by Marion Nestle

Currently browsing posts about: Food-safety

Sep 12 2018

South Africa’s record-setting (not in a good way) Listeria outbreak: an update

In April, I wrote about the deadly outbreak of Listeria-contaminated processed meat (“polony”) in South Africa.  Back then, the country’s Health Department explained what it was doing to try to stop the outbreak.  It’s now pretty much over, and the Health Department has issued an updated report on it.

  • Cases reported: 1060
  • Deaths: 216

Listeria is deadly.  For this outbreak, the death rate is 27% (216 of 806 cases in which the outcome is known).

As is typical of foodborne disease outbreaks, most cases occurred long before the products were recalled.

 

Of those cases interviewed after the recall

38/65 (58%) of ill people or their proxy reported consuming polony prior to their illness onset; brands manufactured by Enterprise Foods were most commonly reported to have been consumed where brand of polony was known.

The health department is doing a lot to try to understand what happened here.  But it faces challenges:

There are challenges regarding the turn-around time of testing of environmental swabs from facility inspections. Challenges are arising on account of the volume of specimens received during the last three weeks, machine failure and in some cases, challenges regarding test result interpretation. Each challenge is being addressed through appropriate interventions.

Food safety lawyer Bill Marler offers advice to the CEO of Tiger Brands, and to any other CEO of a company selling a product that makes people ill, beginning with an explanation of “why it’s always a bad idea to poison your customers.”

His advice:

  1. Know your regulators.
  2. Stop making the implicated product and recall the ones at risk.
  3. Launch your own investigation.
  4. Be transparent.
  5. Admit fault.
  6. Do not blame your customers.
  7. Reach out to customers who have been harmed.
  8. Teach what you have learned.

Marler has put money behind this advice.  Let’s hope the CEO takes him up on it.

Aug 8 2018

CDC’s latest stats on foodborne illness

The CDC has issued its counts for the extent and cause of illnesses and deaths caused by eating contaminated food for the years 2009-2015.

For starters, outbreaks of foodborne illness increased during this period.

The figure above is a bar chart showing by year the number of foodborne disease outbreaks in the United States for 2009–2015 as reported to CDC’s Foodborne Disease Outbreak Surveillance System.

From 2009–2015, the CDC reports:

  • 5,760 outbreaks (more than one person becoming ill from the same source)
  • 100,939 illnesses
  • 5,699 hospitalizations
  • 145 deaths

Every US state and territory reported at least one outbreak.

Multistate outbreaks were particularly serious.  They accounted for only 3% of all outbreaks, but were responsible for:

  • 11% of illnesses
  • 34% of hospitalizations
  • 54% of deaths.

What organisms caused the outbreaks?  Of the 2,953 outbreaks in which the cause could be pinned to one organism, the top two causes were:

  • Norovirus (1,130 outbreaks, accounting for 41% of the illnesses)
  • Salmonella (896, accounting for 35%)

ListeriaSalmonella, and Shiga toxin-producing Escherichia coli (STEC) accounted for 82% of all reported hospitalizations and 82% of the deaths.

What foods were associated with the outbreaks?  Of the 1,281 outbreaks in which the contaminated food could be identified, the top carriers were:

  • Fish (222 outbreaks),
  • Dairy (136)
  • Chicken (123)

Looking at illnesses, the most frequent associated foods were:

  • Chicken (3,114 illnesses)
  • Pork (2,670)
  • Seeded vegetables, meaning tomatoes and beans (2572)
  • Eggs (2470)
  • Fruits (2420)
  • Beef (1934)

What does all this mean?

Foodborne illnesses remain a serious public health problem, not least because it is so difficult to trace illnesses back to a specific source.  The contaminated food could only be identified in about one-fifth of total outbreaks.

Although foods of animal origin were leading carriers of illness, plant foods are also at risk.

All of these illnesses are preventable.  We have laws requiring food producers and handlers to follow food safety procedures.  When they do, the risk of foodborne illness is greatly diminished.

These procedures were designed originally to prevent astronauts from getting sick in outer space under conditions of zero gravity (you don’t even want to think about the consequences of foodborne illness in a space capsule).

If the methods worse in outer space, they ought to work on earth—but only if they are designed and used appropriately.

These data argue for stronger food safety regulation.

Jul 30 2018

What’s up with the Salmonella recall of Ritz crackers and Goldfish?

I am baffled by food safety issues related to the recent recall of Ritz Crackers and Goldfish by their manufacturers, Mondelēz and Campbell/Pepperidge, respectively.

I understand how their whey protein ingredient could be contaminated by SalmonellaWhey is an excellent growth medium for bacteria.

What I don’t understand is how people eating Ritz Crackers or Goldfish could become ill with Salmonella (the New York Times reports two cases of illness).

Aren’t crackers baked?  Isn’t that a kill step?

I can understand why Mondelēz would issue a recall as a precautionary measure.

But can someone please explain to me how Ritz Crackers or Goldfish could contain live Salmonella from whey baked into them?

I am not the only one puzzled by this.  BakeryAndSnacks.com quotes Stewart Eton, an industry food safety official, who emphasizes that baked goods undergo a kill step.

This would ordinarily be a CCP [Critical Control Point] under their HACCP [hazard analysis and control plan] program with the process validated and verified at regular intervals.  Under the FSMA [FDA’s food safety laws], for example, this risk-based rationale would be deemed sound and would not require a recall.

What’s going on here?

A possible explanation

A reader writes that flavoring agents are sprayed on to Goldfish after they are baked.  If this is true, Goldfish would be make in the same way as dry pet foods and would not be sterile.

 

Jun 25 2018

Trump’s government reorganization plan: really?

The Trump Administration announced its new plan to reorganize government.  Obviously, this affects the agencies dealing with agriculture, food, and nutrition issues—USDA, FDA, and FDA’s parent agency, HHS.  Here is my translation of the major shifts being proposed:

  • Move most of USDA’s nutrition programs—SNAP, WIC, the Child and Adult Care Food Program, and the Farmers’ Market Nutrition Program—to HHS.
  • Move FDA’s food safety oversight to USDA, putting USDA in charge of all food safety.
  • Downsize the Public Health Service Commissioned Corps.

Congress would have to vote on all this so there’s no point in going too deeply into the weeds at this point, but I have just a few comments:

  • Putting all food safety oversight in one agency is a good idea, but not if it’s USDA.  USDA’s principal purpose to to support agribusiness.  Holding agribusiness responsible for food safety puts USDA in conflict of interest.
  • Moving SNAP and WIC into HHS (or whatever its new name will be) would make sense if HHS weren’t already overwhelmed by everything else it has to deal with (more than a trillion dollars in spending).
  • The proposal still leaves school breakfasts and lunches and commodity programs in USDA, meaning that food assistance programs will still be split between USDA and HHS.
  • Downsizing the Commissioned Corps doesn’t make much sense either.  Public health needs all the health it can get.

Whatever happens with this is unlikely to happen quickly.  USDA will not be happy about losing SNAP’s $80 billion a year or WIC’s $6 billion budget.

Many other agencies are also affected by these proposals.  My prediction: Congress will have a lot of trouble coming to agreement on these ideas.

Maybe this is just another attempt to distract us from more pressing matters.

Law Professor Timothy Lytton, an expert on food regulatory policy, has plenty to say about why moving food safety to USDA won’t work (in my paraphrasing):

  • Congressional committees are unlikely to support any reorganization that would reduce their power.
  • Industry associations are unlikely to support a reorganization that would disrupt their influence with existing agencies.
  • The two agencies are different in jurisdiction, powers and expertise; a merger would require a complete overhaul of federal food safety laws and regulations, a task of extraordinary legal and political complexity.
  • A merger might create new forms of fragmentation.
  • Reorganization is expensive and will take years.  The payoff is unclear.

As I’ve explained before, plans for a single food safety agency have been in the works for years, but have encountered many barriers.  The Food Safety Modernization Act was meant to be step #1 in a three-step process:

  1. Pass and implement rules governing FDA’s oversight of pretty much all foods except meat and poultry (this is now done).
  2. Fix USDA’s food safety rules governing meat and poultry so they are consistent with FDA’s (in the talking stage, hopefully).
  3. Merge the food safety responsibilities in one agency.

These proposals, alas, ignore step #2.  Good luck with that.

Jun 21 2018

Salmonella in Honey Smacks cereal?

I guess I shouldn’t be surprised.  The latest source of Salmonella is a kids’ cereal, Kellogg’s Honey Smacks.  They may be a good source of vitamin D, but watch out!

This is no joke.  The CDC reports the damage: 73 cases in 31 states, with 24 hospitalizations.

The CDC says you should not eat this cereal.  Period.  You should especially not eat this if its used-by date ranges from June 14, 2018 to June 14, 2019.  Kellogg has recalled packages with this used-by date.

I took this photo on June 16 at Wegmans in Ithaca.  I was surprised to see them on the shelf, but their use-by date was May 19, 2019 so Wegmans must think they are OK.  Even if I habitually bought sugary kids cereals, I’d pick another one until this outbreak is over and gets an all-clear signal.

Recent Salmonella outbreaks have involved pre-cut melon, eggs, dried coconut, pre-made salads, and sprouts.  Food safety lawyer Bill Marler says don’t eat them either.

Outbreaks caused by contamination of commercial boxed products are rare.  Bacteria don’t grow well in dried foods.  The CDC doesn’t discuss how the Salmonella got into the package.

Could honey be the source?  Honey is not sterile, but bacteria don’t grow in it very well (not enough water).

This reminds me of the situation with dry pet foods and treats.  Canned pet foods have been cooked and are sterile until they are opened.

Dry foods are not sterile.  Although the extrusion process heats them enough to kill bacteria, flavors and other additives are sprayed on before they are packaged.  Contamination with Salmonella and other pathogens is a constant problem (Mal Nesheim and I discuss this in our book about the pet food industry, Feed Your Pet Right).

I will be interested to see if Kellogg can find the source of the contamination.

Jun 6 2018

The Romaine lettuce outbreak: source still unknown, victim count rising

The FDA did something quite unusual.  It issued an apparently frank description of where it is in investigating the Romaine lettuce E. coli outbreak that has sickened 197 people, put 89 in the hospital, and killed five—so far.

It published a chart summarizing what the agency has learned about the various distribution channels along the way to the contaminated lettuce that made people sick.

As the FDA explains:

As can be seen in the diagram, in the current outbreak, and based on the information we have to date, there are still no obvious points of convergence along the supply chain…These pathways lead back to different farms, sometimes many farms, where possibly contaminated lettuce could have been harvested during the timeframe of interest.  The only point of commonality in our traceback efforts to date is that all of the farms are located in the Yuma growing region…What does this traceback diagram tell us?  It says that there isn’t a simple or obvious explanation for how this outbreak occurred within the supply chain…The contamination likely happened at, or close to, the Yuma growing area.  Our task now is to investigate what happened.

I used “apparently” with reference to the FDA’s frankness because food safety lawyer Bill Marler, who represents many of the victims of this outbreak,* points out that the FDA must know the names of the farms, distributors, and sellers of the contaminated lettuce, but refuses to say who they are.  Of his own work, Marler says:

We are in the unique position to know many, but not all, of the “points of sale” – restaurants and grocery stores – involved in the E. coli O157:H7 outbreak linked to romaine lettuce. Having over 100 clients allows us to dig deep into their purchase history and consumption history.

We have already determined clusters of illnesses linked to Panera, Texas Roadhouse, Red Lobsters and Papa Murphy’s. We also have identified a processor – Freshway Foods.

If you knew the names of places selling contaminated lettuce, wouldn’t you have sense enough not to eat in them?

May 8 2018

Don’t eat romaine lettuce until this outbreak ends

I’ve been following the E. coli 0157:H7 outbreak caused by eating romaine lettuce grown in Yuma, Arizona.

The CDC says the body count so far is:

  • Cases = 121
  • Hospitalizations = 52
  • Deaths = 1

Where the cases have been found:

Map of United States - People infected with the outbreak strain of E. coli, by state of residence, as of May 1, 2018

 

What the “epi curve” looks like:

Epi curve of people infected with the outbreak strain of E. coli, by date of illness onset, as of May 1, 2018

What’s happening with the FDA’s investigation:

The FDA has identified one farm [Harrison Farms of Yuma, Arizona] as the source of the whole-head romaine lettuce that sickened several people at a correctional facility in Alaska. However, the agency has not determined where in the supply chain the contamination occurred…All of the lettuce in question from this farm was harvested during March 5-16 and is past its 21-day shelf life. Because the growing season in the Yuma region is at its end, the farm is not growing any lettuce at this time.

Most of the illnesses in this outbreak are not linked to romaine lettuce from this farm, and are associated with chopped romaine lettuce. The agency is investigating dozens of other fields as potential sources of the chopped romaine lettuce and will share information as it becomes available.

Some interesting aspects of this and other leafy green outbreaks:

In the meantime, the CDC’s advice to you:

  • Do not eat or buy romaine lettuce unless you are sure it was not grown anywhere near Yuma.
  • Do not eat or buy romaine lettuce if you cannot tell where it was grown.
  • Do not eat salad mixes unless you are sure it is free of romaine lettuce.
  • This applies to romaine lettuce in any form: heads, hearts, chopped, baby, organic, in salads or salad mixes.

But Consumer Reports says to avoid romaine lettuce entirely.

Seems like good advice until this one gets figured out.

Apr 24 2018

Food recalls increasing: Is this good or bad news?

Do food recalls reflect failures in food safety regulation or should they be considered a success?

USDA reports a significant increase in recent food product recalls.

  • Between 2004 and 2008, food recalls averaged 304 a year
  • Between 2009 and 2013, they averaged 676 a year.

USDA attributes the increase to

  • Improvements in pathogen and risk-detection technology
  • Increased regulatory oversight and enforcement
  • Congressional passage of food safety legislation

This sounds like success, no?

The food categories accounting for most recalls?

  • Prepared foods and meals
  • Nuts and seeds
  • Baked goods and grains
  • Candy
  • Sauces, condiments and dressings

The most common reasons for the recalls:

  • Failure to declare major allergens
  • Possible Salmonella contamination.

Here’s another reason, according to a new report from the Government Accountability Office: USDA’s inadequate standards for pathogens in meat and poultry, particularly turkey breasts and pork chops.

The report recommends that USDA work on this problem.  The USDA says it will.

Food safety requires endless vigilence, and government agencies need to do vigilent oversight.