 or 9/25.

The recalled bread, which may contain tree nuts not mentioned on the ingredient list, was distributed for retail sale in Iowa, Wyoming, Nebraska, Colorado, New Mexico and Moab, UT. 

Most consumers can eat the recalled product without suffering any ill effects. But individuals who are allergic to tree nuts may develop severe – possibly life-threatening – reactions on consuming this bread. 

The bread may be returned to the place of purchase for a refund. For more information about the recall, contact Bimbo Bakeries at 877-224-7374.

"Sorry" Isn't Good Enough

Three babies are dead, 1,327 are in hospital – 158 with severe kidney failure – and 6,244 infants have been sickened so far, after having been fed melamine-adulterated baby milk formula. 

Melamine is an industrial chemical and is not a permitted food additive. It apparently was added to watered-down milk supplied to San Lu and other Chinese dairy companies so that the diluted milk would not fail a standard protein content test. Melamine cannot be distinguished from protein in standard lab tests; its presence produces a falsely high protein content reading. 

In response to the health emergency, the Chinese government conducted an urgent inspection of all 109 domestic milk powder producers. Sixty-nine out of 491 batches tested by the government have been found to contain melamine. 

The 69 contaminated batches were produced by 22 different companies – 20% of the country's milk powder producers. The highest melamine concentration, 2,563 mg/Kg, was discovered in a sample of San Lu milk powder. Positive samples from other milk powder companies contained far less melamine –  from 0.09 mg/Kg to 619 mg/Kg.

China has arrested four suspects at this stage in its investigation – all of them milk dealers who supplied San Lu. An additional 22 people have been detained for questioning.

The scandal has prompted a flurry of news releases – from companies announcing recalls, from companies announcing that their milk was melamine-free, from foreign companies who hold a stake in a Chinese dairy company, and from the Chinese government.

• Synutra International Inc. announced a recall of its U-Smart milk powder, while pointing out that the melamine content of its product was "only" 150 mg/Kg, compared to San Lu's 2,563 mg/Kg. The company also announced a precautionary recall of all products manufactured using milk from Heibei and Inner Mongolia, the two regions implicated in the melamine adulteration.
  
• Yayi International Inc., and Emerald Dairy Inc. both announced that their samples had passed the government's tests, and both companies reaffirmed their commitments to quality and safety.
  
• Arla Foods, a Swedish dairy company advised that its Chinese joint-venture partner, Mengniu Dairy, was caught up in the scandal. Three Mengniu products tested positive for melamine. Arla announced that the adulterated milk powder was being recalled and production had been halted at the Mengniu facility. And Mengniu suspended trading in its stock on the Hong Kong stock exchange on Wednesday, but gave no explanation for its action.
  
• The Hong Kong Centre for Food Safety reported having detected melamine in a Natural Choice yogurt-flavored ice cream bar, produced by Shanghai Yili AB Foods. CFS suggested that the ice cream may have been contaminated by utensils used during manufacture. The contaminated product is being recalled.
  
• And Fonterra – the New Zealand partner of San Lu, the Chinese company in the center of the storm –  announced the recall of ANMUM Materna brand prenatal milk. There have been no illnesses linked to this product. It was, however, also manufactured and distributed by San Lu.
  

The formal apologies are piling up. The chairwoman and general manager of San Lu Group has been fired, and the vice secretary of the Shijazhuang Municipal Committee has been removed from his post.

China placed great emphasis, in the months and weeks leading up to the Olympic games, on its advances in food safety regulation. The Chinese government promised a food-safe Olympic games. And it delivered on that promise. Aside from one or two very minor incidents, there were no reports of food poisoning among the athletes and officials who participated in the games.

But it's hard not to wonder whether San Lu's management dragged its feet in responding to the melamine situation. As we reported on Monday, San Lu management reported the problem to its Board of Directors on August 2nd – 6 days before the Olympic Games opening ceremonies. Yet the company decided against a public recall, despite Fonterra's attempts to convince San Lu that a public recall was necessary. 

Another major food adulteration scandal just before the opening of the Olympic Games would have caused a major loss of face for the Chinese government. And nothing is more important than face. 

A senior marketing lecturer at Massey University in New Zealand offered the opinion that Fonterra had no choice but to adapt to Chinese traditional ways if it wanted to continue doing business in that country. 

"You don't want to go public," Henry Chung told the New Zealand Herald, "unless it is absolutely necessary. It's face saving that is a key issue in doing business in China."

Unfortunately, in an effort to save face, Fonterra, San Lu, and a number of Chinese government officials broke faith with the most helpless segment of the Chinese population – nursing babies. 

"Sorry" isn't good enough. Words are cheap. Actions are what count.

"Big Eddie" Coli Visits MSU Campus

E. coli O157:H7 "Big Eddie" seems to have developed an interest in higher education this year. Once again, he has paid a visit to a university campus. 

In July, Big Eddie turned up at the University of Guelph (Ontario, Canada), where he sickened at least 8 people before the outbreak was "declared over" on August 14th by the local public health authorities. At the peak of the outbreak, health officials were reporting as many as 20 potential outbreak victims. 

The August 14th statement indicated that the final number of confirmed victims could rise, but no follow-up report has been issued. The Guelph outbreak was blamed – in the absence of other, provable, causes – on an ill food service worker who hadn't washed his hands adequately.

Having graduated from University of Guelph with a B.Sc. in food-borne mayhem, Big Eddie has enrolled at Michigan State University for a graduate degree. 

The Ingham County Health Department advised MSU officials on September 15th that 10 students had been diagnosed with infectious diarrhea. Seven of the students are hospitalized and three have been confirmed to be carrying the same strain of E. coli O157:H7. The students began to experience gastrointestinal symptoms between September 8th and 11th, leading health officials to believe that they were exposed to the pathogen between September 5th and 8th – or possibly earlier.

Health officials are asking any additional students who have experienced gastrointestinal distress during the same time period to come forward. And MSU staff is reviewing student "card swipe" records to identify the on-campus locations where the stricken students ate.

It's ironic that both the University of Guelph and Michigan State University are known for their strong food safety research and education programs. Two such outbreaks can be shrugged off as coincidence. But we'll be watching for "Big Eddie" sightings at places like University of Wisconsin-Madison, Kansas State University, Cornell and UC-Davis.

Canada's Listeria Outbreaks Tapering Off

With no new recalls to report, and both the cheese and deli meat outbreaks winding down, it's time for a brief update on the case tallies for these Made-in-Canada Listeria monocytogenes outbreaks.

The Public Health Agency of Canada released its latest update of illnesses and deaths related to the consumption of Listeria monocytogenes-contaminated meat produced by Maple Leaf Consumer Foods. As of mid-afternoon today, the key statistics are as follows:

• Total confirmed cases: 47
  
• Total suspected cases: 9
  
• Deaths where listeriosis was contributing cause: 16
  
• Deaths under investigation: 8
  

Confirmed cases in this outbreak have been reported in seven provinces: Ontario (36 cases, 14 deaths), British Columbia (4 cases, 1 death), Alberta (2 cases, 1 death), Saskatchewan (1 case), Manitoba (1 case), Quebec (2 cases), and New Brunswick (1 case). 

New Brunswick's lone victim of the national outbreak was an elderly woman who lived in a nursing home, and who died recently in hospital. The province received confirmation earlier today that the woman had become infected with the outbreak strain of Listeria monocytogenes. This death is still showing as a case under investigation in today's PHAC update.

Québec posted an update this morning on its cheese-linked Listeria monocytogenes outbreak. The province has confirmed 28 cases so far, including one death – an unidentified person  in his or her 70's. Twenty of the 28 victims were women – 9 of them pregnant. Four of the pregnant victims gave birth to infected babies. A fifth child, not included in the official totals, was still-born. All of the remaining victims were adults, aged 28 to 89 years.

The people most susceptible to serious illness as a result of Listeria monocytogenes infections are the elderly, the very young, people who are immune-deficient, and pregnant women. And these outbreaks were no exception. A disproportionate number of the reported victims were elderly, already in hospital, or were pregnant. 

These outbreaks are a sharp reminder that foods at elevated risk of Listeria monocytogenes contamination – soft cheeses, raw milk, ready-to-eat deli meats, and smoked fish – should not be on the menus of nursing homes or hospitals. Nor should pregnant women consume these foods. 

The consequences of infection are too severe.

Oklahoma: Closing The Books On An Outbreak

The Oklahoma State Department of Health reported today that the E. coli O111 outbreak that killed one person, sickened at least 314, and caused a popular buffet restaurant to close, is officially over. At least 72 of the outbreak victims were hospitalized; 17 of them required dialysis treatment.

No one has fallen ill since September 6th, according to the state. And that means we are now outside the expected maximum incubation period.

In a herculean effort to determine the source of the outbreak, OSDH, aided by CDC and local health officials, interviewed 1,843 people. The results of those interviews are still being collated and analyzed. But the odds that these interviews will yield a conclusive answer are vanishingly slender.

Today's report made no mention of the outbreak cluster associated with the a Church event catered by the Country Cottage restaurant. Implicitly, however, OSDH did not exclude this cluster. The report states:

"All known cases had association with the Country Cottage restaurant in Locust Grove, OK. The spread of E. coli O111 in this outbreak was directly related to the restaurant."

"Association" can include direct association (worked at or ate at the restaurant), indirect association (ate a meal at a venue catered by the restaurant), or secondary infection (became ill as a result of contact with an infected individual).

 

There is no indication when – or if – the restaurant will reopen. Nor do we know when – or if – OSDH will reveal the final results of their outbreak investigation.

PetSmart Poo-Poo's Pedigree® Problem

PetSmart is a retailer of Pedigree® dry dog foods, including one item that is part of this month's Mars Petcare recall. The company has posted a notice on its web site alerting customers to the Pedigree recall.

But the wording of the PetSmart recall notice downplays the seriousness of the risk to pet – and human – health. PetSmart makes the following statements (highlighted in red) in its recall announcement.

"There has been no confirmed link established between the recalled products and any human cases of salmonella"

This statement matches a statement contained in the FDA recall notice. But the FDA notice also makes it clear that Salmonella Schwarzengrund – the cause of the two human cases of salmonellosis that triggered the investigation and recall – was detected in Mars Petcare's Everson, PA production facility.

"Dogs cannot get sick from this particular strain of salmonella"

There is no scientific justification for this statement. PetSmart gives no reference or background information to support this totally unsubstantiated claim. Nor can we find anything in the scientific literature to support PetSmart's statement. 

It's true that no dog illnesses have been linked to this present group of recalled products. It's also true that no dog illnesses were traced to the large number of Salmonella Schwarzengrund-contaminated Mars Petcare products that were recalled in 2007 after a multi-state outbreak of salmonellosis was linked to the pet foods. 

But the outbreak strain of Salmonella Schwarzengrund was found in stools from several dogs during the investigation of the 2007 outbreak. And those dogs had eaten a pet food produced in the Salmonella Schwarzengrund-contaminated Pennsylvania facility. Any pet that carries a pathogen in its stool can transmit that pathogen to its human companion – as likely happened in several of the 2007 outbreak cases.

"We don't believe there is any cause for alarm."

This is the second time in less than a year that Mars Petcare's Everson facility has been the focus of a major recall after its products were linked to human cases of salmonellosis. Both times, the same serovar – Salmonella Schwarzengrund – was recovered from the victims and from the production plant environment. Mars Petcare was dilatory in announcing the recall (more than one month after it stopped production at the Everson facility). But, at least, Mars has urged customers to return or discard recalled products, and has given consumers an easy way to determine whether the product they had purchased was part of the recall.

It's hard enough to achieve a successful and complete product recall under the best of circumstances. Why is PetSmart making it more difficult by minimizing the urgency of thisrecall?

China's Food Safety Mindset: Has Anything Changed?

Two babies have died and at least 1,253 have been afflicted with kidney stones after being fed melamine-contaminated Sanlu brand powdered milk baby formula.

Sanlu Group has issued a public recall of 700 tonnes of baby milk formula produced before August 6, 2008. Chinese police, as part of a government investigation into how the melamine was introduced into milk sold to Sanlu, have questioned 78 people and detained 19 of them. China is conducting a nation-wide inspection of baby milk powder in response to the contamination crisis, and has promised to publicize the results. And the Chinese government has announced that the sick infants will benefit from an all-out treatment effort at government expense.

That's the good news. Here's the rest.

• Melamine was added deliberately to milk supplied to Sanlu Group, or to the milk powder, in an effort to boost the apparent protein content – just as was done in the case of wheat gluten that found its way last year into pet foods manufactured in the United States and Canada.
  
• Sanlu received complaints about the milk powder as early as March. Internally-conducted tests of the milk powder detected melamine in August. Yet the company remained silent.
  
• Sanlu informed its Board of Directors of the contamination problem on August 2nd. Fonterra (the New Zealand dairy cooperative that holds a 43% share of Sanlu) urged the company to initiate a public recall immediately. Sanlu declined to do so, opting instead for a trade-level recall.
  
• Sanlu's initial reaction when the story of sick infants first broke was to blame a "market pirate" for the poisoning. Only after the government investigation began did Sanlu change their story.
  
• A spokesman for the Gansu provincial health department stated that the department had investigated a hospital report about babies with kidney disease received on July 16th. All of the infants had been fed Sanlu baby milk powder formula. Gansu forwarded the report to the Ministry of Health, but no significant action was taken.
  

The Chinese government has been working for several months on a new food safety law. The most recent draft highlights the "social responsibility" of food producers and marketers. 

But it will take more than fine words in a government document to change the country's food safety mindset. It will take a major education and regulatory effort on the part of the Chinese government to bring the safety of the domestic food supply up to a reasonable standard.

Oklahoma E. coli O111 Investigation: Last Unturned Stone

State and federal health officials who are investigating the E. coli O111 outbreak that has sickened at least 291 people have almost run out of leads. The Oklahoma State Department of Health and the CDC have explored all the usual avenues of investigation, without success.

• Well water: No E. coli O111.
  
• Restaurant food samples: No E. coli O111.
  
• Restaurant food preparation/service surface swabs: No E. coli O111.
  
• Interview of victims and healthy restaurant patrons: No clear-cut indication of contamination source.
  
• Interview and testing of employees: No E. coli O111 found, although several employees reported being ill.
  

Investigators are in the process of turning over the last stone. A separate cluster of illnesses recently came to light, involving attendees at a Ladies' Tea held August 16th at the Bethany Free Will Baptist Church in Broken Arrow. The event was catered by the Country Cottage restaurant. At least 30 of the 250 participants complained of gastroenteritis. 

OSDH and CDC investigators are interviewing attendees of the Ladies' Tea in the hopes that this will help to reveal the source of the Country Cottage outbreak. Apparently, the range of food items served at the Tea was more limited that what was available at the restaurant during the August 15-17 weekend – the time frame when most of the outbreak victims ate at the Country Cottage.

It's not surprising that investigators are coming up with empty hands. Water, swab, and food samples were only taken several days after the weekend when the contamination is thought to have occurred. Persons who have suffered an infection with a gastrointestinal pathogen often will not continue to excrete the pathogen in their stools. And the nature of the restaurant's format – a large buffet – makes it very difficult for patrons to recall exactly what they did, or didn't eat.

Unless the Ladies' Tea produces a miracle, this outbreak will likely be added to the "cold case" list of unsolved epidemiological mysteries.

When Will Mars Petcare Come Clean With Pet Owners?

Pet owners woke up this morning to the news of yet another major recall of dry dog and cat food. The recalled items, which may be contaminated with Salmonella Schwarzengrund, were manufactured in the Everson, PA facility operated by Mars Petcare.

According to the recall notice, Mars claims to have initiated the recall as a "precautionary measure" after it was alerted to "... a possible link between dry pet food produced at the plant and two isolated cases of people infected with Salmonella Schwarzengrund."

Yesterday evening's recall is the most recent in a series of reports of Salmonella contamination and illness outbreaks associated with products from the Everson facility. Let's review the time line.

• September, 2007: CDC reports that pet food manufactured in a Mars Petcare plant located in Pennsylvania was linked to an 18-state outbreak of Salmonella Schwarzengrund. The outbreak began in January 2006, and dragged on until September 2007. The outbreak strain was recovered from the stools of two dogs living in the homes of outbreak victims, and in the environment of the production facility. It was also recovered from unopened bags of two brands of dog food produced in the Pennsylvania facility. Mars recalled selected bags of those two brands on August 21, 2007. Because the outbreak strain was not isolated from unopened bags of the brands that were purchased by outbreak victims, Mars got away with a very limited product recall.
  
• July 29, 2008: Mars Petcare shuts down its Everson, PA production facility after an isolate of Salmonella Schwarzengrund detected in the plant environment was a match for the strain that sickened two individuals.
  
• August 10, 2008: Mars Petcare announces a limited recall of Pedigree® Complete Nutrition Small Crunchy Bites (20 lb. bags) due to possible contamination with Salmonella (no mention of whether or not this also was Schwarzengrund). The company claimed that this was due to an "on hold" Salmonella-positive ingredient having been shipped in error to their Tracy, CA manufacturing facility. The recalled items were, according to Mars, sold only through Albertson stores in Las Vegas and Southern California.
  
• August 14, 2008: The California Department of Public Health advises consumers that the recalled pet food also was sold in Costco stores in California.
  
• September 12, 2008: Mars Petcare announces its product recall of all dog and cat foods manufactured in the Everson facility between February 18, 2008 and July 29, 2008.
  

Mars Petcare clearly is more protective of its profits than of its customers and their pets. The company recalled as little product as it could get away with in response to the 2007 outbreak. It failed to eliminate the source of contamination in its Everson facility. The company minimized the scope of its August 2008 Salmonella problem. And Mars Petcare delayed for more than a full month – from July 29th to September 12th – before announcing its most recent recall.

We don't yet know whether or not the same strain of Salmonella Schwarzengrund was the cause of both the 2006/2007 outbreak and this year's illnesses. But it would not be a surprise to find out that the same strain is behind both outbreaks.

Mars Petcare boasts that "[t]he love for dogs and cats is big business at Mars Petcare." It would appear that the company trades on their customer's love for dogs and cats to generate big business for Mars Petcare,  and for its parent company, Mars, Incorporated.

Got Campylobacter - Again!

The Pennsylvania State Health Secretary warned consumers yesterday that raw milk purchased from Hendricks Farm & Dairy (Telford, Montgomery County, PA) may be contaminated with Campylobacter and should be discarded. The dairy's raw milk permit has been suspended.

As we pointed out just two days ago, Campylobacter infections have been linked to consuming raw dairy products on numerous occasions. And this recall is just one more piece in the recurring pattern.

According to Health Secretary, Dr. Calvin B. Johnson, there have been seven confirmed cases of Campylobacter infection among raw milk consumers in seven unrelated households in Pennsylvania and a neighboring state. He did not name the other state.

Consumers may purchase raw milk legally in Pennsylvania from licensed, inspected dairies. As of August 13, 2008, 115 dairies were licensed by the state to sell raw dairy products. Licensed dairies must meet specific sanitary standards and microbiological testing requirements, including a total coliform limit of 10 per milliliter. These requirements clearly were not enough to prevent the contamination of raw milk at Hendricks Farm.

Anyone who has consumed raw milk or other raw dairy products from Hendricks Farm, and who has since experienced symptoms of gastroenteritis should seek immediate medical attention. Young children, especially, are at risk of severe dehydration from symptoms of gastroenteritis.

Ivanhoe Recalled Cheese List Corrected by CFIA

CFIA announced yesterday evening that its recall notices issued September 10th and 11th that identified Ivanhoe cheeses bearing code 3070 as being possibly contaminated with Listeria monocytogenes were in error. Those cheeses have been removed from the CFIA consolidated recall list.

Instead, the following Ivanhoe cheeses have been added to the list of recalled Ivanhoe cheeses:

• Great Canadian brand Shredded Marble Cheese, 400g, code 1089, UPC 0 68642 00211 0
  
• Great Canadian brand Shredded Marble Cheese, 200g, code 1089, UPC 0 68642 00201 1
  

The eFoodAlert posts mentioning the recall of Ivanhoe code 3070 cheeses have been removed from this site.

For more information, consumers should contact the Ivanhoe Consumer Hotline, toll-free, at 1-888-473-4269.

Pedigree Dog Food Recalled Due To Salmonella - Again

Mars Petcare US announced today that it was recalling all products manufactured at its Everson, PA facility between February 18, 2008 and July 29, 2008, after the same strain of Salmonella Schwarzengrund that sickened two pet owners was also detected in the Everson plant.

Mars was quick to add that none of the samples of pet food found in the consumers' homes were found to contain the Salmonella, and that the pets living in those homes had not become ill. Nevertheless, the company has ceased production in Everson until the source of the contamination can be found and removed. The company did not explain why it waited more than a month after stopping production before it initiated the product recall.

The list of recalled products is extensive, and can be found on the Mars Petcare News Release. The products were distributed through Giant Food and Stop & Shop stores, and may also have been distributed through other major food chains.

Please check the recall notices posted so far. We'll be adding to the list as more information becomes available.

"Meals on Wheels" Frozen Entrée Recalled

Private Recipes Limited (Brampton, ON) has recalled its Private Recipe brand Creamed Salmon with Mashed Potatoes & Glazed Carrots frozen meal, because of a risk that it may be contaminated with Listeria monocytogenes, according to an announcement this evening by CFIA.

The frozen entrée was supplied to "Meals on Wheels" and other charitable organizations for distribution in British Columbia, Ontario and New Brunswick. The recalled 370-gram entrée bears item number 12012 and a Best Before date of 2009 JN 06.

There have been no illness reports associated with this recall. 

Maple Leaf Listeria: Aftermath Of An Outbreak

As this tragic outbreak drags on, updates posted by provincial health authorities sometimes overtake the timeliness of the federal data. Such is the case today.

We are still waiting ( at 7:00 pm) for the Public Health Agency of Canada's daily update on the illness and death totals in the Maple Leaf outbreak. As of 4 pm yesterday (Sept. 11th), PHAC posted the following totals:

• Confirmed cases: 43 (34 in Ontario)
  
• Suspect cases: 19 
  
• Confirmed deaths attributed to the outbreak: 16 (14 in Ontario)
  
• Deaths under investigation: 5 
  

These numbers already are out of date. Ontario reported today that one of its suspect cases had been confirmed as part of the outbreak, raising the province's total to 35 confirmed cases. And Manitoba also reported today that its sole suspect case of listeriosis had been linked definitively to the outbreak.

It's far too easy to get caught up in the statistics, though, and to ignore the other ramifications of this national outbreak.

Impact on the lives of victims and their families. 

At least 16 – perhaps as many as 21 – families are mourning the untimely loss of a family member who did nothing more nefarious than eat deli meat processed and packaged at Maple Leaf's Bartor Road plant. Dozens of additional families have had their lives disrupted due to the illnesses suffered by outbreak victims who recovered.

Impact on Maple Leaf employees and shareholders.

The recall, alone, has cost the company approximately CDN$20 million. To this must be added the cost of lost business, and job layoffs. Probably, the company also will find itself spending a significant amount of money – either voluntarily or as a result of court proceedings – to compensate victims and their families. Maple Leaf is fortunate that Canada provides universal health care. And it's anyone's guess when – even whether – the Bartor Road facility will reopen.

Impact on the Canadian taxpayer.

Because Canada provides universal health care to its citizens and legal residents, the bulk of the medical costs incurred by outbreak victims will be borne by Canadian taxpayers. In addition, CFIA, PHAC and provincial health departments have had to carry the cost of the outbreak investigation and recall oversight.

Impact on the reputation of Canada's food safety system.

It's difficult to understate the impact of this outbreak on Canada's international food safety reputation. Canada's reputation already had been damaged by the slow, steady drip of reported BSE ("mad cow") findings. Now the country's processed meats also will be viewed askance. Mexico and China both halted the importation of Maple Leaf sausage casings after the outbreak was announced, even though the casings were produced at a different location from the contaminated deli meats. 

Impact on the meat industry.

As we reported previously, CFIA has advised all Canadian meat processors to disassemble, clean and sanitize their slicing equipment – a costly interruption of their normal production and cleaning cycles. Formax, Inc. has initiated a review of its recommended sanitation and operating instructions for its model S-180 slicer – the equipment that had harbored Listeria monocytogenes in Maple Leaf's Bartor road facility.

Impact on the just-announced Canadian elections.

The blame game began almost as soon as the outbreak was announced. At the federal level, the Liberal opposition party cast aspersions on the actions of the ruling Conservative Party. In Ontario, the opposition parties blamed the Liberal Party Premier Dalton McGuinty. Dr. Donald Low, Medical Director of the Ontario Public Health Laboratories, blames the lack of genetic typing facilities in the provincial lab for delays in recognizing the outbreak. The need to send isolates of Listeria monocytogenes from suspect meat and from patients to the national reference center (located in Winnipeg) for genetic fingerprinting cost several days.

Impact on the confidence of Canadians in the safety of the country's food supply.

This confidence has been badly shaken – by the Canada-wide Maple Leaf outbreak, the Ontario-wide recall of Ivanhoe cheeses, and the outbreaks of Salmonella and Listeria monocytogenes associated with cheeses in Québec.

Anyone for an "old-fashioned" Montreal Smoked Meat on rye?

China Recalls Melamine-Laced Baby Formula Powder

The Chinese government has ordered a recall of 700 tonnes (772 US tons) of Sanlu Bei Bei Infant Powder after one infant who was fed the milk powder died, and 50 others were hospitalized with kidney stones, according to an AP report carried by CBC. 

The recall is in sharp contrast to Sanlu's earlier protestations of innocence. The company claimed, at first, that a "market pirate" had sold sub-standard milk powder under the Sanlu name. Sanlu is 43% owned by Fonterra Cooperative Group, a New Zealand dairy company. To the best of Fonterra's knowledge, none of the contaminated milk powder was exported from China.

US manufacturers of infant formula do not use imported ingredients in their products. FDA, however, is concerned that some of the contaminated milk powder may be available for sale in Asian ethnic food stores. The agency is working with state health agencies across the country to alert the Asian community to the danger. 

This recall is the first major post-Olympic Games food poisoning scandal to hit China. It has dealt a serious blow to the PRC's attempt to present a new food safety face to the world. The Chinese government has reacted swiftly and strongly to the incident, and has promised "serious punishment" for the guilty party.

Got Campylobacter?

Campylobacter, year after year, is one of the two most common foodborne bacterial causes of gastroenteritis in the United States, with Salmonella being the other. No other species of bacteria – not E. coli O157:H7, not Listeria monocytogenes – even comes close.

Campylobacter, which can be carried in the intestines of birds and mammals, usually is spread through fecal contamination of food or water. Most human infections result from the drinking contaminated water, eating raw or undercooked contaminated meat or poultry, or consuming contaminated raw milk.

The World Health Organization has this to say about Campylobacter and raw milk:

"There are no proven intervention methods to reduce Campylobacter in cattle farms. Prevention of the contamination of raw milk on the farm is not consistently possible; therefore, consumption of raw milk should be avoided."

This statement on the part of WHO is reinforced regularly by the detection of Campylobacter in raw milk sold to retail consumers – in stores, where legal, or through cow-share programs – in the United States. And that message is further underscored by the periodic cases of Campylobacter gastroenteritis that are traced back to contaminated raw milk. Here are just a few recent examples.

• On December 17, 2007, the State of Washington warned consumers against consuming raw milk with a 12/20 "sell by" date from the Pleasant Valley Dairy, after detecting Campylobacter in a sample of the milk. The milk was linked to five cases of Campylobacter gastroenteritis.
  
• In April 2007, New York State issued a recall of raw milk from the Phil Stauderman farm after finding Campylobacter in the milk. There were no illnesses specifically associated with that recall.
  
• In April 2007, the Pennsylvania Department of Agriculture warned consumers about Campylobacter-contaminated raw milk from the Amos B. King dairy farm in that state.
  
• In August 2008, an outbreak of Campylobacter gastroenteritis that caused 15 people to fall sick, convinced Alexandre Family EcoDairy Farms, a northern California dairy, to end its raw milk program. One of the victims was hospitalized with Guillain-Barré syndrome, a form of paralysis that occasionally results from Campylobacter infections.
  

And today, the California Department of Food and Agriculture advised consumers that it had detected Campylobacter in Grade A raw cream from Organic Pastures of Fresno County. The contaminated cream, which bears a code date of Sep 12, is the subject of a statewide recall and quarantine.

This is not the first time that Organic Pastures has been the subject of a recall or regulatory action. The company's raw dairy products have been linked in the past to an outbreak of E. coli O157:H7, and have also been the subject of a recall due to Listeria monocytogenes. And the owner of Organic Pastures also has crossed swords with FDA for attempting to contravene the federal regulation against interstate transport of raw milk for retail sale.

As we've pointed out several times, consuming raw milk exposes individuals to an unnecessary risk of infection with Listeria monocytogenes, Salmonella, Campylobacter and E. coli O157:H7. Young children are especially susceptible to severe – sometimes life-threatening – illnesses when infected by one of these pathogens. 

Think before you drink.

Oklahoma E. coli Investigation Running Out Of Gas

Oklahoma's State Department of Health reported today that none of the food samples submitted for lab analysis yielded E. coli O111. 

While waiting for the lab results, investigators continued with their interviews yesterday, and now have spoken with more than 1,500 restaurant patrons. OSDH continues to beat the bushes in an effort to uncover additional people to interview, but the state is probably coming face-to-face with the law of diminishing returns.

The extensive series of interviews has turned up additional cases of E. coli O111 gastroenteritis. OSDH now says that at least 248 people fell victim to the outbreak – 202 adults and 46 children. Sixty-four people were hospitalized, and 16 of them required dialysis. Nine of the dialysis patients were children.

In an interview yesterday, the State Epidemiologist, Dr. Kristy Bradley, spoke for the first time of the possibility that a restaurant employee might have been a carrier of the outbreak strain. According to Dr. Bradley, the Country Cottage employed 58 food handlers. 

We suggested several days ago that a human carrier might be the source of the outbreak. OSDH has been very forthcoming in discussing the number of interviews it is conducting, and releasing the negative lab results obtained from environmental and equipment swabs, food samples and well water. But Dr. Bradley has said nothing at all about the Department's investigation – if any – of restaurant employees.

Have we missed something?

Creamy Soup and Cut-Rate Milk Power: A China Connection?

Campbell Soup Asia Limited, a Hong Kong-based company, has recalled two varieties of canned soup because of an unspecified off-smell, according to an announcement made by Hong Kong's Centre for Food Protection.

The recalled soup products are:

• Condensed Cream of Mushroom Soup (405g/14.3 oz)
  
• Condensed Creamy Chicken Mushroom Soup (410g/14.5 oz)
  

No production codes or lot numbers have been indicated. Consumers, merchants and anyone else in need of additional details should contact Campbell Soup Asia at: 3128 8022.

Separately, China's Xinhua News Agency reports that 14 babies have been hospitalized with kidney stones in Gansu province. All of the infants – none of them older than 11 months – had been fed Sanlu milk powder, described as a "cheap" brand in the news report. Sanlu Group is blaming the problem on "market pirates" and has sent its own investigators to the region to look into the problem.

Is this coincidence, or has some sub-standard milk powder found its way into those Campbell "creamy" soups?

Métro Richelieu Recalls Ham

Métro Richelieu (Montreal, QC) has recalled Merit Selection Delicatessen Cooked Extra Lean Ham, distributed to stores in 4.5-kilogram logs and carrying a "Best Before" date of OC 12, because the ham may be contaminated with Listeria monocytogenes.

The product was distributed to Métro, Richelieu, Ami and Extra stores in the province of Québec. It was sliced in the stores and sold at in-store deli counters between August 13th and September 10th.

This recall is completely unrelated to the Maple Leaf Listeria monocytogenes outbreak. It also is not related in any way to the Ivanhoe Cheese recall or the recalls of soft cheeses in Québec. No illnesses have been linked to Merit Ham. Nevertheless, any consumer who has eaten sliced ham that was purchased from in-store deli counters in any of the above-mentioned stores, and who has experienced symptoms of listeriosis, should seek medical assistance.

Consumers who have purchased this product should either discard it or return it to the store for a refund. For more information, contact Métro Richelieu's Customer Service department at 1-800-561-8429.

Iraq And Cholera: An Annual Event

The World Health Organization (WHO) has made it official. This year's cholera outbreak has begun in Iraq.

A year ago, the country suffered a major outbreak of cholera that sickened almost 4,700 people and claimed 24 lives. That outbreak took place mostly in the northern part of Iraq. But Vibrio cholerae, the water-borne microbe that is responsible for the bloody diarrhea that is the hallmark of cholera, has moved farther south this year.

The 2008 outbreak began officially on August 20th, when the first cases were lab-confirmed. By August 28th, 181 suspected cases – 7 confirmed – already had been reported from Baghdad and Misan Province. From Baghdad, the outbreak has traveled south to Babil Province, which has reported 116 suspected cases. As of September 10th, 21 of the suspected cases have been confirmed, and 10 people have died.

Last year's outbreak also began in mid-August. It was still raging in early October, having spread through 9 of the country's 18 provinces. Prior to 2007, the last cholera outbreak in Iraq that was large enough to attract the attention of the WHO took place in Basra during May 2003. In reporting on that outbreak, WHO commented that cases of cholera had occurred in Basra every year since 1989. It's our guess that there were outbreaks in 2004, 2005 and 2006 as well, but that these were not well reported – due, at least in part, to the ongoing conflict in many parts of the country.

As WHO points out in its report on the current outbreak, cholera outbreaks are facilitated by the lack of potable water, and an absence of infrastructure for hygienic disposal of sewage. More than five years after the United States, supported by the United Kingdom and the "Coalition of the Willing" invaded Iraq, "... the overall quality of water and sanitation remains very poor..." according to the WHO report.

Maybe next year?

Oklahoma E. coli O111: Interviews Uncover Additional Victims

Even when a food poisoning outbreak has been well publicized, some outbreak victims fall between the cracks. Oklahoma's intensive search for answers has uncovered 25 more cases of E. coli O111 gastroenteritis.

As of today, the Oklahoma State Department of Health reports that at least 231 people have been infected with E. coli O111 – including 185 adults and 43 children. At least 61 of the victims were hospitalized as a result of the severity of their symptoms; 16 required dialysis treatment. One person has died.

As part of their investigation into the source of the outbreak, the state submitted samples of well water, restaurant food, and environmental swabs of food preparation and serving surfaces for lab analysis. The water and swab samples did not uncover any traces of E. coli O111. Lab results on the food samples are not yet available.

Oklahoma investigators continue to ask everyone who ate at the Country Cottage restaurant during the period of August 15-17, and who has not yet been interviewed, to contact OSDH at 1-800-990-2769. 

Québec Listeria monocytogenes Outbreak: Cross-Contamination Concerns

In case anyone is wondering why the Québec Ministry of Agriculture's recall of cheeses seems to be never-ending, the Ministry of Health and Social Services (MSSS) made the reason clear in its press release yesterday. For readers of this blog who don't understand French, following is our translation of the key explanatory paragraph:

The Department of Public Health Protection recommends that the public not consume cheeses cut and purchased before September 7 at any one of the 300 retail points of sale reported by the Québec Ministry of Agriculture, Fisheries and Food (MAPAC). It is possible that these cheeses have been in contact with cheeses contaminated by the bacterium Listeria monocytogenes. The contamination may have occurred, for example, when someone neglected to disinfect a knife or working surface between cutting two cheeses, one of which was contaminated. This is referred to as cross-contamination. If you have purchased a cheese from one of the distribution points listed on the MAPAQ web site, it is recommended that these cheeses be discarded, along with any other food with which they may have come in contact, or which were handled using the same utensils. It is extremely important to wash with soapy water containing a small amount of bleach all kitchen utensils and containers that have been in contact with the cheeses (refrigerator shelves, cutting boards, knives, dishes, etc.)

Retailers, who are taking a financial hit from this massive recall, are complaining that the government is overreacting. Given, however, number of different brands and manufacturer listed in the MAPAQ recall notices, cross-contamination is a real possibility. 

Meanwhile, the size of the Québec outbreak continues to grow. The province now has confirmed 22 cases of listeriosis – 3 of them newborn infants – due to the cheese outbreak strain (up from 15 cases as of September 6), and one person infected with that strain has died. 

It's understandable that MAPAQ is taking extreme measures to contain the outbreak. Perhaps MAPAQ also should reexamine its recently announced plan to liberalize rules for production and sale of raw milk cheese in the province.

Québec Listeria Outbreak: Consolidated Recall List

UPDATED SEPTEMBER 10, 2008

The Québec Ministry of Agriculture (MAPAC) has announced ten cheese recalls due to the presence of Listeria monocytogenes since August 22nd. At least some of the recalled cheeses have been linked to the province's recently-revealed listeriosis outbreak.

As a convenience to consumers who are trying to wade through the multiple recall announcements, we have begun a consolidated list of MAPAC's cheese recalls. This list will be updated as new information becomes available.

All of the cheeses mentioned below are potentially contaminated with Listeria monocytogenes and SHOULD NOT be eaten. Consumers who have purchased any of the recalled cheeses should either discard them or return them to the store.

• IGA Marché au Vieux Beauport (771 ave Royale, Québec, QC). All cheeses cut in the store and sold in various sizes between September 2nd and September 8th. ADDED Sept. 10, 2008 
• Boulangerie Lesage (809 Harvey ouest, Alma, QC). Médard triple choco. Fram. brand chocolate cheesecake with best before dates earlier than September 20, 2008 and sold in 800-gram packages carrying the name Boulangerie Lesage or 250-gram unlabeled slices purchased from the service counter. 
• Au Petit Marché de Contrecoeur (6065, Marie-Victorin, Contrecoeur, QC). All cheese identified as Fromage Le 14 Arpents, sold in various sizes on or after August 29, 2008.
  
• Supermarché Saint-Hilaire (345, Raymond Dupuis, Saint-Hilaire, QC). Cheeses manufactured by Ferme du Domaine de la Rivière, and sold in various sizes on or after August 29, 2008, including: Le Rang des Iles, Le 14 Arpents, Le Petit Vieux, Le Gédéon, Le Médard, La Couventine, Le Cabrouet and Les Calles.
  
• Ferme du Domaine de la Rivière. Cheeses manufactured and sold in various sizes between July 12 and September 6, 2008, including: Le Rang des Iles, Le 14 Arpents, Le Petit Vieux, Le Gédéon, Le Médard, La Couventine, Le Cabrouet, and Les Calles.
  
• La Maison du Fromage (2888, Cosmodôme, Laval, QC). All cheeses cut and sold in various sizes on or after August 29, 2008. 
  
• Étal du Fromager (140, Bélanger, Saint-Jérôme, QC). All cheeses cut and sold in various sizes on or after August 25, 2008.
  
• Les Fromagiers de la Table Ronde (317 rte 158, Ste-Sophie, QC). Cheeses manufactured and sold – regardless of date – in various sizes either at the manufacturer or in certain retail stores (see consolidated list of retailers, below), and identified as Le Fleur de Lysé, Le Fou du Roi and Le Rassembleu.
  
• Aux Petits Délices GT (1191, rue Cartier, Québec, QC and 2500, chemin des Quatre-Bourgeois, Québec, QC). All cheeses cut and sold in various sizes on or after August 6, 2008.
  
• S. Bourassa (St. Sauveur) Ltée. (105, B. Guindon, Saint-Sauveur, QC). Tomme de Grosse-Ile brand cheeses of various sizes, packaged on August 15 and bearing a "best before" date of September 5, 2008.
  
• Octofruit Maître Gourmet (190, boul. Labelle, Sainte-Thérèse, QC). Mont Jacob brand cheeses of various sizes, packaged on August 14 and bearing a "best before" date of August 29, 2008.
  
• Aux Petits Délices (1191, rue Cartier, Québec, QC). Riopelle de l'Ile brand cheeses sold in various sizes between August 6 and August 11, 2008.
  

In addition to the above recall notices, MAPAC has posted a list of retail establishments where the recalled cheeses were sold. This list, which includes both food stores and restaurants, is being updated by MAPAC as new information becomes available.

Maple Leaf Listeria Outbreak: Slicing and Dicing

UPDATED SEPTEMBER 10, 2008

The number of confirmed illnesses and deaths in Canada's Listeria monocytogenes outbreak continues to creep up, even though the worst of the outbreak is probably over.

The Public Health Agency of Canada reported the following tallies, as of mid-afternoon, September 9th:

• Confirmed illnesses linked to the outbreak: 38
  
• Suspected cases linked to the outbreak: 20
  
• Deaths where listeriosis was an underlying or contributing factor: 14
  
• Deaths under investigation: 5
  

Twenty-nine of the confirmed cases and 12 of the deaths due in whole or in part to the outbreak strain of Listeria monocytogenes were reported by Ontario.

Not yet included in the federal totals are the newly reported deaths of a New Brunswick woman and a woman from British Columbia, both of whom were infected with Listeria monocytogenes. Lab tests are underway to determine whether these deaths are related to the Maple Leaf outbreak.

Maple Leaf announced last Friday that it had identified a probable source of the Listeria monocytogenes contamination in its meats. Intensive testing uncovered contamination inside the slicing machines on the #8 and #9 production lines. The same day, CFIA issued an advisory to all federally registered meat establishments, instructing operators to dismantle and check the interiors of their slicing equipment immediately,  "... and perform a systematic and thorough aggressive cleaning and sanitation procedure..."

Formax, Inc., the manufacturer of the slicing equipment, responded to the news by stating that nearly 300 units of this model (Formax S-180) are installed in processing plants around the world, and that this was the first occasion in 13 years that anyone had reported an incident. The S-180 appears to be an older model, and is no longer featured on the Formax web site. 

________________________

UPDATE: September 10th. Janie Gabbett of Meatingplace OnLine reported this morning that Formax has announced a review of its recommended sanitation protocols for the Model S-180 slicer. The Company's President and CEO, David Brown, told Meatingplace that both the equipment and the operating manuals are being reviewed. (Update ends)

________________________

Contamination deep within the slicing machine is consistent with a pattern of recurring contamination farther down the production/packaging line. If Maple Leaf was as assiduous as it claims to have been in its post-sanitation environmental swabbing program, the Company's quality assurance team should have noticed the disappearance and reappearance of Listeria monocytogenes on the line.

Testing cannot make a production line – or a product – microbiologically safe. All that testing can do is highlight potential problems and, if everything is working correctly, spur someone to ask the right questions.

Alaska Reports Campylobacter Outbreak

The Alaska Department of Health and Social Services reported today that the south-central part of the state – which includes Anchorage – has experienced an unusually large number of cases of Campylobacter enteritis since the beginning of July. 

Thirty-two people were diagnosed with Campylobacter in July and August of this year, compared to just 15 people during the same period last year. One person was hospitalized for observation.

Except for Salmonella, Campylobacter causes more cases of gastroenteritis annually in the United States than any other known bacterial pathogen. Individuals usually contract an infection by drinking raw milk, drinking or swimming in contaminated water, eating undercooked poultry, or eating food that has been cross-contaminated by contact with raw poultry or untreated water.

Most infections with Campylobacter are self-limiting, and disappear in a few days with no lingering aftereffects. But, in a small number of cases, the infection can trigger arthritis or – in approximately 0.1% of cases – a severe, acute neurological autoimmune disease known as Guillain-Barré syndrome.

As part of their investigation into the source of the outbreak, the state is asking any resident or visitor who has experienced a bout of bloody diarrhea since the beginning of July to contact the Section of Epidemiology at:  1-877-469-8067.

Oklahoma Still Searching for Source of E. coli O111

The Oklahoma State Department of Health has received the results of its environmental swab samples. The state found no trace of E. coli O111 on any of the food preparation and serving surfaces at the Country Cottage restaurant.

Under normal circumstances, this would be good news. But in the context of the state's outbreak investigation, thought not unexpected, it is a disappointment. 

Investigators had hoped that their swab samples might yield a clue to the source of the pathogen that has sickened 206 residents of the northeastern part of Oklahoma and has killed one man. 

Now they must pin their hopes for an answer to the mystery on lab results from food samples, and on the statistical analysis of information obtained during interviews with restaurant patrons. Those interviews are continuing, with the assistance of CDC staff members who have joined the investigation team.

The state has been conscientious about issuing daily reports on the status of its investigation into this outbreak. Those reports, however, have been strangely silent about any interviews conducted with restaurant employees, or any lab tests of employee stool samples. Why?

OSDH continues to ask anyone who ate at the Country Cottage restaurant between August 15 and August 23 – and especially during the period of August 15-17 – and who has not yet been interviewed, to please contact the Department of Health, toll-free at 1-800-990-2769.

Oklahoma E. coli Outbreak: A Weekend of Activity

Oklahoma's State Department of Health (OSDH) investigators are still scratching their heads over the source of the E. coli O111 strain that has sickened 206 people and killed one. They may not have the answer yet, but one must give them an "E" for Effort.

According to the update posted late this afternoon on the OSDH website, state investigators – and three staff members from the CDC – spent their weekend interviewing 310 additional patrons of the Country Cottage, the restaurant that is at the epicenter of this outbreak. So far, 1,300 people have been interviewed in an attempt to differentiate between the menu or buffet items eaten by outbreak victims, and food eaten by those who did not become sick.

OSDH has not mentioned the total number of cases since the September 3rd update. We can probably assume this means that the number of new cases has dried up and that the final tally will remain at 206 victims, including one death.

The weekend's interviews generated the names of another 300 or so restaurant patrons. These individuals will be contacted and interviewed. CDC staff members are assisting both in the interviews and in the epidemiological analysis of the information obtained from restaurant patrons. The state also is waiting for lab results to arrive for environmental swabs and food samples taken at the restaurant.

There has been no official indication whether any employees of the Country Cottage restaurant became ill, or whether the employees were asked to submit a stool specimen for lab testing. It would be usual, in this type of investigation, to make such a request of all restaurant staff. But cooperation with this sort of request is voluntary.

If luck is on the side of the investigation team, the lab results and interviews will provide some answers. Otherwise, the source of this outbreak will remain a mystery forever.

Cholera Makes A Comeback

Cholera is back (not that it ever really left) thanks to all the usual suspects: major flooding, military activities, overcrowding, shortage of health supplies and government indifference.

India

Even before the monsoonal floods hit, Delhi was writing the most recent chapter in its permanent almanac of cholera outbreaks. The city logged 450 cases of cholera in the first eight months of 2008. And the worst is still ahead. Indian officials warned yesterday that 2.1 million refugees are at risk of contracting cholera and other gastrointestinal diseases, with "large numbers" of people already complaining of stomach aches, fever and diarrhea. 

Villagers in Murshidabad, where the village wells haven't been operating for several months, have been drinking untreated water from the Banshlai River. The Vibrio cholerae-contaminated water has infected 70 villagers; eleven of them have been hospitalized in critical condition. Two children, aged 2 and 4 years, have died. The government has done nothing to repair or replace the wells.

Pakistan

Northwest Pakistan, near the Afghan border, is the scene of another cholera outbreak. Fighting between Pakistani government forces, and Taliban/al Qaeda forces has prompted 300,000 villagers to flee their homes and congregate in refugee camps. The International Committee of the Red Cross reported on Friday that cholera and other cases of watery diarrhea already have appeared among the refugees.

Zimbabwe

Residents of the town of Chitungwiza, near Harare, find themselves in the midst of a cholera outbreak that has killed 10 people so far. Nurses who work in the town's hospital are apparently on strike. They claim to be too hungry to work.  Chitungwiza now joins the ranks of several other Zimbabe towns that have all experienced recent outbreaks of cholera: Mabvuku, Tafara, Msasa Park and Letombo Park. The CEO of the Combined Harare Residents Association blames the Mugabe government for its total lack of response to the outbreak, and for the absence of clean water and sanitary sewage services.

Iraq

Cholera has reappeared in Iraq, this time in Babil province, south of Baghdad. At least 20 cases have been confirmed, according to the Iraqi government, and one person has died. Local officials in Babil, though, say that many more people are ill with cholera – as many as 300 – and that 10 have died. The ruling provincial council, complaining of the lack of action on the part of the national government, has taken its own steps. It has ordered the closure of all ice plants and many juice stands in an attempt to control the spread of the disease.

Myanmar

This is the dog that never barked. In spite of the massive flooding experience by residents in the low-lying Ayayerwaddy (Irrawaddy) Delta, cholera did not add to the devastation. Perhaps the Myanmar people were fortunate in the slow, heartless response of their government. 

By not amassing in the tens of thousands into overcrowded camps with few sanitary services and limited fresh water, the Myanmar people avoided the usual diseases of disaster that spread explosively in crowded, unclean environments. The fortunate outcome does not excuse the behavior of Myanmar's military regime, but perhaps the United Nations and international aid organizations should consider whether any lessons can be learned from this inadvertent experiment.

Maple Leaf Outbreak: Some Unanswered Questions

Yesterday, I called for a Walkerton-style Judicial Commission of Inquiry to investigate fully – and publicly – all aspects of the Canada-wide Listeria monocytogenes outbreak that has sickened at least 38 people and has killed 13 of them.

Yesterday, Doug Powell of Barfblog wrote: 

"Others are calling for a full-scale inquiry, like what happened after Walkerton and in Ontario after some dodgy meat slaughtering practices were uncovered (the Haines report). I participated in both inquiries. There is no need for another."

In the United States, each federal government department maintains an Office of Inspector General. The Inspector General has the power, on his or her own initiative, to audit any of the department's activities. The Inspector General's detailed audit reports are public information, often directly accessible over the Internet.

Canada is not this generous with its information. The independent investigation announced by Prime Minister Harper will not be a public inquiry, and there is no promise that the detailed report of this investigation will be made public. The investigator will report his or her findings to the Minister of Agriculture. Period.

In calling for a public inquiry, I am not suggesting that either Maple Leaf or the Canadian Food Inspection Agency set out deliberately to spread Listeria monocytogenes to hospitals, seniors' residences, nursing homes and other similar facilities across Canada. I am not proposing a witch hunt. But I think Canadians deserve some answers.

What do I think should be included in the scope of a Judicial Commission of Inquiry? Here are a few items:

• Why did Maple Leaf's food safety program not detect the contamination before the problem spiraled into an outbreak?
  
• Why did CFIA not respond to Maple Leaf's internal lab findings of Listeria monocytogenes in the Bartor Road facility environment, or was CFIA not privy to Maple Leaf's internal lab reports? 
  
• Why did the initial recall notice – dated August 17 and issued jointly by CFIA and Maple Leaf – say, disingenuously, that "[t]here have been no confirmed illnesses associated with the consumption of these products," when an outbreak investigation was already in progress and under investigation?
  
• Why are elderly and immune-compromised Canadians being fed high-risk prepared meats in the country's health care institutions?
  
• What can be done to prevent this from happening again?
  

This investigation must not only be carried out. It must be seen to be carried out, if Canadians are to regain – and retain – their confidence in the nation's food safety system.

Maple Leaf Listeria Outbreak: Harper Announces Investigation

As the Canada-wide Listeria monocytogenes outbreak winds down, politics are breaking out all over.

Prime Minister Harper promised Canadians an independent investigation into the circumstances surrounding the outbreak, and an investigation there will be. The Prime Minister's Office announced the terms of the Listeria investigation yesterday.

This investigation might well be independent, as Harper promised, but it will be far more limited in its scope and frame of reference than the thorough and public investigation that followed the Walkerton E. coli O157:H7 outbreak eight years ago. 

The independent investigator's mandate for this "broad, independent investigation" include:

• (i) examine the events, circumstances and factors that contributed to the listeriosis outbreak;
  
• (ii) review the efficiency and effectiveness of the response of the federal organizations, in conjunction with their food safety system partners, in terms of prevention, recall of contaminated products and collaboration and communication with its food safety system partners and consumers;
  
• (iii) make recommendations, based on lessons learned from this event and from other countries in terms of best practices, as to what could be done to enhance both prevention of a similar outbreak occurrence in the future, and removal of contaminated product from the food supply;
  
• (iv) perform his/her duties without expressing any conclusion or recommendation regarding the civil or criminal liability of any person or organization;
  
• (v) adopt procedures for the expedient and proper conduct of the investigation, including reviewing relevant records and documents and consulting as appropriate; and
  
• (vi) submit to the Minister of Agriculture and Agri-Food, in both official languages, before 15 March 2009, a report on the matters listed in (i) to (iv) above.
  

Wow! All of this in 6 months? Not very likely. And not very public.

The terms of reference described above are fine, as far as they go. The investigation report should provide some direction to CFIA as it seeks to improve its food safety regulatory systems. But Harper has not gone far enough. 

Canadians deserve a full, independent, Judicial Commission of Inquiry into all circumstances leading up to and surrounding the Maple Leaf Listeria monocytogenes outbreak. The Commissioner must have broad powers to subpoena witnesses, to examine CFIA inspection reports, and to subpoena and examine Maple Leaf's internal quality assurance records. 

Victims and their families should be given the opportunity to testify before the Commission of Inquiry. Hearings should be public, and the final Commission report should be released to the public at the same time that it is submitted to the Minister of Agriculture and Agri-Food. 

Nothing less will do.

Listeria Outbreak Linked To Contaminated Cheese In Quebec

There is a significant outbreak of Listeria monocytogenes in the province of Québec that no one seems to have noticed yet. The information is buried deep within the web site of Québec's Ministry of Health and Social Services (MSSS).

Fifty-six cases of listeriosis have been reported in Québec so far this year, including nine deaths. Two of the cases have been linked to the Canada-wide Maple Leaf. At least 15 cases are associated with the consumption of contaminated cheese.

Québec first announced this outbreak on August 27th. At the time of the announcement, there were a total of 42 cases of listeriosis in the province since the beginning of 2008 and 8 deaths. Today, MSSS released a consumer advisory, "Des précautions à prendre pour éviter la listériose" (Precautions for avoiding listeriosis) and a link to the listeriosis status page.

The provincial Ministry of Agriculture (MAPAQ) has been issuing recall notice after recall notice for several days now, without specifically mentioning the outbreak. The latest recalls were announced today. 

Ferme du Domaine de la Rivière, DBA Fromagerie Médard (10, Dequen, à Saint-Gédéon, Lac-Saint-Jean, QC) has agreed to recall a series of cheese products, identified by a packaging or "best before" date of 12 juillet 2008. As part of the same notice, MAPAC reminded consumers of an earlier recall of cheeses produced by Ferme Raymond Alary & Fils (1981) Inc., DBA Les Fromagiers de la Table Ronde (317, route 158, Saint-Sophie, QC).

An updated list of retail outlets that may have sold the recalled cheeses can be found by clicking here.

It's very evident that this series of recall announcements is not over. The affected cheeses have been widely distributed to many independent cheese shops throughout the province. Finding the recalled products and ensuring their removal from the marketplace will be a gargantuan task – much more difficult than if the distribution had been through large supermarket chains.

Unfortunately, this means that the number of cases of listeriosis resulting from eating the contaminated cheese will continue to grow. 

Ivanhoe Cheese Retail Recall List

The Canadian Food Inspection Agency has expanded its Health Hazard Alert on Ivanhoe Cheese once again. A consolidated list of cheeses recalled by Ivanhoe due to possible contamination with Listeria monocytogenes is available on the CFIA web page.

In addition, retailers have begun to announce their own recalls of sandwiches and party platters that contain cheeses covered by the Ivanhoe recall. We'll be updating this list of retail recalls as more information becomes available.

Metro Ontario Inc. (Toronto, ON). "Fresh 2 Go" (F2GO) sandwiches; unbranded sandwiches; and "Gourmet," "Wrap Delight," and"Kings Assortment" trays, all identified with "PKGD on" dates up to and including 08.SE.4. These items were sold in "... selected A & P, Dominion, The Barn, Ultra, and Loeb stores..." throughout Ontario.

CFIA reiterates that the recalled cheeses were distributed only in Ontario and that no illnesses have been associated with the products.

This statement, of course, is not a guarantee, as Canadians learned in the Maple Leaf outbreak. There are a number of cases of listeriosis in Ontario and Quebec that were not caused by the Maple Leaf outbreak strain. Some of these may possibly be linked to one or more varieties of recalled cheese. 

Anyone who has experienced symptoms of listeriosis – mild or severe – and who has consumed one of the recalled products, should seek medical attention without delay, and should ensure that the results be reported to the appropriate district health office.

If you have purchased a recalled product, either discard it safely or return it to the store for a refund. Retail customers can contact Metro Ontario Inc., toll-free, at 1-877-763-7374 for more information.

Maple Leaf: Any Way You Slice It

The CEO of Maple Leaf announced this evening that poorly cleaned slicing machines might have been the source of Canada's lethal national outbreak of Listeria monocytogenes, according to a CBC report.

Michael McCain apparently told reporters that bacteria trapped deep inside the slicing equipment escaped the company's "rigorous sanitation procedures."

Before Maple Leaf is permitted to restart operations, may we suggest that the company and CFIA conduct a thorough reappraisal of those sanitation procedures, as well as the intensity, scope and frequency of equipment swabbing tests used to verify the rigor and effectiveness of those procedures? 

Maple Leaf Listeria Outbreak: What About The Unconfirmed Cases?

The Public Health Agency of Canada released another update this afternoon on the Canada-wide outbreak of Listeria monocytogenes that has been linked to processed deli meats from Maple Leaf's Bartor Road plant.

According to the report, the number of confirmed cases of listeriosis – 38 – remains unchanged from two days ago. And the number of outbreak-related deaths also has remained stable, at 13. Eleven of the deaths were reported in Ontario, and one each in British Columbia and Alberta.

Twenty suspect cases remain under investigation, including 8 in Ontario and 9 in Quebec, and 6 deaths (4 of them in Ontario) have not yet been either eliminated from the outbreak tallies or confirmed as being outbreak-associated.

One more retail-level recall announcement was released this morning, and our consolidated list was updated accordingly. But, for all practical purposes, the worst is over – except for the politicians and Maple Leaf executives, all of whom must answer for their actions prior to and during this outbreak. And for the victims and their families.

One question, though, has remained unasked. What is the source of the Listeria monocytogenes that sickened all of the "suspect" cases unlinked to the Maple Leaf outbreak strain? Most of those listeriosis victims, as well as the illnesses and deaths still under investigation, are from Quebec and Ontario. Could any of these people have been infected by the several varieties of Listeria monocytogenes-contaminated cheeses that have been recalled in these two provinces during the last two weeks?

It's not unheard of for two different strains of the same pathogen to cause two unrelated outbreaks in the same country within a relatively narrow time window. We saw it happen this year in the United States, when E. coli O157:H7 was the cause of two separate multi-state outbreaks.

Don't be surprised if a second – even a third – Canadian outbreak of Listeria monocytogenes comes to light in the near future.

Oklahoma Digs Deeper For Clues To Outbreak

The Oklahoma Department of Health announced today that it has invited representatives from the CDC's Foodborne and Diarrheal Diseases Branch to take part in its investigation of the Locust Grove E. coli O111 outbreak.

Investigators with the ODH also have decided to expand their epidemiological investigation by interviewing as many as 320 additional people who ate at the Country Cottage restaurant between August 15 and August 17, and who did not become ill. 

The state has taken this step because the information it has obtained so far is insufficient to finger a probable source for the E. coli O111. By comparing what was eaten by the 206 victims of the outbreak against what was eaten by those who remained unaffected, investigators hope to identify the item (or items) that made people ill.

If the additional interviews don't produce a clear-cut outcome, that could point to the possibility of a human carrier as the source of the outbreak. Obtaining stool samples from all employees for testing is routine in this type of investigation. But we've heard from two separate – though unconfirmed – sources that some of the employees may be reticent to provide samples, possibly due to immigration-related issues. 

The good news for citizens of Locust Grove is that no new cases have been added in the last two days to the total of 206 outbreak victims reported on September 3rd. If this trend continues, the ODH soon will be able to declare the outbreak over, even as the investigation into its source continues.

This declaration can't come soon enough for area residents, restaurants and other businesses. The town has suffered loss of business and even outright ostracism – a high school football team from the neighboring town of Wagoner backed out of a scheduled game out of concern that their players might become infected. 

In the absence of any unexpected developments, there will be no daily bulletins posted by the ODH over the weekend, even though the investigation will continue without interruption. Let's hope that Monday brings good news.

Hershey Issues Allergy Alert

FDA announced today that The Hershey Company has recalled 7.25-ounce plastic bottles of Hershey's Chocolate Shell Topping because they contain undeclared almonds.

The recalled bottles can be identified by a UPC Bar Code number of 346000 and the number 69N printed below the bar code number. The recalled bottles have been available for sale since July 8, 2008.

Individuals who are not allergic to almonds can consume this product without danger. But those who are allergic to almonds risk a severe reaction after ingesting the Chocolate Shell Topping.

According to FDA, the labeling error was discovered by a consumer, who brought it to the attention of the company. No illnesses have been reported.

Listeria monocytogenes in French Cheeses

The European Union maintains a "Rapid Alert" program to notify member countries of food contamination issues. This week's list included French cheeses from two different manufacturers. 

In both cases, the recalls were triggered by the presence of Listeria monocytogenes in the cheeses in excess of levels permitted by the EU. The contamination was detected during testing carried out by the manufacturers.

Fromagerie de la Houssaye has recalled four varieties of cheese after finding 520 Listeria monocytogenes per gram. The recalled products include lot numbers 140-210 of Livarot AOC, Pont l'évêque, pavé d'Auge and Deauville cheeses. The Food Safety Authority of Ireland advises that two of the cheeses – Livarot and Pont l'évêque – were distributed in the Republic of Ireland in small independent retail outlets, and have been withdrawn from sale.

The EU weekly alert summary does not identify the manufacturers by name – just the country of origin of the food product. We learned of the de la Houssaye recall details only thanks to the advisory posted by the Republic of Ireland.

Listeria monocytogenes is a common microbe that is present in the environment world-wide. It grows quite happily under reduced levels of oxygen and at refrigerator temperatures – two traits that help explain its frequent presence in refrigerated meat and dairy products. Processed vacuum-packaged meats and soft or semi-soft cheeses are especially prone to contamination with this pathogen. 

Pregnant women, very young children, the elderly, and people with weakened immune systems are especially susceptible to severe illness as a result of infection with Listeria monocytogenes, and should try to avoid consuming foods that are at risk of contamination with this pathogen.

Hawaii Warns Against Illegal Roadside Food Vendors

The Hawaii Department of Health warned yesterday that consumers should check that a roadside food vendor has been issued a food permit before purchasing or consuming anything from that vendor. The permit is evidence that the vendor is aware of – and required to comply with – safe food handling practices.

No confirmed illnesses associated with illegal food vendors have been reported in the state, but consuming food prepared by one of these vendors is potentially risky.

Anyone who encounters an unlicensed food vendor should report the individual to the Hawaii Department of Health Sanitation Branch, using the telephone numbers listed at the end of the news release.

Quebec Expands Warnings on Listeria-Contaminated Cheese

Québec's Ministry of Agriculture (MAPAQ) must be systematically surveying cheese makers for microbial contamination – perhaps as a result of the recent cheese-linked Salmonella outbreak in that province, which sickened 87 people, killing one.

The province has just reissued yesterday's recall warning on three varieties of Fromagiers de la Table Ronde cheeses, and has added two more recalls to the list.

The reissued recall notice for Fromagiers de la Table Ronde cheeses advises that these were sold in 250 retail stores throughout the province. Follow this link for a complete printer-friendly list of the 250 stores that carried the recalled lots of Le Fleur de Lysé (lots 08135-08178), Le Fou du Roi (lots 08105-08247) and Le Rassembleu (lots 08105-08247) cheese.

The two newly announced recalls are as follows:

• Etal du Fromager, 140 Bélanger, Saint-Jérome, QC. Cheese cut in the store and sold in variable weight packages on or after August 25th may be contaminated with Listeria monocytogenes and should not be consumed.
  
• La Maison du Fromage, 2888 Cosmodome, Laval, QC. Cheese cut in the store and sold in variable weight packages on or after August 29th may be contaminated with Listeria monocytogenes and should not be consumed.
  

MAPAQ requests that consumers, distributors and retailers aid in the recall by checking their supplies for any recalled cheeses. Consumers and other interested individuals can ask questions or report any unusual food-related incidents to the Province by calling, toll-free, 1-800-463-5023.

Another Canadian Cheese Recall

UPDATED SEPTEMBER 5, 2008

Ivanhoe Cheese Inc. (Madoc, ON) is recalling several cheese products, which may be contaminated by Listeria monocytogenes. According to the CFIA Heath Hazard Alert, no cases of listeriosis have been linked to these cheeses.

The recall encompasses various package sizes of Ivanhoe, Great Canadian, and Iqbal Products bearing best before dates from 09 FE 20 to 09 MR 01, inclusive. Several varieties of Iqbal Products – Cheddar, Marble (brick and cheddar), Asiago, Gouda, Swiss, Parmesan, Mozzarella, Havarti, Colby, Brick and Feta – are included in the recall.

A complete list of the recalled cheeses was posted  by the Canadian Food Inspection Agency, and can be viewed by clicking here. NEW (Sept 5, 2008)

The cheeses were distributed to supermarkets and delis across Ontario, and were sold at retail between August 20 and September 3, inclusive. Neither Ivanhoe nor CFIA have released a list of retail stores that carried the recalled items.

This is the fifth recall of cheese in Canada in less than a month, and the fourth due to Listeria monocytogenes. All of these recalls are apparently unrelated to each other, and are also not related to the on-going Maple Leaf Listeria monocytogenes outbreak.

Anyone who has purchased Ivanhoe, Great Canadian or Iqbal Products cheeses should check the packaging to determine whether the cheese variety and best before date indicate that the product has been recalled. Cheese that may be contaminated with Listeria monocytogenes should not be consumed. Either discard the recalled product or return it to the store for a refund.

Maple Leaf Retail Recall List

UPDATED SEPTEMBER 5, 2008

One of the frustrations that consumers face when a food recall is announced is the lack of information about which retail stores received and were selling the recalled products. This information is especially important when the product recall is triggered by a deadly food poisoning outbreak.

Most of the meat recalled by Maple Leaf Consumer Foods was sold to food service operators, hospitals, nursing homes and some retail delis. 

The following retail items have been recalled so far. Click on the highlighted company names to navigate to the recall notices, which provide details on product descriptions and Best Before dates.

• Royal Touch Foods has recalled Shopsy's deli-fresh Classic Reuben, sold in a 180g package labeled with UPC 7 76393 17001 8 and Best Before dates of AU 22 and AU 24. The sandwiches were sold at the Bloor Superfresh Mart and several Shoppers Drug Mart locations.
  
• Lucerne Foods, a Calgary-based company, has recalled Safeway Gold Standard sandwiches labeled with Best Before dates up to and including AU 25, sold in Safeway stores in Alberta and Saskatchewan, and TakeAwayCafé sandwiches labeled with various Best Before dates up to and including 08 SE 10, sold in Mac's Convenience stores throughout Alberta.
• Metro Ontario, Inc. has recalled three varieties of Fresh 2 Go (F2GO) brand sandwiches with "PKGD on" dates up to and including 08 AU 24. The sandwiches are sold in Ontario through selected Dominion and A&P stores.
• Atlantic Prepared Foods Limited (Alberton, PEI) has recalled Irving, Sub Delicious, and Needs brands sandwiches with various Best Before dates up to and including 08 SE 3. The sandwiches were distributed at unspecified locations throughout New Brunswick, Nova Scotia and Prince Edward Island.
• Costco Wholesale Canada Ltd. (Ottawa, ON) has recalled two varieties of Kirkland Signature platters, with best before dates up to and including 08 AU 28 and 08 AU 29, respectively. The platters were sold through Costco Wholesale stores across Canada.
• Sobey's Inc. (Mississauga, ON) has recalled its Cooked Ham and Salami sandwiches and Deli Lunch Box Wraps. The sandwiches are sold in Sobeys, Foodland and IGA stores throughout Ontario. The recalled sandwiches and wraps are labeled with "Packed on" dates up to and including 2008 AU 24.
• White House Meats Inc. (Toronto, ON) has recalled "oven roasted turkey breast" sold at the deli counter from its Bloor Street and Bayview Avenue locations, as well as oven roasted turkey breast packaged in 200g vacuum packs that were sold at the Bayview location. All of the recalled products were last sold on August 24th.
• Delta Country Market (Delta, ON) has recalled three ready-to-eat deli meats that are included in the Maple Leaf meat recall.
• Glen Fine Foods (Cornwall, ON) has recalled its Big Glen Sandwich, sold in vending machines in eastern Ontario. The recalled sandwiches are labeled with Best Before dates up to and including Aug 30/08.
• Loblaws Companies Limited (Brampton, ON) has recalled several different ready-to-eat items that contain meat products recalled by Maple Leaf Consumer Foods. Some of the  recalled items were made and sold at Loblaws, Loblaw Superstore, and Real Canadian Superstore in Ontario and are labeled with Best Before dates up to and including August 25, 2008; some products were made and sold at Loblaws and Provigo in Quebec and are labeled with Best Before dates up to and including August 27, 2008.
• Sobey's Inc. (Stellarton, NS) has recalled a large number of ready-to-eat products, including hospitality trays. Some of the recalled products were sold at Sobeys and Foodland stores in New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland & Labrador. A number of sandwiches, wraps and deli meats were sold at Sobeys and IGA stores in British Columbia, Alberta, Saskatchewan, Manitoba and Ontario. Other recalled products were sold in IGA, Bonichoix, Tradition, and Omni stores in Quebec. Please navigate to the CFIA recall notice for details on the stores and locations involved.
• Metro-Richelieu, Inc. (Montreal, QC) has recalled three deli meat products bearing Best Before dates up to and including 05 SE 08. The vacuum-packed meats were sold in certain Metro, Richelieu, Ami and Gem stores in Quebec.
• Metro Ontario Inc. (Toronto, ON) has recalled Reduced Cold Cut Ends sold in some A&P, Dominion, Loeb and The Barn stores in Ontario. The packages bear Best Before dates up to and including August 27, 2008.
• Canada Safeway Limited (Calgary, AB) has recalled store-made sandwiches sold at Safeway stores in British Columbia, Manitoba, Ontario and Saskatchewan. The sandwiches are labeled with Best Before dates up to and including 08 AU 26.
• Country Traditions Frozen Foods (Napanee, ON) has recalled kielbassa sausage cuts sold at Country Traditions, Taste of Country, and Country  Farm Supply stores in Ontario. The kielbassa carries Best Before dates up to and including Oct 22/08.
• Co-op Atlantic (Moncton, NB) has recalled several ready-to-eat deli meats, vacuum-packaged in-store, and sold at certain Co-op Atlantic stores in the Atlantic provinces and Quebec's Magdalen Islands. The deli meats bear Best Before dates up to and including 08/09/07 or 08/09/14.
• King Bean Wholesalers (Surrey, BC) has recalled certain of its sandwiches, which were sold in stores in New Westminster, Surrey, and Langley, BC. The sandwiches are labeled with Best Before dates up to and including 01-SEP-08.
• Canex Retail Supermarket (Happy Valley-Goose Bay, NL) has recalled Canex Maple Leaf Bologna, vacuum-packaged in various weights. The recall includes all Best Before dates up to and including Oct 10, 08. NEW

Maple Leaf has now recalled all outstanding products that were processed in the Bartor Road facility. The list, which is nine pages long, is available on the Maple Leaf web site (click here). CFIA also has posted a recall list, which is available here. Both generic and brand name institutional and retail package sizes have been recalled, including: 

Artisan Collection, Best Value, Bittners, Bittners/Schneiders, Boston Pizza, Burns, Campfire, Compliments, Coorsh, Country Morning, Equality, Fleetwood, Food Service, Harmonie, Hickory Farms, Hygrade, Kirkland Signature, Main Street Deli, Maple Leaf, Tim Horton, Mayfair/Marque, McDonalds, Mitchell's, Mr. Sub, No Name, Northern Best Value, Olympic, Our Compliments, Overlander, Parma, Pizza Nova, Rouyn, Safeway, Schneiders, and  Shopsy's

We'll continue to update as additional retail-level recall information is released. If you hear of any retail level recalls that are not on this list, please post a comment, below.

Alfalfa Sprouts Fingered in Salmonella Outbreak – Recalled

Sprouters Northwest, Inc. (Kent, WA) today agreed to recall packages of alfalfa sprouts after the sprouts were linked to an outbreak of Salmonella Typhimurium in Washington and Oregon. 

The following products, all of which contain alfalfa sprouts, are included in the recall and should be discarded immediately:

• Alfalfa Sprouts 5 oz cup
  
• Alfalfa Sprouts 4 oz clamshell
  
• Salad Sprouts 5 oz cup
  
• Salad Sprouts 4 oz clamshell
  
• Onion Sprouts 5 oz cup
  
• Onion Sprouts 4 oz clamshell
  
• Alfalfa Sprouts 1 lb bag
  
• Alfalfa Sprouts 2 lb tray
  

The contaminated sprouts are responsible for 9 cases of salmonellosis in 7 Washington counties (Clark, Island, King, Pierce, Snohomish, Thurston, Whatcom). Two of the 9 Washington victims have been hospitalized. Four Oregonians also have been infected. All of the illnesses have occurred since August 1st.

The recalled products were distributed to grocery stores, wholesalers, delis and restaurants in both Washington and Oregon. Neither state has posted a list of retail establishments that stocked the recalled sprouts.

The sprouts may have been served raw in salads or sandwiches. Anyone who has consumed raw alfalfa sprouts, either at home or while eating out, since the beginning of August, and who has experienced symptoms of salmonellosis – diarrhea, stomach cramps, vomiting, mild fever – should seek medical attention promptly.

Oklahoma Still Investigating E. coli Outbreak

The state's Department of Health has conducted nearly 600 interviews so far – with 200 more still to come – in its investigation into the E. coli O111 outbreak that has been linked to the Country Cottage restaurant in Locust Grove. The town is situated in the northeastern part of Oklahoma, about 50 miles from Tulsa.

At this stage of the investigation, nearly two weeks after the last victim ate at the Country Cottage, the state is fairly certain of the following:

• The E. coli that has sickened more than 200 people did not come from the well located on the restaurant property;
  
• No other restaurants or food sources appear to have been involved in the outbreak; and
  
• Most of the victims ate at the Country Cottage restaurant between August 15th and August 23rd.   
  

The most probable sources of this rare (for the United States) strain of E. coli are either a food that was prepared and served exclusively at the restaurant or a human carrier – perhaps someone who had traveled recently outside the Unit