Cholera - A Disaster of a Disease

In May 2003, the World Health Organization warned of the risk of an epidemic of diarrheal disease, including cholera, in Iraq due to “...the lack of access to clean, safe water and the problems with security...” The WHO reported 18 confirmed cases of cholera in Basra (in southern Iraq), and warned that the disease could spread throughout the war-torn country. Fortunately, the outbreak subsided.

Cholera is caused by a bacterium, Vibrio cholerae, which is endemic (present all the time at low levels) in many areas of the world. The pathogen, which causes a severe, watery diarrhea resulting in life-threatening dehydration, is spread mostly through contaminated water. Crowded living conditions, poor sanitation and inadequate clean water supplies can also lead to secondary person-to-person transmission.

If the microbe is present in the environment, a cholera outbreak often flares up wherever a natural or man-made disaster strikes. Floods, earthquakes, war and tsunamis are all breeding grounds for cholera, which takes advantage of the crowded refugee camps, contaminated water and general chaos that follow in the wake of disaster to strike down its victims.

The list of countries that have struggled with cholera outbreaks in recent years include, among others, Angola, Afghanistan, Uganda, Sudan, Zambia, Liberia, Somalia and the Congo. It’s no coincidence that these same countries have been decimated by war, famine, floods or drought.

This year, it’s Iraq’s turn again. In September the WHO reported that nearly 300 cases of cholera had been confirmed in the area of Kirkuk, in northern Iraq. By the beginning of October, the number of cases in the north had surpassed 3,000, and the disease had spread to 9 of Iraq’s 18 provinces. Cases were reported in Diala, a province neighboring Baghdad, in Baghdad itself, and in a few other cities - including Basra.

Cholera is the great leveler. It doesn’t discriminate based on race, religion, gender, age or national origin. The tools to defeat it are well known - a clean, adequate water supply and basic sanitation. Isn’t it about time that Iraqi’s had reliable access to these fundamental items that most of us take for granted?

Cattle, E. coli and Crohn's Disease

Some news out of the UK could help to explain the cause of Crohn's Disease. For quite a few years, researchers have suspected that a bacterium known as Mycobacterium paratuberculosis was somehow tied in to the disease. M. paratuberculosis, which is found in dairy products, causes a similar disease to Crohn's in cattle, known as Johne's disease. Now a group of researchers from the University of Liverpool think that they have figured out how M. paratuberculosis causes Crohn's disease.

The researchers have determined that M. paratuberculosis produces a molecule that interferes with the ability of macrophages (a type of white blood cell) to kill E. coli. Macrophages play an important role in the immune system, swallowing up invaders and then killing them. Speculation is that this interference might produce inflammation in the intestines, leading to Crohn's.

If this work is corroborated, the researchers believe that it could lead to improved treatment for patients of Crohn's disease.

By the way, people who drink raw milk or who eat dairy products (such as yogurts or cheese) made from raw milk are at an increased risk of encountering Mycobacterium paratuberculosis.

Would You Like Hormones With Your Hamburger?

Recently, I was reading a couple of research reports on a new E. coli O157:H7 cattle vaccine. The vaccine, which is meant to reduce the incidence of the microbe in feedlot cattle, has not yet been approved for use in the United States and has “investigational” status in Canada.

What caught my eye in these reports was the mention of the use of growth implants. These are pellets which are placed under the skin of the ear and slowly release growth hormones into the animal’s bloodstream. The hormones help the cattle “bulk up” more rapidly - just like athletes on anabolic steroids.

Growth promoting implants have been used by beef producers for more than 30 years. There are hundreds of articles in the scientific and technical literature touting the economic benefits of various growth-promoting hormones. I decided to check whether anyone had thought to investigate whether the use of these hormones might have an impact on the susceptibility of cattle to become colonized with E. coli O157:H7.

As far as I can tell, only one study has addressed this issue. A group of Canadian researchers systematically tested the effects of a growth promoting implant and the use of antibiotic feeding supplements on the presence or absence of E. coli O157 in cattle feces. In this study, some of the cattle (the control group) received neither hormones nor antibiotics; the others received a hormone implant, an antibiotic supplement, or both. At various times during the course of the 165-day experiment, feces from all of the cattle were tested for E. coli O157.

At no time during the entire study was E. coli O157 found in the feces of the “control” group - the cattle that received no hormones and no antibiotics. In contrast, more than half (54%) of the treated animals were positive for E. coli O157 at least once. The authors of the report (published in the Journal of Food Protection in November 2006) concluded that “...the high prevalence of E. coli O157 we observed may have been caused by the administration of growth-promoting agents...”

The authors went on to note that the differences between the treated and untreated cattle were not statistically significant. This was likely due, at least in part, to the small size of their experiment (only 80 animals in total). They went on to suggest that a larger study would allow more conclusive results to emerge. While we’re waiting, anyone for a hamburger?

A Honey of a Dilemma

A recent study reported by Pennsylvania State University has confirmed what Grandma told us many years ago. The best remedy for a sore throat is a spoonful of honey. Unfortunately, for children under one year old, eating honey carries a risk of developing infant botulism.

Infant botulism was first diagnosed in California nearly 30 years ago, and is thought to be one of the causes of Sudden Infant Death Syndrome. In the typical form of botulism, the microbe grows in a food and produces its toxin before the food is eaten. But infant botulism results when the victim ingests spores of Clostridium botulinum (or one or two other species of Clostridium). Those spores then germinate inside the intestines, and the toxin-producing bacteria multiply.

Symptoms of infant botulism include lethargy, constipation, and poor muscle tone. Infant botulism can be deadly if untreated. It is essential to have your infant seen by a doctor as soon as you suspect that something is wrong. Victims of infant botulism require an extended hospital stay - often in a pediatric intensive care unit and, usually, with mechanical breathing assistance for part of their stay. Intravenous treatment with Botulism Immune Globulin can speed up the recovery period. With appropriate care, the chances for a full recovery are good.

There is some controversy over the extent to which honey is the source of infant botulism. It is certainly not the only source of C. botulinum spores. The microbe is a normal inhabitant of soil and has been found in house dust and the contents of vacuum cleaner bags. But contaminated honey has been linked to some of the cases that have been reported in the United States, Japan and a handful of other countries, including Denmark.

An obvious question is whether certain types of honey (raw, pasteurized, organic, commercial) are safer than others. I have not found any evidence that this is so. The spores of C. botulinum are heat-resistant. They can easily survive pasteurization. And while C. botulinum will not multiply in the honey, its spores are very capable of surviving in a resting state until they reach a more welcoming environment, such as an infant’s large intestine.

The authors of the Pennsylvania State University study have suggested that honey is a better choice for relieving a child’s sore throat than commercial cough suppressant syrups. They have also - correctly - included a caution that honey should not be used for this purpose with children younger than one year. It’s far better for you and your infant to spend a few sleepless nights due to the infant’s sore throat than to risk exposing your baby to a potentially life-threatening illness.

Managing Risks - A Page from the Australian Playbook

When my husband and I were running our business and trying to ship products to Australia, we had to deal with that country’s tough meat and dairy product import regulations. Australia’s requirements seemed a bit paranoid to us at the time, but their strict import provisions stood the country in good stead. Australia has never experienced a case of mad cow disease.

Australia developed a risk-based approach to food import control that the FDA would do well to examine and learn from. Imported foods fall into one of three categories.

“Risk categorized foods” are those thought to present the greatest risk for food-borne disease. These foods are subjected to the most intensive scrutiny by Food Standards Australia. The first five shipments of each food on the high risk list from each foreign producer are inspected. After five consecutive shipments of a given food have passed muster, one in four shipments of that food from that producer are held for inspection. After 20 successful inspections, the frequency of inspection drops to one in 20 shipments. In all cases, shipments selected for inspection are held until results are known. Any unsatisfactory result causes the risk clock to reset and, of course, the unsatisfactory shipment is refused entry.

“Active surveillance foods” represent the next lower level of perceived risk. Ten percent of shipments of these foods from each and every supplying country are sampled for lab analysis. Because of the lower perceived risk, shipments of these foods are released after sampling.

“Random surveillance” covers all remaining foods not included in one of the two higher risk categories. Five percent of these shipments are sampled randomly for lab analysis.

Food Safety Australia reviews the results of these inspections periodically and, if appropriate, moves foods to a higher or lower risk category.

No system can ensure 100% safety, but basing a screening program on scientific risk assessment, and adjusting that assessment as more information become available seems a logical way to go.

Metromint Flavored Water - Canadian Alert

The Canadian Food Inspection Agency has alerted Canadian consumers to the Metromint Flavored Water recall. Two varieties of this product were sold in Canada. Please check the CFIA recall alert notice for details of flavours, size and lot number.

Recall Update - Metromint Flavored Water

The FDA and the California Department of Public Health have just updated the Metromint flavored water recall. The recalled products are sold in retail stores and supermarkets throughout California, and nationally over the Internet.

There are, as yet, no confirmed illnesses tied to the recalled water, but there is one illness complaint in Illinois that is being investigated. Please do NOT drink this water!

Bush-League Food Protection Plan

On Tuesday, the Senate Committee on Health, Education, Labor and Pensions (HELP) held hearings on the Bush Administration's new "Food Protection Plan". This Plan, together with its companion "Import Safety Plan", was developed in response to a tsunami of food-related recalls and illness outbreaks which have taken place in the last 12-18 months.

According to news media reports, the focus of the hearing was mainly on the issues surrounding risk assessment and the concentration of FDA attention on "high-risk" products. But in zeroing in on the "high-risk" issue, Senators have apparently overlooked an even greater flaw in this Plan - the so-called "mandatory recall" provision.

For several years, Senator Tom Harkin (now Chairman of the Senate Agriculture Committee) has sponsored legislation to provide the FDA and USDA with authority to mandate recalls of foods that present a hazard to human health. Each time, the Bush Administration claimed that it had no need of such authority; the voluntary recall system was working. Now, the Administration appears to have had a change of heart. Or has it?

The mandatory recall authority proposed in the Plan reads as follows:

"This authority would be limited to foods that the Secretary has reason to believe are adulterated and present a threat of serious adverse health consequences or death. It would be imposed only if a firm refuses or unduly delays conducting a voluntary recall. An order to recall food could only be issued by the HHS Secretary, Deputy Secretary, or Commissioner of Food and Drugs, and would be accompanied by appropriate due process rights."

There are several major flaws in this proposal. The most glaring is the total exclusion of mandatory recall authority for USDA, the federal government department that regulates all meat, poultry and processed egg products in the United States (including, for example, pepperoni-topped pizza). Another loophole is the lack of definition of the terms "threat of serious adverse health consequences", "unduly delays" and "due process rights". Are vomiting or diarrhea "serious adverse health consequences", or would the new authority only cover life-threatening situations such as botulism or hemolytic uremic syndrome (HUS)? How long is an undue delay? Who decides? And what constitutes "due process rights"? Will FDA need to go to court each time it needs to exercise its mandatory recall authority?

Canada has had mandatory recall authority on its books for ten years under the Canada Food Inspection Agency Act. The law, which covers all foods, simply states:

"19. (1) Where the Minister believes on reasonable grounds that a product regulated under an Act or provision that the Agency enforces or administers by virtue of section 11 poses a risk to public, animal or plant health, the Minister may, by notice served on any person selling, marketing or distributing the product, order that the product be recalled or sent to a place designated by the Minister.”

There is no requirement, under the Canadian law, for the Canada Food Inspection Agency to demonstrate that a company has "unduly delayed" implementing a recall. The authority is the Agency's to use as needed to ensure prompt action and to protect public health.

President Theodore Roosevelt once advised that we should "Walk softly and carry a big stick." That advice should be heeded by this Administration in its dealings with the food industry, both domestic and foreign. Unfortunately, the "mandatory recall" proposal described in the Food Protection Plan will have the FDA walking on eggshells with nothing more than a small twig in hand with which to enforce its mandate.

Recall Alert - Soma Beverages

Soma Beverage has announced a recall of its mint-flavored waters, due to the presence of Bacillus cereus, a food poisoning bacterium. Please check the FDA announcement for details on lot number and products affected by this recall. As of 1:42 PM (EST), the company has not posted information on this recall on its own web site.

No illnesses have been reported so far.

The FDA..Through Rose-colored Glasses

The latest on-line FDA Consumer update contained a Q&A session with the Director of FDA's Office of Regional Operations, Deborah Ralston. In response to a question about FDA's import surveillance program, Ms. Ralston said,

"For example, we work cooperatively with U.S. Customs and Border Protection to help identify shipments containing potentially dangerous foods and prevent them from entering the country. By law, certain information must be submitted to FDA about food products before they are allowed to enter the U.S. We keep our Prior Notice Center open to receive this information 24 hours a day, 365 days a year. This means that FDA knows in advance when and where specific food shipments will enter the United States, what those shipments will contain, the countries and entities where they originate, and the facility where the food was manufactured.

So although we don't physically inspect every product, we electronically examine 100% of imported food products before they reach our borders. Based on criteria we have set up, an automated system alerts us to any concerns. Then we investigate further and, if warranted, do a physical examination of the product."

But compare this statement to the following excerpt from the recently released internal FDA report:

"Many of the FDA systems reside on technology that has been in service beyond the usual life cycle. Systems fail frequently, and even email systems are unstable — most recently during an E. coli food contamination investigation. More importantly, reports of product dangers are not rapidly compared and analyzed, inspectors’ reports are still hand written and slow to work their way through the compliance system, and the system for managing imported products cannot communicate with Customs and other government systems (and often miss significant product arrivals because the system cannot even distinguish, for example, between road salt and table salt)."

FDA is overwhelmed and underfunded, and has been for many years. The problem gets worse day by day. Yet, instead of giving us an honest appraisal of the agency's problems, its spokespeople continue to paint a rosy picture of FDA's ability to carry out its diverse mandates. Is it any wonder that the agency is struggling to deal effectively with the deluge of imported products arriving at our ports of entry?

India's Dirty Little Secret

An Australian tennis player, Adil Hakeem, found out for himself this past week that India has a major food and water contamination problem. He developed a sudden bout of vomiting and fever on the eve of a tennis tournament - one of two back-to-back tournaments that he had entered in India.

For many decades after gaining its independence, India suffered from hunger and poverty. More recently, the country has become a major international economic power, but its food and water infrastructure has failed to keep up with the rest of the country's progress.

An article in the November 2007 issue of Smithsonian makes very clear the difficulties that surround attempts to reduce pollution in the Ganges River. In spite of well-meaning efforts on the part of government and private individuals, the Ganges remains a repository for raw sewage, chemical pollutants and - until recently - rotting corpses.

The food safety situation in India is not much better. The FDA issues monthly reports on-line listing, by country, products that have been refused entry into the United States. Over the past 12 months, India and China have been neck-and-neck in the race for the title of "Most Often Refused Entry". FDA inspectors have turned back 1,836 shipments from mainland China and 1858 shipments from India during the past year. In October 2007, 22% of the refused shipments from both countries were rejected due to the presence either of "filth" or of a pathogen - most often Salmonella.

In the wake of this year's series of product safety scandals, China has taken steps to improve its safety regulation system. The government has issued new regulations on food safety and, most recently, the country announced a crack-down on manufacturers of "inferior" drugs and medical devices. Will it take a major international product safety incident to prompt India to do the same?

This Takes The Cake

The government of Singapore is advising its population that chocolate cake from Prima Deli, a bakery chain, is contaminated with Salmonella enteritidis, and should not be eaten. This cake has claimed 106 victims to date, with six of the victims needing hospitalization.

Salmonella enteritidis is the most common contaminant of intact shell eggs. Either there was a gross lapse of good sanitation practices in the bakery kitchen, or the cakes were decorated with an icing that contained raw egg.

Salmonella and Peanut Butter

By now, the ConAgra (Peter Pan) peanut butter outbreak is old news. But it’s still on the mind of a lot of people. A couple of weeks ago, I was asked to settle an argument about whether it was safer to store an open jar of peanut butter in the refrigerator or at room temperature. I’ve done some digging into the scientific literature, and here’s my answer.

Salmonella cannot grow in peanut butter, but it is shielded from heat damage by the high fat and low water content of this food. Peanut butter is so protective that the typical processing temperatures of 70-75ºC (158º-167ºF) can’t kill Salmonella in the product. Even boosting the temperature to 90ºC (194ºF) doesn’t do the job. For comparison, USDA recommends that we cook raw poultry to an internal temperature of 165ºF (74ºC), which is more than enough to kill Salmonella in that food.

This might help, by the way, to explain ConAgra’s problem. Salmonella probably found a home somewhere on the production line that wasn’t easily accessible for cleaning (maybe one of the filling nozzles?). The Salmonella probably was shed sporadically into the peanut butter. Even if the microbe entered the peanut butter before the pasteurization step or while the peanut butter was still hot, the Salmonella would have been protected from heat by the high fat/low water environment.

I was able to find just one study that compared the survival of Salmonella in different types of peanut butter at room temperature (21ºC) and in the refrigerator (5ºC). Under the conditions of that study, Salmonella survive for at least 24 weeks in peanut butter stored in the fridge - except in the case of natural peanut butter, in which most of the Salmonella died off during the 24-week period. Storage at room temperature hastened the death of Salmonella in all of the peanut butter varieties, although there were still a few survivors hanging around at 24 weeks.

What does this mean for storing an open jar of peanut butter? Room temperature storage might be a bit safer, and it's certainly easier to spread room temperature peanut butter than rock-hard peanut butter right out of the fridge. But neither storage temperature will ensure a safe product. For better or for worse, we have to rely on ConAgra and other peanut butter manufacturers for that.

'Tis The Season To Drink Eggnog

With the holiday party season fast approaching, my husband suggested that it was time for me to talk about eggnog - especially the home-made variety.

Out of curiosity, I "Googled" eggnog. This produced 162,000 hits. Limiting the search to "eggnog recipes" cut the list to 94,900. One of the first sites I looked at from this list was Martha Stewart's. To my dismay, her eggnog recipe uses raw eggs and makes absolutely no mention of the risk of Salmonella contamination. Given Martha Stewart's high profile, I wish she would have included a cautionary message or - even better - offered a recipe for eggnog that included a cooking step.

Sadly, Martha wasn't alone. The National Public Radio website's eggnog recipe was equally remiss, as were 80% of the sites that offered a recipe for home-made eggnog. Only 20% (19,100) of the sites offering eggnog recipes (I searched for "eggnog recipe cooked") provided a recipe for eggnog that included a cooking step. The American Egg Board was one site that offered a tasty-sounding recipe, but there were also many others to choose from.

According to USDA estimates, approximately 1 egg in 20,000 contains Salmonella enteritidis, a strain of Salmonella that has created a niche for itself in laying hens. Infected eggs appear completely normal; the shells have no apparent cracks or defects, and the yolk and white look completely normal. There is no reliable way to detect a contaminated egg. The proportion of eggs containing Salmonella varies from country to country, but the problem is widespread. For safety's sake, handle raw shell eggs in the kitchen just as carefully as raw poultry or other raw meats. And use pasteurized shell eggs in recipes such as Caesar salad, hollandaise dressings, and other dishes that do not include a cooking step.

So, enjoy your home-made eggnog this holiday season, but please make sure that Salmonella isn't one of the ingredients in the recipe.

FDA - An Agency in Crisis

One year ago, the Commissioner of the US Food and Drug Administration directed the agency's Science Board to review whether the FDA had the necessary personnel, science expertise, equipment and budget to carry out its various mandates effectively. The results of that review have just been made public.

The findings reported by the Science Board are shocking, but not surprising to anyone who has followed the deteriorating state of our food safety systems these last several years. Among its series of observations, the Board had this to say about the current state of the FDA (and these are direct quotes):

• The FDA cannot fulfill its mission because its scientific base has eroded and its scientific organizational structure is weak.
• The FDA cannot fulfill its mission because its scientific workforce does not have sufficient capacity and capability.
• The FDA cannot fulfill its mission because its information technology (IT) infrastructure is inadequate.
• FDA does not have the capacity to ensure the safety of food for the nation.
  

Peter Barton Hutt, a former FDA Commissioner and a contributor to this report, observes that the FDA has been underfunded for decades, and faults both Democratic and Republican administrations for piling additional unfunded mandates onto the agencies plate. In Hutt's opinion, the FDA needs a doubling of its current budget and a 50% increase in manpower to begin to address its deficiencies.

The budget shortfalls and resultant lack of equipment, resources and personnel to carry out FDA's responsibilities have also seriously damaged the morale of agency personnel. This, in turn, has accelerated the loss of trained scientists and administrators - many of whom are difficult to replace.

While all parts of the agency are hurting, the two most seriously affected appear to be the Center for Food Safety and Nutrition (CFSAN), and the Center for Veterinary Medicine (CVM). The Board observes in its report that a simple lack of resources prevented the FDA from timely introduction and enforcement of new animal feed regulations to prevent the spread of mad cow disease in the United States. And even in the face of the recent pet food recalls, the CVM can only afford to have two people working on pet food issues.

The Food and Drug Administration once was one of the most respected agencies of the US government. In the 1970s, approximately 80% of Americans surveyed expressed confidence in the agency. That level of confidence has deteriorated (to 36% in 2006) along with the capabilities of the FDA to manage all of the statues that fall into its areas of responsibility.

Finally, the Science Board observes that "(r)ecommendations of excellent FDA reviews are seldom followed," and that failure to act on past recommendations "...has jeopardized the public's health." Let's hope that, this time, someone is listening.

E. coli O157:H7 in Spinach - How it Got There

You'll probably remember that outbreak of E. coli O157:H7 linked to bagged baby spinach in September 2006 - the one that caused 205 cases of illness and 3 deaths in the United States and Canada. I've just finished reading the CDC report that details how E. coli O157:H7 might have been carried from cattle feces to the field of baby spinach one mile away.

The report explains that the same pathogen that was responsible for the illnesses was found in cattle feces, in feral (wild) swine, in samples of surface water and in soil samples. The authors of the report suggest that feral swine might have carried E. coli O157:H7 from the cattle to the spinach fields.

This is not news - CDC released that information many weeks ago. But there are a couple of tidbits buried in the official published report that are worth noting:

1. There were four ranches suspected of being the source of the September 2006 food poisoning outbreak. Only one of these was found to be contaminated with the outbreak strain of E. coli O157:H7. But fields on the other three ranches were also contaminated with E. coli O157 - just not the strain that caused this particular outbreak.
2. Mechanical harvesting was probably a contributor to the outbreak. The reports states: "Notably, baby spinach is harvested with a lawn mower–like machine that could pick up fecal deposits in the field and thereby contaminate large volumes of product during processing."

The bottom line is that there will be more outbreaks. We have allowed a deadly pathogen to spread through a major agricultural area. And by maximizing "efficiency" through the use of this type of mechanical harvesting equipment, we are increasing the likelihood that E. coli O157:H7, Salmonella, and any other pathogens that may be lurking in the soil will find their way into our salad bowls.

A Week for Recalls

Sweetwater Valley Farms in Tennessee has recalled cheddar cheese due to contamination by Listeria monocytogenes. This is the company's second recall in less than two weeks. In both cases, the contamination was detected by the Tennessee Department of Agriculture, but not until the products had been distributed over the entire 48 contiguous U.S. states. No reported illnesses have been linked to these products - yet.

A New Zealand company, Red Sea Natural Health, is recalling its Spirulina Powder (an herbal supplement) because of Salmonella contamination. The product is distributed throughout New Zealand. Please check the production codes listed in the recall notice. There have not been any reported illnesses linked to this product.

Update on the Australian orange juice recall. According to my sources "down under", the Salmonella contamination was detected by the manufacturer. There do not appear to have been any illnesses associated with this product as yet.

Another Recall from "Down Under"

The Australian government has just announced a recall of Curlwaa Orange Juice with a pull date of December 10, 2007. The juice is contaminated with Salmonella. The recall notice does not indicate whether or not any illnesses have been associated with this product.

An Abundance of Caution

Sanford, a New Zealand company, has just recalled 280 metric tonnes of green-lipped mussel meat. Most of the meat was exported to North America (United States and Canada), Australia, Japan, the UK and a handful of European countries.

The company initiated its international recall after finding what it described as a "low level" of Listeria monocytogenes on its production line. L. monocytogenes is a common environmental bacterium that can grow at refrigerator temperatures, but is killed by normal cooking. It has been associated with food-borne disease outbreaks linked to ready-to-eat foods such as delicatessen meats, cheeses, cole slaw and smoked fish.

There isn't a lot of detail in the article, but I think that this meat was meant for further processing - not to be eaten raw. I give Sanford "two thumbs up" for erring on the side of consumer safety by initiating a recall of this product.

Setting the Record Straight

Earlier this week, a television station in Charleston, SC reported on an investigation, which they had carried out, into the (un)sanitary state of restaurant menus. The intrepid reporter, armed only with swab kits, invaded several restaurants, swabbed a menu at each location and then retreated to a local lab, where the swabs were analyzed for bacteria.

The reporter made it clear that she wore a sterile glove to avoid contaminating the menus herself, and swabbed the same size area on each menu. She also refrigerated the swabs until she was able to transport them to the lab. Once she received the lab results, she discussed them with the head of Infectious Diseases at the Medical University of South Carolina.

In her news segment, the reporter stated that one of the menus had no bacteria on it, and that three of the menus had “...normal levels of normal staph...: The remaining menus yielded Enterobacter durans, Acinetobacter calcoaceticus, Bacillus cereus and Flavimona (sic) oryzihabitans.

According to the news item, Enterobacter durans grows in “...feces in the human gut...”; 100 units of Bacillus cereus is enough to cause nausea and diarrhea; and Acinetobacter indicates contamination with fecal matter. About Flavimona, the report was silent.

While the intent of the news investigation was perhaps admirable, the accuracy of the report was abysmal. Acinetobacter calcoaceticus is a normal inhabitant of human skin; it takes many times more than 100 Bacillus cereus to cause food poisoning; “Flavimona” is actually Flavimonas (or Pseudomonas) oryzihabitans and is widely distributed in the environment; and Enterobacter durans is also an inhabitant of the environment. None of these microbes are indicators of fecal contamination - of menus or anything else!

The media have an important role to play in educating consumers and food handlers about food safety. And the medical practitioners have a responsibility to make sure that information they provide to the media is both accurate and clearly understood. I applaud the desire of this reporter to publicize a potential food safety issue. But I deplore her inability to get the story straight.