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 United States. Since the Country Cottage offers a buffet, the carrier could have been either a restaurant worker or a customer. The one-week window would suggest a worker, unless management was very lax in its sanitation routine.

Country Cottage was inspected under Oklahoma's food service establishment inspection program on August 23rd. The restaurant was cited for several violations, including two critical holding temperature violations, either of which could have contributed to this outbreak. These were described in the inspection report, available on-line, as:

• Cold Hold (41/45 F)
  
• Hot Hold (140 F)/Time Control
  

Attention to correct holding and display temperatures is fundamental. Neglecting to do so is unpardonable. Holding food for any length of time at temperatures between 45ºF and 140ºF is a recipe for an outbreak. 

At nearly two weeks after the last theoretical exposure date, we are nearing the outer limits of the incubation period for this type of E. coli infection. The outbreak is unlikely to grow much larger. And that's good news for Locust Grove. The town will survive.

Whether, and in what form, the Country Cottage restaurant will survive is another story.

Traveler's Roulette: Bringing Home The Bacteria

One of the joys of travel is experiencing novel cuisines. One of the banes of travel is returning home with an unwanted souvenir – food poisoning.

It's not necessary to go very far away from home to become a victim of traveler's gastroenteritis. Hong Kong's Centre for Health Protection reported yesterday that it was investigating two clusters of illnesses in vacationers returning from Macao. 

The five men and six women ate at a Macao hotel buffet on August 30. All eleven victims complained of typical symptoms of gastroenteritis – stomach pain, nausea, vomiting, diarrhea and fever. Eight of them sought medical treatment; none were hospitalized.

European travel also can be the source of gastroenteritis outbreaks. Ten Icelanders – mostly students – became ill with salmonellosis earlier this summer. Health authorities traced that illness cluster to a hotel on the island of Rhodes (Greece) where all the victims stayed during late July and early August. Sweden also has reportedly linked cases of salmonellosis among its citizens to that same hotel. 

Estonia's Viimsi Spa is fighting the claims of 16 Finnish clients, who say that they contracted Salmonella food poisoning while staying at the spa in late July and early August. According to Viimsi's CEO, Mark Vuuk, none of the staff – who eat the same meals at the spa as the guests – became ill. Vuuk suggests that the guests contracted their infections as a result of eating meals elsewhere. The Estonian Health Protection Inspectorate is investigating the outbreak.

Finally, two states that once were part of Yugoslavia – Serbia and Montenegro – reported last week that a "[m]ysterious, dangerous and very infectious..." stomach flu had struck Podgorica, the capital of Montenegro, and had spread along the Montenegro coast and into Serbia. The disease was believed to be responsible for two deaths: an 18-year old Macedonian woman who had vacationed in Montenegro and died after returning home at the beginning of August, and a 26-year old Montenegran woman. 

The nature of this mysterious stomach flu was clarified after Sweden reported five cases of enterohemorrhagic E. coli infections (various serotypes) in tourists who had returned from holidays in the Balkan peninsula. The five victims – three very young children, one teenager, and one adult (the mother of the youngest child) – all became ill either while still in the Balkans or shortly after their return to Sweden. The teenage girl, who visited Sarajevo (Bosnia-Herzegovina), was infected with Salmonella in addition to E. coli.

How can someone minimize the risk of infection while still enjoying the travel adventure? Here are a few tips.

Be wary of buffets, especially those where the food does not appear to be kept hot, or where there are not many customers. Food that is sitting around at or near ambient temperature is a perfect growth medium for bacteria.

Avoid beverages that contain ice, unless you are 100% certain that the ice was made with safe drinking water.

Don't take chances with ready-to-eat foods, especially those sold at a roadside stand.

Only eat raw fruits or vegetables that you peel or wash (with bottled water) yourself, and avoid lettuce, strawberries, and other produce items that are difficult to wash.

By following these simple rules, by drinking only bottled water, and by paying scrupulous attention to personal hygiene and effective hand-washing procedures, you can reduce – but never eliminate – the risk of bringing home an unwanted souvenir of your foreign travel.

Bon Voyage!

More Listeria-Contaminated Cheese In Quebec

Ferme Raymond Alary et Fils (1981) Inc. has voluntarily recalled three types of cheese sold under the brand name "Les Fromagiers de la Table Ronde" due to a risk of contamination by Listeria monocytogenes.

The recall encompasses all of the following products bearing production or "best before" dates of July 14 or later. The recalled products are identified as:

• Le Fleur de Lysé - lots no. 08135 to 08178
  
• Le Fou du Roi - lots no. 08105 to 08247
  
• Le Rassembleu - lots no. 08105 to 08247
  

The cheeses were sold in retail stores in intact packages, or may have been cut and repackaged for sale. In the latter case, the lot number or date may no longer show on the package. Any cut, repackaged cheese that carries the name "Les Fromagiers de la Table Ronde" should be considered to be part of this recall.

There is no indication in the recall notice whether or not any illnesses have been associated with this cheese. Nevertheless, under no circumstances should anyone consume the recalled items. The cheese either should be discarded in a safe manner or returned to the place of purchase for a refund.

For more information, retailers and consumers can call the Quebec government, toll-free, at 1-800-463-5023.

Maple Leaf Listeria Outbreak Slows Down

The Public Health Agency of Canada released its latest tally of victims today, and things are starting to look up. While one more death has been confirmed in Ontario – bringing the national total to 13 – the number of confirmed cases nationally remains unchanged from yesterday, at 38. More importantly, the number of suspected cases still under investigation has decreased to 15 (from 21 yesterday).

Of course, there is still the political fallout to deal with. Canadian Prime Minister Harper, who is on the cusp of calling a national election, has promised an independent investigation into the outbreak. No doubt, food safety policy will play a role in the coming campaign.

Maple Leaf's Bartor Road facility remains closed, and there is no indication when it might reopen. According to the federal Minister of Agriculture, an investigation would not begin until after the plant resumes normal operations.

Until the outbreak is declared over and sufficient time has passed to ensure that none of the recalled products remain on the market, consumers should continue to take extra care when purchasing ready-to-eat deli meat, either in packages or sandwiches. 

**US Mandates Food Irradiation**

Washington, DC. August 28, 2033– The Secretary of State for Food Safety announced today that – effective January 1, 2034 – all food shipped interstate for retail sale must be sterilized by irradiation. The Secretary urged food regulators in all fifty states to follow suit.

When asked whether this new mandate would also apply to imported foods, Secretary Jenna Bush replied, "You betcha!"

The announcement was made on the 25th anniversary of the date that the Centers for Disease Control and Prevention (CDC) declared the largest produce-related Salmonella outbreak in US history to be at an end. That outbreak, which was traced eventually to contaminated jalapeño and serrano peppers imported from Mexico, sickened 1,442 people, sending nearly 300 of them to hospital.

In the 25 years since that watershed outbreak, the number of food poisoning incidents linked to meats, eggs, poultry, produce and dairy products has increased steadily. And the number of different types of disease-causing E. coli in the environment, in livestock, and in our food supply has grown dramatically. 

"It's not just about E. coli O157:H7 anymore," said Secretary Bush. "There are at least two dozen different toxin-producing E. coli that are just as deadly as O157:H7. Twenty-five or thirty years ago, we might have been able to clean up feedlot runoff. We could have prevented these pathogens from overrunning our agricultural areas. But we didn't – it would have cost too much."

Slaughterhouse operators and meat packers welcomed the announcement. "It's great news," said the CEO of Universal Beef, "we'll finally get away from all the expensive and burdensome HACCP/SSOP regulations that were imposed on us by the government a generation ago." Spokespeople for the produce and poultry industry associations were equally effusive.

Not everyone, though, welcomed the announcement. Small-scale farmers, livestock operators and food processors expressed concern about the cost of implementing this new mandate. And "natural food" activists were fighting mad. "This is disgusting," said one woman who asked not to be identified, "Irradiation will destroy the nutrients in our food. We've polluted our water and soil, and we should clean it up. What kind of a world are we leaving our children?"

We contacted Phyllis Entis, the now-retired founder of eFoodAlert and author of the classic text Food Safety: Old Habits, New Perspectives, for her reaction to the announcement. "I saw this coming 25 years ago," said Ms. Entis. "I predicted in 2008 that we were on a slippery slope to mandatory food irradiation."

Most of the country's trading partners reacted angrily to the US announcement. "It's an unfair trade barrier," exclaimed the President of Mexico. "Not fair dinkum," commented Australia's Minister of Trade, "our food is clean and we should not have to irradiate in order to sell to the US market." "I'm outraged that we were not consulted beforehand," commented the President of the EU, "we must consider very carefully before deciding to allow irradiated US foodstuffs into Europe."

When contacted, the Canadian Minister of Foreign Affairs declined to comment. His aide, however, hinted that Canada would soon be announcing its own mandatory food irradiation policy.

The US Food and Drug Administration authorized the use of radiation for the first time in 1963, permitting its use to control insect infestation in wheat and wheat products. During the following decades, additional applications of gamma radiation and electron beam sterilization were approved, including spices, certain fruits and vegetables, as well as fresh meat and poultry. And on August 22, 2008, spinach and iceberg lettuce were added to the list.

But these were voluntary uses, to be accompanied by appropriate retail package labeling. Now the rules have changed, and almost everything we eat will be irradiated.

Will this be a change for the better, or the downfall of our food supply?

No one really knows. Are we worried?

In the words of our Secretary of State for Food Safety, "You Betcha!"

___________________________

**Disclaimer** Of course, this is pure fantasy. Will it happen? We don't know. Could it happen? Yes. Should we worry? You Betcha!

Oklahoma Update

There's very little new to report on the northeast Oklahoma E. coli O111 outbreak. According to today's Situation Update (issued by the Oklahoma Department of Health), there has been no change in the total number of confirmed victims; the tally stands at 206. 

Approximately 50 of the victims required hospitalization, and 27 remain in hospital as of today. One person has died. The Country Cottage restaurant remains closed, and the investigation – consisting of lab tests, restaurant inspection and patron interviews – is continuing. 

The state believes that this outbreak is restaurant-associated, and that the relatively small number of patients who did not eat at the Country Cottage were the victims of a secondary infection carried by a restaurant patron. 

The Department of Health is reminding everyone to pay special attention to personal hygiene – especially careful and thorough hand-washing – during and after this outbreak. Anyone who is experiencing symptoms of E. coli O111 infection, such as diarrhea, should not be preparing food, washing dishes, or cleaning up in the kitchen. 

Salmonella Saintpaul Outbreak - Looking Back

The CDC has made it official. The marathon outbreak of Salmonella Saintpaul that spread through 43 states, the District of Columbia and even touched Canada is now over. All remaining advisories against consuming raw tomatoes, jalapeño peppers and serrano peppers have been lifted. Salsa lovers can smile again.

The outbreak began with a whimper. The first two (?) victims became ill on April 16th. About one week later, another person began to experience symptoms of gastroenteritis. A few more people were sickened in late April/early May.

The number of illnesses exploded in mid-May, peaked early in June, and gradually began to fall off. The last victim of the outbreak fell ill on August 11th. In all, 1442 people became infected with the outbreak strain of Salmonella Saintpaul between early April and early August; 286 people were hospitalized, and the pathogen contributed to the death of two victims in Texas.

New Mexico was the first state to spot the outbreak, notifying CDC of four cases with a common outbreak strain fingerprint on May 22nd. On May 23rd, the New Mexico Department of Health announced that it was investigating 19 apparently related cases of Salmonella, reported since May 8th. The victims lived in several different counties, and their ages ranged between 2 and 82 years old. About one week later, New Mexico announced that the Salmonella outbreak had grown to at least 31 people, and appeared to be linked to the consumption of raw tomatoes.

The Texas Department of Health was the next state out of the starting gate. Their news release, dated June 3rd, announced that the state had confirmed 21 cases of salmonellosis due to Salmonella Saintpaul. By this time, CDC had already posted its first outbreak summary.

On June 2nd, CDC announced that the United States was experiencing a multi-state outbreak of salmonellosis due to Salmonella Saintpaul. By then, 70 cases – 40 of them in Texas and New Mexico – had been confirmed in 9 states. Based on epidemiological evidence gathered in New Mexico and Texas, raw tomatoes were suspected to be the source of the pathogen. 

The following day – June 3rd – FDA warned consumers in New Mexico and Texas to avoid eating certain types of raw tomatoes: red plum, red Roma, and round red. Four days later, the agency expanded its warning to consumers across the entire United States. FDA also began to post its much-maligned list of "safe" growing areas from which tomatoes could be eaten with confidence.

It would be more than a month – July 17th – before FDA lifted its tomato advisory. By then, the number of outbreak victims had risen to 1,220 and the focus of the investigation had shifted to raw jalapeño and raw serrano peppers. 

It appeared for a painfully long time that investigators would never find a plausible source for the outbreak. Then fate intervened. The Colorado Department of Public Health and Environment announced on July 28th that their state lab had found the outbreak strain of Salmonella Saintpaul on a jalapeño pepper obtained from a Colorado outbreak victim. The Mexican-grown jalapeño had been purchased at a local Wal-Mart store.

Two days later, FDA's David Acheson reported to a Congressional committee hearing that their investigation had uncovered the outbreak strain in irrigation water and serrano peppers from a farm in Nuevo Léon, Mexico.

But what about the tomatoes? CDC continues to say that raw tomatoes may have been a vehicle for the outbreak, especially in the early stages. Initial epidemiological investigations support this association, as does the detection of Salmonella Saintpaul on two different types of peppers from two different farms. But neither state labs, the CDC or the FDA ever succeeded in finding a tomato that was contaminated with the outbreak strain of Salmonella Saintpaul. 

Barring a miracle – or a recurrence of the contamination next growing season – no one ever will.

Ontario Company Recalls Mushrooms

Ravine Mushroom Farms Inc. of Woodbridge, ON has recalled one production batch of Fresh Obsessions brand Ready To Serve Pre-washed Sliced White Mushrooms, according to a Health Hazard Alert posted yesterday evening by the Canadian Food Inspection Agency. The recalled mushrooms may be contaminated with Listeria monocytogenes.

The recalled mushrooms, which were sold only in Ontario, were packed in 8 ounce / 227 gram packages bearing the identifying UPC 0 69200 00902 2 and lot code R12398.

There have been no illnesses associated with this recall, which is completely unrelated to the Maple Leaf outbreak of Listeria monocytogenes and is also not related to some recent recalls of Listeria monocytogenes-contaminated cheeses in the province of Quebec.

Consumers who have purchased the recalled mushrooms should either discard them or return the packages to the store for a refund.

Quebec Cheese Recalls Expanded

The Canadian Food Inspection Agency announced this evening that the public recall of La Chaudière brand unripened cheese blocks and cheese curds has been expanded to include additional products.

The initial recall was triggered by an outbreak of Salmonella Enteritidis infections in the province of Quebec that sickened 87 people, and killed one of the victims.

The following products have been added to the original recall:

All sizes and flavors of La Chaudière brand, Firm Unripened Cheese Curd, sold flavored in packages bearing a sticker to indicate the flavor: BBQ, Tomates Basilic, or Fines Herbes. The affected products bear Best Before dates up to and including 29SE2008 and were distributed in the province of Quebec.

The Quebec Ministry of Agriculture and Fisheries (MAPAQ) also announced this evening an expansion of its earlier recall of cheese from Aux Petits Délices GT Inc., due to contamination with Listeria monocytogenes. This recall now encompasses all cheeses packaged in variable weights and sold at the following two locations since August 6th:

• 1191, avenue Cartier, Québec
  
• 2500, chemin des Quatre-Bourgeois (Halles de Sainte-Foy), Québec
  

According to the original recall notice, one case of listeriosis has been associated with cheese from Aux Petits Délices. This case is unrelated to the Canada-wide outbreak of Listeria monocytogenes that has been linked to Maple Leaf deli meats.

Anyone who has purchased these cheeses should either discard them or return them to the store for a refund.

Oklahoma's E. coli Mystery

Northeast Oklahoma's E. coli outbreak keeps on getting worse.

The state's Department of Health reported this morning that at least 206 people – among them, 149 adults and 53 children – have now been infected with E. coli O111. Victims range in age between 2 months and 88 years, and one person has died as a result of his infection.

Most of the victims ate at the Country Cottage restaurant in Locust Grove, OK between August 15th and August 23rd. Not all of the restaurant's patrons became infected, however, and not all of the victims ate at the Country Cottage.

Investigators are still puzzling over the source of the infection. Suspicion fell, briefly, on water from a private well. This possibility now has been discounted. The state continues to interview victims and other restaurant patrons – more than 500 people have been contacted so far –  and is conducting an intensive microbiological investigation of the restaurant's food preparation and serving areas.

The symptoms reported by the victims of the outbreak suggested, at first, that E. coli O157:H7 had decided to pay a visit to Locust Grove. But the culprit proved to be a different, and – at least in North America – far less common strain, known as E. coli O111. Unfortunately, though less common, E. coli O111 has proven itself to be just as virulent as its better-known relative.

E. coli O111 is better known on the other side of the world – in Australia, where E. coli O157:H7 is far less prevalent than in North America or Europe. In 1995, E. coli O111 was responsible for an outbreak of hemolytic uremic syndrome that sent 23 children in and around Adelaide, South Australia to hospital. Sixteen of the victims required dialysis, and one little girl died. The microbe was recovered from several samples of mettwurst, an uncooked, semidry fermented sausage. All of the contaminated sausages were from a single manufacturer. 

Although uncommon, E. coli O111 is not completely unknown in the United States. A 2004 outbreak of severe gastroenteritis in New York State was traced to unpasteurized apple cider that was contaminated with E. coli O111 and Cryptosporidium. That outbreak was responsible for 213 illnesses; 15 of the victims were hospitalized.

It is fruitless, at this point, to speculate on the source of Oklahoma's E. coli O111. That will only be determined – if at all – as a result of the state's epidemiological and microbiological investigations. Until the investigation has been completed, the Country Cottage restaurant will remain closed. And the mystery will deepen.

Maple Leaf Listeria Outbreak: Post-Labour Day Update

Canadians may take a holiday the first weekend of September, but Listeria monocytogenes never rests. 

As of mid-afternoon September 1st, the Public Health Agency of Canada, in cooperation with provincial health authorities have confirmed 38 cases of Listeria monocytogenes in this national outbreak. Twenty-nine of the confirmed cases are from Ontario; the rest of the 9 victims are from British Columbia (4), Alberta (2), Saskatchewan (1) and Quebec (2). An additional 21 suspect cases are still under investigation, including one each in Manitoba and Prince Edward Island.

This outbreak has killed, or contributed to the death of, at least 12 people so far – 10 of them in Ontario, and one each in Alberta and British Columbia. An additional seven deaths are still being investigated.

Maple Leaf has closed its Bartor Road processing facility temporarily, and has initiated a precautionary recall of all food produced and shipped from that facility since January 2008. The company estimates that this recall will cost Maple Leaf approximately CDN$20 million.

Much of the recalled meat was supplied to nursing homes, hospitals, and other institutions across Canada. The six regional health authorities in British Columbia have each listed the institutions in their respective jurisdictions that served recalled products to residents or staff. Following are the links to the BC lists.

• Northern Health Authority: 2 confirmed cases
  
• Vancouver Island Health Authority: 1 confirmed case
  
• Interior Health Authority: 1 confirmed case
  
• Vancouver Coastal Health Authority: no confirmed cases
  
• Fraser Health Authority: no confirmed cases
  
• Provincial Health Services Authority: no confirmed cases
  

Canadians in other parts of the country should contact their local health districts or provincial health departments to inquire which institutions may have purchased and served recalled products to their residents or staff. For an updated list of retail-level recalls, keep an eye on our Maple Leaf Retail Recall List post, which is revised whenever new information becomes available.

   

Fonterra Recalls Feta Cheese - Listeria Strikes Again

Fonterra Brands (Australia) recalled all 200g and 500g packages of Mainland Feta Crumble earlier today (Sept 1) due to the presence of Listeria monocytogenes in the product.

The cheese was distributed nationally. The 200g packages of Crumble were sold through Coles supermarkets and through independent markets, while the 500g packages were supplied to cafés and restaurants. 

The recall was initiated after the company detected Listeria monocytogenes in a "... limited number of samples ..." as part of its routine testing program. No illnesses have been associated with the product, and the company has suspended shipments until it can determine the source of the contamination.

Customers – individual consumers, retail establishments or food service operators – who have purchased the recalled cheese should return it to the store for a refund or contact their supplier. Under no circumstances should anyone consume or serve this product.

Landshire Recalls Sub Sandwiches: Listeria monocytogenes

Landshire, Inc. (Belleville, IL) announced last week that it was recalling Lot No. 21882 of its"Fresh From The Deli" brand American Sub sandwiches, after the Ohio Department of Agriculture detected Listeria monocytogenes in one of the sandwiches during routine retail-level surveillance sampling.

The sandwiches were sold in Circle K convenience stores in Indiana, Kentucky, Ohio and Pennsylvania. The contaminated sample was collected at the Circle K store located at 36391 Vine Street, Willoughby, OH on August 18th.

No illnesses have been reported, and the company has suspended production and distribution until the source of the contamination is found and corrected.

Customers who have purchased the recalled sandwiches should return them – uneaten – to the store for a full refund. For answers to any questions about this recall, contact Landshire, toll-free, at 1-800-468-3354.

Would You Prefer Salmonella Or Listeria With Your Cheese?

It seems like only yesterday – it was about a month ago – that the the province of Quebec announced that it would be introducing new rules to allow local cheese makers to produce and sell raw milk cheeses. The Montreal Gazette celebrated this epiphany on the part of the province's food regulators with an unequivocal "It's about time."

In fact, it's about safety – or the lack of it. 

During the month of August, Quebec health authorities noticed an unusually high number of reported cases of Salmonella gastroenteritis in the region south of Quebec City, in the central part of the province, and in the Eastern Townships. At last count, 87 people were infected with the outbreak strain of Salmonella Enteritidis. One elderly person died, and at least 40% of the victims were hospitalized briefly due to dehydration.

On August 29th, Fromages La Chaudière Inc. (Lac-Mégantic, QC) announced a recall of firm unripened cheese,  sold in curds and blocks. The recalled cheeses – manufactured between July 24th and August 24th – are marketed under the brand names La Chaudière, Polo, Tradition, and Super C. Some of the cheese may have been cut and repackaged at retail.

Quebec consumers who have purchased mild unripened cheese curds or block cheese in the last month should contact their retailer to find out whether the cheese they purchased is included in this recall announcement. Anyone living in the affected parts of Quebec, who has eaten this type of cheese and later experienced symptoms of Salmonella gastroenteritis, should seek medical attention.

The Salmonella news broke just one day after the province announced the third in a series of three cheese recalls due to Listeria monocytogenes within a one-week period.

On August 22nd, Aux Petits Délices (1191 avenue Cartier, Quebec, QC) recalled all Riopelle de l'Ile cheese sold at their location between August 6th and August 11th. The cheese – contaminated with Listeria monocytogenes – was linked to a single illness. Consumers who purchased the cheese were advised either to return it to the retailer or to destroy the cheese.

Four days later – August 26th – Octofruit Maître Gourmet (190, boul Labelle, Sainte-Thérèse, QC) recalled Mont-Jacob brand cheese, packaged on August 14th and labeled with a Best Before date of August 29th. Once again, the reason given for the recall was Listeria monocytogenes contamination. And once again, a single case of listeriosis was traced to the contaminated cheese.

Trouble is said to come in threes, and the third cheese recall was announced on August 28th. S. Bourassa (Saint-Sauveur) Ltée. (105, B. Guindon, Saint-Sauveur, QC) recalled Tomme de Grosse-Île brand cheese packaged by the retailer on August 15th and labeled with a Best Before date of September 5th. This time, although the cheese was contaminated with Listeria monocytogenes, no illnesses had been reported.

Researchers at the University of Vermont reported last month in Journal of Food Protection that "... most raw milk intended for farmstead cheesemaking [in Vermont] is of high microbiological quality with a low incidence of ..." pathogens such as Salmonella, Listeria monocytogenes, Staphylococcus aureus and E. coli O157:H7. Nevertheless, 8 of the 11 farms included in their study produced milk that contained Staphylococcus aureus. Three (out of 133)  milk samples – two from the same farm – yielded Listeria monocytogenes, and one sample was positive for E. coli O157:H7.

Quebec is not alone in proposing to allow the commercial manufacture of dairy products made using unpasteurized milk. New Zealand is considering a similar step. Having enjoyed raw milk cheeses while traveling in France, I understand the gastronomic and marketing appeal of these foods. But I hope that regulators in these and other jurisdictions will consider very carefully how to minimize the risks inherent in raw milk-based dairy products before finalizing their policy shift.

Market trends must not be allowed to trump food safety.

Washington Company Recalls Smoked Salmon

Trans Ocean Products (Bellingham, WA) has recalled Lot No. 54933-2 of "Cracked Pepper Style Smoked Salmon" after finding Listeria monocytogenes in one 4-ounce package. The company also has suspended distribution of the product while it conducts an investigation into the source of the contamination in cooperation with FDA.

The recalled smoked salmon was sold in supermarkets in seven states:

• Brookshire Brothers – Texas, Louisiana
  
• Giant Eagle – Ohio, Pennsylvania
  
• Price Chopper – New York, Pennsylvania, Massachusetts, Vermont
  

No illnesses have been reported so far, but Listeria monocytogenes has a very long incubation period. This pathogen typically causes a mild flu-like or gastrointestinal illness in healthy adults, but can be deadly – as Canadians are reminded daily – to the elderly, very young children, people with weakened immune systems, and pregnant women. 

Deli Meats Recalled In Australia

Never let it be said that pathogenic bacteria play favorites. An Australian company, P & M Quality Smallgoods Pty Ltd., has just recalled 100g packages of "Primo Roast Beef Thinly Sliced" and Primo Pastrami Thinly Sliced", due to the chance that they contain Listeria monocytogenes.

The meats are packaged in plastic containers with laminate tops, and are labeled with a "use by" date of 16/09/08. The roast beef was distributed in the states of New South Wales, Queensland and Victoria; the pastrami was sold in Tasmania and South Australia, in addition to the other three states.

The recalled meats should be returned to the place of purchase for a full refund.

There is no indication in the recall notice of any illnesses associated with these products. But the lethal Canadian outbreak of Listeria monocytogenes is a vivid reminder to take these recall notices seriously. Anyone who has eaten one of these recalled products and who has experienced any symptoms consistent with Listeria monocytogenes infection, should seek medical attention immediately.

Oklahoma Food Poisoning Outbreak - E. coli Suspected

The Oklahoma State Department of Health announced yesterday that it is looking into an outbreak of bloody diarrhea in the northeastern part of the state. One person has died so far, at least 14 people have been hospitalized, and more than 20 possible cases are under investigation. 

The victims are from Tulsa and several other communities in that part of the state, including Bixby, Pryor, Sand Springs, Locust Grove, Broken Arrow, Peggs and McAlester. Many of them ate at the Country Cottage restaurant in Locust Grove, OK.

Health authorities suspect E. coli, based on the range and severity of the symptoms – diarrhea, bloody diarrhea, vomiting, severe abdominal cramps, with little or no fever. There is not yet any confirmation of this hypothesis; lab tests are still in progress.

There is no firm evidence that the outbreak originated with the restaurant; an investigation is still in progress. The Country Cottage is reportedly "in compliance" with health standards, according to a report in the Tulsa World, and was given permission by health inspectors on Saturday to remain open. Nevertheless, the restaurant was planning to close today (Tuesday) in order to cooperate in the outbreak investigation.

Anyone who lives in or has recently visited the northeastern part of Oklahoma – including Tulsa – and who is experiencing any of the symptoms described above, should seek medical attention immediately. Whether this proves to be an outbreak of E. coli O157:H7 or some other gastrointestinal pathogen, it is a very dangerous microbe.

Canada's Listeria Outbreak Continues Unabated

Dr. Mark Raizenne, the Director General of Canada's Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, announced today that the national death toll from the country's Listeria monocytogenes outbreak now stands at twelve, according to a CBC report. The number of lab-confirmed cases has risen to 26 from 21, and there are 29 suspected cases still under investigation.

The hardest-hit province is Ontario, which is reporting 20 confirmed cases, with an additional 13 under investigation. There have been 11 deaths among the 20 confirmed cases; in at least 6 of those deaths, the Listeria monocytogenes infection has been judged an "underlying or contributing cause." 

The outbreak was traced to processed meat from Maple Leaf Consumer Foods' Bartor Road facility in Toronto. Microbiological analysis of two samples of meat from that facility yielded cultures of Listeria monocytogenes that are have genetic fingerprints identical to the outbreak strain isolated from patients. A third sample yielded a very slightly different strain of Listeria monocytogenes.

Maple Leaf has responded to the lab findings by recalling everything produced at the Bartor Road facility since the beginning of June. Some secondary recalls have also been announced by companies who used the Maple Leaf meats to produce prepared sandwiches for retail sale.

Consumers,  managers of institutional food service operations, and owners and operators of deli shops are being reminded to check their food supplies against the recall lists published by Maple Leaf, and to discard any suspect food items. 

Anyone who experiences symptoms consistent with listeriosis and who may have eaten a cold cut or deli meat in recent weeks, should be examined by a doctor. Pregnant women, the elderly, young children and immune-compromised individuals must be especially careful to avoid eating these types of foods. 

For more information, call toll-free 1-800-O Canada.

Maple Leaf Releases Expanded Recall List

CTV Toronto is reporting that Maple Leaf Consumer Foods has released an expanded list of recalled products from its Bartor Road processing facility. The list does not yet appear on the Maple Leaf web site, but can be found in the CTV report.

The list of products includes all Schneiders, Burns, Sure Slice and other cold cuts – beef, pork and poultry – identified as coming from Establishment No. 97B, in addition to Shopsy's sandwiches labeled with Best Before dates up to and including AU 22 and  AU 24.

The recalled products were distributed to food service operators, nursing homes, retirement homes, hospitals, and deli counters across Canada. The company has not released a list of recipients of the recalled meat.

Consumers should avoid eating cold cuts unless they can establish with certainty the source of the meat. Especially, the elderly, young children, immune-compromised individuals and pregnant women should not eat cold cuts until this outbreak is over. 

Maple Leaf Recalls All Food Products From Bartor Road Facility

Maple Leaf Foods has responded to the confirmation that its products were the source of Canada's lethal Listeria monocytogenes outbreak by recalling all outstanding food products from its Bartor Road facility (Establishment No. 97B).

The company will post a complete list of recalled items on its web site some time today. The production facility will remain closed until workers complete a thorough scrub-down and sanitation of the plant. The facility is expected to reopen sometime this week.

As of yesterday evening, 21 cases of listeriosis have been linked by genetic fingerprinting to the contaminated Maple Leaf meat products. Four of those people died as a direct or indirect result of their infection. An additional 30 cases of listeriosis are under investigation to determine whether or not they are part of this same outbreak.

All of the confirmed cases so far have been concentrated in four provinces: Ontario (16 cases, including 3 deaths), British Columbia (3 cases and 1 death), Saskatchewan (1 case) and Quebec (1 case). The 30 additional suspected victims live in Ontario (14), British Columbia (2), Alberta (4), Saskatchewan (2) and Quebec (8).

There will be a press briefing this afternoon in Ottawa at 2pm (EDT) to provide an update on the progress of the outbreak investigation.

Maple Leaf Link To Outbreak Confirmed

According to a report this evening on CBC, the Prime Minister's Office has confirmed the link between Canada's deadly outbreak of Listeria monocytogenes and contaminated meat produced by Maple Leaf Consumer Foods.

As I reported earlier this evening, there have now been four confirmed deaths associated with this outbreak. Twenty one cases of listeriosis have been linked genetically to the outbreak strain, and an additional 30 cases are under investigation.

Canada Issues Updated Information On Listeria Outbreak

Following the progress of a food poisoning investigation in the news media can be frustrating, to say the least. Every reporter has his or her own media sources, and the numbers don't always add up.

This evening, the Public Health Agency of Canada released an update statement on the progress of the investigation. Here are the latest statistics:

• Contrary to press reports of five fatalities, PHAC has confirmed four deaths so far – three in Ontario and one in British Columbia.
  
• Federal and provincial health agencies have confirmed 21 cases of listeriosis linked to the outbreak strain so far – 16 in Ontario, 3 in BC and one each in Saskatchewan and Quebec.
  
• There are 30 additional suspect cases awaiting genetic fingerprint confirmation, including 4 in Alberta.
  
• PHAC and the Canadian Food Inspection Agency are still waiting for genetic fingerprint results on an isolate of Listeria monocytogenes obtained from Maple Leaf samples before they are prepared to say, definitively, that the company's meat was the source of the outbreak. 
  

The CFIA has posted a FAQ sheet on its website. Consumers in search of information on Listeria monocytogenes and on the specifics of the outbreak and recall can navigate to the CFIA site for some answers.

There have been suggestions in the news media and in the blogosphere that Canadian government agencies were dilatory during the early stages of this outbreak. But that's a separate story. We'll be reviewing the outbreak time line in the next week or so.

Nebraska Beef Ltd.-Recalled Meat Distribution List

UPDATED AUGUST 23, 2008

Since USDA has not yet gotten its act together and delivered on its promise to begin listing retail stores that were supplied recalled meat and poultry, we'll do our best to fill in the knowledge gap. 

California consumers can obtain a complete list of retail markets, restaurants and hotels that received the recalled meat by navigating to the California Department of Public Health site for the most recent update.

Here is a consolidated list of all US retail recipients outside California that we've learned about so far.

Whole Foods Markets: all stores in Alabama, Colorado, Connecticut, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Mexico, New Jersey, New York, North Carolina, Ohio, Rhode Island, Pennsylvania, South Carolina, Tennessee, Utah, Virginia, Washington DC, Wisconsin. 

Fred Meyer (a Kroger company): all stores in Oregon, Idaho, Washington, Alaska.

King Soopers and City Market (both Kroger companies): all stores in Colorado and Wyoming. A second recall notice, with additional items, was issued August 19th.

Jay C: all stores in southern Indiana.

Kroger: all stores in Cincinnati, Dayton, northern Kentucky and southeast Indiana.

Kroger: all Kroger, Scott's, Owen's, Hilander and Pay Less stores in Indiana, Illinois and Missouri. A second recall notice, with additional items, was issued August 14th.

Cub Foods and bigg's (subsidiaries of Supervalu): Cub Foods stores in Minnesota and bigg's stores in greater Cincinnati and northern Kentucky. Thank you to reader "Batman" for pointing us to this one.

Please read the linked press releases for details of lot numbers and product descriptions, and return any recalled meat to the store for a full refund.

This distribution list will continue to be updated as more information becomes available. Please link to this post and check back periodically.

Alaskan Smoked Salmon Contaminated With Listeria, Recalled

FDA has announced that Interior Alaska Fish Processors, Inc. has recalled batch #637 of its Santa's Smokehouse smoked keta salmon due to possible contamination with Listeria monocytogenes. The FDA recall notice is dated August 13, 2008, but was only distributed by email today.

The recalled product, described as "teriyaki style smoked keta salmon," was packed in random weights in clear vacuum-sealed plastic bags and was sold at the company's Fairbanks, Alaska store or sold in gift packs over the Internet between mid-December 2007 and July 2008.

The contamination was detected during a routine survey sampling carried out by the Alaska Department of Environmental Conservation. No illnesses have been reported in associated with this recall.

The Interior Alaska is asking its customers to return any recalled product to the company for a full refund.

Star Foods "Blows" It, Issues Recall Notice

The UK Food Standards Agency is alerting consumers to a recall initiated by Star Foods Inc. due to date labeling and vacuum packaging issues. The company has recalled all sizes and date codes of the following products:

• Star Foods Peppered Mackerel
  
• Star Foods Smoked Mackerel
  
• Star Foods Sliced Chicken Roll
  
• Star Foods Sliced Chicken Breast
  
• Star Foods Sliced Spiced Chicken
  

Several of the recalled items were labeled with incorrectly extended use-by dates. The peppered and smoked mackerel products were not vacuum packaged correctly, and some of the packages have blown. Blowing of a normally vacuum-packaged product is a symptom of possible microbial growth in the package.

The recalled items were distributed only in the southeast region of the UK. Star Foods has requested that its customers return these products to the place of purchase for a full refund. Consumers may contact Harry by telephone at 07958 194963 to obtain any additional information they may require. 

Kentucky Company Recalls "Hot Pockets"

USDA is advising consumers this morning that Nestlé Prepared Foods Company of Mt. Sterling, KY has recalled some 215,660 pounds of "Hot Pockets" frozen pepperoni pizza sandwich products, because they "... may contain foreign materials." 

The Class I recall was initiated as a result of consumer complaints. No illnesses or injuries have been reported.

The following product has been recalled:

54-ounce, 12-pack cartons of "HOT POCKETS PEPPERONI PIZZA" brand stuffed sandwiches. Printed on the side of each carton is "8157544614D," "EST 7721A," and "BEST BEFORE JAN2010."

The recalled food was produced on June 5th and distributed to retail stores nationwide. Neither Nestlé nor USDA have provided a list of retailers that received the recalled items. 

The following retailers have issued their own recall notices as a result of the Nestlé recall:

• Giant Food LLC, with stores in Virginia, Maryland, Delaware and DC
  
• Stop & Shop Supermarket Company, with stores in Massachusetts, Connecticut, Rhode Island, Maine, New Hampshire, New York and New Jersey
  

This retail recall list will be updated as additional food chains chime in. For more information on the recall, consumers can contact the Nestlé Consumer Services Center at (800) 350-5016.

New Zealand Norovirus: More Victims, But Hospital Reopens

Dunedin Hospital in New Zealand has reopened for business after closing its doors to visitors, out-patients and new admissions in an effort to contain a recent outbreak of Norovirus.

The decision to reopen the hospital was taken despite the onset of additional cases of gastroenteritis due to this highly contagious virus. Some wards, however, remain closed.

At last count, more than 150 patients and staff at Dunedin and Wakari hospitals have been infected with Norovirus, and 30 patients remain in isolation.

In an apparently unrelated incident, Norovirus also has infected approximately about half of the 24 residents of a rest home in Greymouth, New Zealand. And, halfway around the world, Cheltenham General Hospital in Gloucestershire, England has closed a trauma ward in the hope of containing an outbreak of Norovirus gastroenteritis that has sickened an unspecified number of people.

Misery (a.k.a. Norovirus) not only loves, but also thrives on, company.

Canadian Listeria Outbreak Claims Five Lives

The death toll in the nationwide Canadian outbreak of Listeria monocytogenes has grown to five – all in Ontario – according to a report today by the Canadian Broadcasting Corporation. Three of the victims are from Toronto. Sun Media reports one death in Hamilton, and one in Peterborough.

So far, there have been a total of 17 confirmed cases of Listeria monocytogenes, including the five fatalities. Thirteen of the 17 are from Ontario. There are an additional 16 cases under investigation. All of the confirmed cases – including those from British Columbia – have been tied to the same outbreak strain.

Earlier today, the Canadian Food Inspection Agency issued a clarification to its previous Health Hazard Alert. The revision corrects confusion over the range of products and expiration dates covered in the Maple Leaf recall.

Health authorities continue to stress that the link between the Listeria monocytogenes outbreak strain and the strain of Listeria monocytogenes found in the Maple Leaf meat samples has not yet been confirmed. But, if the scope of the recall is any indication, CFIA and Maple Leaf are acting on the assumption that the link will be confirmed.

As we reported earlier, Maple Leaf has closed its processing facility temporarily to permit a complete tear-down, testing and comprehensive cleaning and sanitation of the two processing lines on which the recalled foods were produced and packaged. The plant is expected to reopen on Monday.

Most of the recalled products were supplied directly to nursing homes and other food service operations, which helps to explain the demographic profile of the outbreak victims. Their average age is 65 years, and many of them were in nursing homes or already hospitalized for another reason at the time of their exposure to the pathogen.

Listeria monocytogenes is especially dangerous to the very young, the elderly, pregnant women and immune-compromised individuals. If you have a family member or friend who is in a nursing home, an assisted living facility, a seniors' residence, or is hospitalized, please contact the institution's management and verify that they are aware of – and have responded appropriately to – this recall.

Salmonella Agona Outbreak Spreads

An outbreak of Salmonella Agona, which began in the British Isles, and was traced to sliced meats processed and distributed by Dawn Farm Foods in the Republic of Ireland, has spread to three countries on the European mainland.

Last week, Eurosurveillance reported that 110 illnesses due to the outbreak strain had been confirmed in the Republic of Ireland, the UK – England, Scotland and Wales – and Finland. Fourteen of the victims were hospitalized, and one elderly woman died. An additional nine cases were under investigation.

Since then, two cases of Salmonella Agona have been reported in Sweden and one case in France. The total number of confirmed and probable cases in the EU has risen to 132.

Yesterday, the Food Safety Authority of Ireland posted an updated list of products recalled by Dawn Farm Foods. Food service operators and caterers are reminded to check the list of recalled items to make certain that they have been withdrawn from use.

Nebraska Beef Recall Fallout Continues

Some supermarket chains who already issued ground beef recall notices as a result of the Nebraska Beef fiasco, updated those notices today.

Kroger has asked customers of Kroger, Scott's, Owens, Hilander and Pay Less stores in Indiana, Illinois and Missouri to discard ground beef with sell by dates of August 1st through 16th, inclusive.

King Soopers and City Market stores are asking customers throughout Colorado and Wyoming to check for the following frozen ground beef items:

• Kroger Ground Beef Patties, 73% Lean/27% Fat; 3-pound packages; "sell by" date of 11/06/08; UPC 11110 97981
  
• Kroger Ground Beef Family Pack, 73% Lean/27% Fat; 6-pound packages; "sell by" date of 11/06/08; UPC 11110 97988
  
• Kroger Ground Sirloin Beef Patties, 85% Lean/15% Fat; 2.5-pound packages; "sell by" date of 11/06/08; UPC 11110 97987.
  

Recalled meat should be returned to the store for a full refund or replacement.

These recalls are the result of Nebraska Beef's recent expanded recall of nearly 1.4 million pounds of beef. The company agreed to the recalls after meat from their processing facility was linked to two separate outbreaks of E. coli O157:H7 infections earlier this summer.

Water Woes: Cryptosporidium

Cryptosporidium – a protozoan parasite that is able to withstand normal levels of water chlorination – has popped into the news once again, with outbreaks reported in Ohio and New Mexico.

Health officials in Columbus and Franklin County, Ohio have received reports of 31 cases of Cryptosporidium infection since the beginning of July. Suspicion has fallen on public swimming pools – a common means of spread. 

In Albuquerque, the health department has confirmed two cases of Cryptosporidium and is investigating 10 more. Victims reported swimming at the West Mesa Aquatic Center. The city has hyperchlorinated its swimming pools in order to kill the pathogen, and advises that public pools are safe for swimming.

Cryptosporidium infections may be asymptomatic, or they can induce watery diarrhea, stomach cramps, nausea and vomiting. The protozoa is transmitted through contact with infectious feces. Children suffering from diarrhea often can contaminate water in swimming pools or wading pools and pass their infection on to others.

Maple Leaf Expands Listeria Recall

Maple Leaf Consumer Foods today expanded its previously announced recall of "Sure Slice" sliced roast beef and sliced corned beef to include a long list of products that were processed on the same lines as the two products already recalled.

The initial recall was due to the possibility that the sliced meat products may have been contaminated with Listeria monocytogenes. According to Maple Leaf's most recent news release, the pathogen has been found at a low level in a small number of packages of the corned beef and roast beef.

This morning, the Canadian Broadcasting Corporation reported that Health Canada is investigating an outbreak of Listeria monocytogenes that has affected at least 17 people nation-wide and has claimed the life of an Ontario resident. Thirteen of the 17 victims live in the province of Ontario; the others are in British Columbia, Saskachewan and Quebec.

While Health Canada has not yet directly linked the Maple Leaf meats to this outbreak, the company has decided to expand its recall to include all products processed since June 2nd on the same two lines used for the sliced roast beef and sliced corned beef. Maple Leaf has also closed its processing facility temporarily, "... in order to fully reassess all aspects of its food safety procedures at this facility, including supplementary sanitation of equipment and validation of our testing protocols."

All of the recalled meat was produced at the company's Bartor Road facility in Toronto, identified on the packaging as Establishment No. 97B. The meat was sold mostly to food service operators, nursing homes, restaurants and fast food chains – including McDonald's and Mr. Sub. Some of the packaged meat also was distributed to retail food stores and delis. McDonald's has temporarily withdrawn its turkey BLT sandwich from store menus as a precaution.

The Canadian Food Inspection Agency has issued a Health Hazard Alert that provides a complete list of the recalled products. The affected brand names include Schneiders, MSD and Burns, among others. Please check the CFIA notice or the Maple Leaf news release for details.

Anyone who may have eaten any of these sliced meat products and who has experienced symptoms consistent with Listeria monocytogenes infection should contact a doctor. While Listeria monocytogenes usually produces only mild flu-like or gastrointestinal symptoms in healthy adults, it can cause serious illness – even death in young children, the elderly, immune-compromised individuals and pregnant women.

New Salmonella In New Mexico

The New Mexico Department of Health and the New Mexico Environment Department are investigating a cluster of nine cases of Salmonella gastroenteritis traced to Diego's Restaurant in Santa Fe. According to a news release dated August 18th, two of the nine victims were hospitalized. 

The investigation in ongoing, but there is no indication from the news release of any connection between this outbreak and the nation-wide Salmonella Saintpaul outbreak that has had FDA running around in circles for the last three months. An inspection of the restaurant, conducted as part of the investigation, uncovered some inappropriate food handling practices, which have since been corrected.

The nine victims fell ill between August 2nd and August 7th. They range in age from 5 to 62 years old. Eight of the nine live in Santa Fe County.

Anyone who ate at Diego's Restaurant in Santa Fe since late July and who has since experienced symptoms of Salmonella gastroenteritis – nausea, stomach ache, diarrhea, low-grade fever – should contact their doctor. Medical practitioners who suspect one of their patients is suffering from Salmonella gastroenteritis should obtain a stool specimen for culture, whether or not the patient ate at Diego's. 

Salmonella is a reportable disease. For more information, individuals or medical practitioners can call the New Mexico Department of Health at (505) 827-0006.