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 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.