The La Crosse County Health Department is conducting a disease investigation on reported cases of E. coli among La Crosse County residents.

Children under age 5 and the elderly are most susceptible to infection. To date, there have been 8 cases of E. coli O157, a particularly nasty form, which produces a toxin that can be harmful to the body organs such as the kidneys. This form of E. coli is also called STEC- Shiga Toxin-Producing Escherichia coli. Of the 8 cases, 6 children have been hospitalized for HUS – Hemolytic Uremic Syndrome.

The Health Department is working with the Wisconsin Division of Health to complete disease investigation to contain the outbreak. At this time, the investigation is ongoing, and a single source of infection or contamination has not be identified.

E. coli is a bacterial infection that is more common during the summer months. Cases can be linked or stand alone. It is transmitted by eating contaminated food or water and by contact with fecal material from infected persons or animals. Person to person spread of bacteria is possible and may occur in family settings, daycare centers and nursing homes.

Signs and symptom of E. coli O157 infection or STEC include severe abdominal cramps and loose and bloody diarrhea. Symptoms occur an average of 3-5 days after swallowing the germ. Some individuals become infected but do not develop symptoms. People do not develop immunity to E. coli.

Parents and caregivers whose children have persistent diarrhea (2-3 days) should consult their child’s doctor, keep the child out of daycare and school and follow extreme hand hygiene to prevent the spread of the bacteria. Testing for E- coli is done by sampling the stool and culturing the bacteria in a laboratory. Testing can take several days for results to be completed.

Precautions for the public at this time consist of:

  • Hand hygiene – hand washing with plenty of soap and water. Special attention should be given to hand washing after using the bathroom, when changing diapers, before preparing food and eating and after coming in from outside activities.
  • Parents need to supervise handwashing for their young children to ensure that hands have been appropriately washed.
  • Parents and caregivers should keep their ill children out of school and daycare until advised to return by their medical provider. The Health Department recommends children stay home until they have been symptom free for 48 hours (2 days).

Persons with E. coli infection usually feel better over a few days without specific treatment. Rest and fluids to prevent and treat dehydration are recommended. For more information on E. coli (O157), STEC or HUS and hand washing techniques, please visit the La Crosse County Health Dept. website at www.lacrossecounty.org/health/

The Times Union reported today that Death Wish Coffee is recalling its Nitro Cold Brew because there is a risk of Clostridium botulinum (C. botulinum) or botulism, a serious toxin that causes weakness of the muscles and difficulty breathing.

The coffee is being pulled from shelves at Price Chopper/Market 32, Healthy Living Market & Café, and independent retailers at the behest of Death Wish Coffee.

Nitrogen-infused coffee is a fairly new process with few federal standards and regulations through the Food and Drug Administration (FDA).

According to the Center for Disease Control, C. botulinum or botulism is a rare but serious illness caused by a toxin that attacks the body’s nerves. Symptoms of botulism usually start with weakness of the muscles that control the eyes, face, mouth, and throat. This weakness may spread to the neck, arms, torso, and legs. Botulism also can weaken the muscles involved in breathing, which can lead to difficulty breathing and even death.

CDC and Texas Health Officials Warn About Illness Linked to Raw Milk from Texas Dairy – Raw milk contained rare but dangerous germ, consumers should get antibiotics

People who consumed raw milk or raw milk products from one Texas dairy should contact their health care provider immediately, warn health investigators from the Centers for Disease Control and Prevention (CDC) and the Texas Department of State Health Services (DSHS). Raw milk from the K-Bar Dairy in Paradise, Texas (northwest of Fort Worth), tested positive for a rare but potentially serious bacteria known as Brucella RB51.

CDC advises that people who consumed raw milk or milk products from the K-Bar Dairy between June 1 and Aug. 7, 2017, should get antibiotic treatment to avoid the risk of lifelong, chronic infections. Initially, people with brucellosis experience fever, sweats, aches and fatigue. If not treated, Brucella RB51 infection can result in long-term complications, like arthritis; heart problems; enlargement of the spleen or liver; and, in rare cases, nervous system problems, like meningitis RB51 can cause severe illness in people with weakened immune systems and miscarriages in pregnant women.

“It’s very important for people who drank raw milk from this dairy to seek treatment to prevent infection with Brucella RB51,” said William Bower, M.D., team lead for the CDC group that investigates brucellosis. “Even if people don’t have any symptoms now, they can develop a chronic infection that can impact their health for years to come.”

Milk from K-Bar dairy is known to have caused Brucella infection in one Texas resident. One illness in a Texas woman has been linked to the dairy. Purchase records and illness reports indicate additional people in Texas and some as far away as California and North Dakota may need antibiotics to prevent or treat infection. In Texas, raw milk is only allowed to be sold on site at the dairy. According to Texas DHSH, K-Bar dairy has been operating in compliance with state dairy laws and rules and is cooperating fully with the investigation.

CDC and Texas health officials have been trying to reach people in more than 800 households known to have purchased K-Bar raw milk. Texas is following up with 170; CDC tried to contact the remaining 672 households but many did not provide contact information. Of the 485 households with contact information, CDC successfully reached 236 households. Among the 236 households, 83 percent of people were exposed to RB51 by drinking the milk.

Officials Worried People Not Aware of Risk

Due to incomplete contact information, CDC staff have been unable to reach about 200 households in which someone bought K-Bar milk. People who sampled the milk at the dairy or got the milk from friends or family also may not be aware of their risk.

So far, CDC and Texas health officials have received reports about people who drank K-Bar milk or have symptoms consistent with brucellosis caused by RB51 in Alabama, Arkansas, California, Ohio, North Dakota, Tennessee and Texas.

Those Exposed Need Antibiotics

CDC recommends that anyone who drank raw milk or consumed milk products from K-Bar dairy between June 1 and Aug. 7, 2017, see their doctor for antibiotics to prevent infection. Because Brucella can cause complications during pregnancy, including miscarriage, it is especially important for pregnant women who may have been exposed to seek medical care. RB51 is resistant to some antibiotics that would normally be used to prevent or treat brucellosis, so people who drank the milk should tell their doctor that they may have been exposed to RB51 and refer their healthcare provider to the CDC website (link below).

People who have consumed the milk should also check themselves for fever for four weeks after they last drank the milk and watch for other brucellosis symptoms for six months. These symptoms include but are not limited to: muscle pain, lasting fatigue, arthritis, depression, and swelling of the testicles.

Doctors can find more information about testing patients for RB51 and which antibiotics to use to prevent infection on the CDC website at: https://www.cdc.gov/brucellosis/clinicians/rb51-raw-milk.html.

About RB51

RB51 is a weakened strain of Brucella used to vaccinate young female cattle against infection with more serious strains of Brucella. Vaccinating cows with the RB51 vaccine helps prevent abortions in cows and reduces the risk of people coming into contact with cows infected with more severe strains of Brucella. However, in rare cases, vaccinated cows can shed RB51 in their milk.

Testing of milk from the individual cows in the dairy herd revealed two cows that were infected with Brucella RB51, supporting the conclusion that these cows are a source of RB51 contamination of the dairy’s raw milk. Testing is ongoing by Texas officials to assure that the remaining cows in the herd do not pose an ongoing risk of RB51contamination of the dairy’s raw milk. The only way to avoid this potential exposure is to drink milk that has been pasteurized to kill the germs.

Brucella is rare in the United States, largely due to our vaccination practices in cattle to prevent brucellosis. There are about 120 reported cases in people each year. Most cases of brucellosis in the U.S. occur in people who traveled to countries where Brucella is more common and drank contaminated cow, sheep or goat milk or had contact with infected animals. Among cases in the U.S. who acquired brucellosis here, infections occur from contact with feral swine or, more rarely, dogs, or because of accidental exposure in lab settings.

Raw Milk: a Risk for Infections

Raw milk and raw milk products are those that have not undergone a process called pasteurization that kills disease-causing germs. CDC recommends that people only drink milk that has been pasteurized to kill germs. Even healthy animals may carry germs that can contaminate milk. There is no substitute for pasteurization to assure that milk is safe to drink.

The risk of getting sick from drinking raw milk is greater for infants and young children, the elderly, pregnant women, and people with weakened immune systems, such as people with cancer, an organ transplant, or HIV/AIDS. However, healthy people of any age can get very sick if they drink raw milk contaminated with harmful germs.

More info on raw milk: https://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.htmland www.realrawmilkfacts.com

The CDPH Food and Drug Branch (FDB) and Sacramento County Environmental Management Department (SCEMD) recently investigated an outbreak of botulism linked to the consumption of ready to eat nacho cheese purchased at Valley Oak Food and Fuel in Walnut Grove, California. The nacho cheese was applied to chips by customers from a counter-top, self-service warming and dispensing unit supplied by the cheese manufacturer. These types of warming and dispensing units are typically designed to maintain the cheese at approximately 140 deg. F.

As of May 31, 2017, a total of 10 case-patients were laboratory-confirmed with C. botulinum toxin type A. All patients were hospitalized; nine were in an intensive care unit, seven required ventilator support, and one died. Leftover nacho cheese sauce collected from the gas station yielded C. botulinum toxin type A bacteria and toxin. Due to the extensive distribution of the same lot code of nacho cheese throughout the United States without additional botulism cases, internal testing conducted by the Wisconsin manufacturer of the nacho cheese, and only a single bag of cheese linked to human illness, FDB and SCEMD suspect the nacho cheese was likely contaminated at the retail location. A few items in particular were noted during the investigation that was concerning:

The 5 pound bag of nacho cheese collected at the retail location on May 5, 2017 was being used past the “Best By” date.

Records were not being maintained by the gas station employees indicating when the bag of nacho cheese was originally added to the warming unit.

The plastic tool designed to open the bags of cheese (provided with the nacho cheese warming and dispensing unit) was not being used by employees. 
FDB is aware that these types of nacho cheese warming and dispensing units are in use at many retail locations throughout California. These units generally provide safe, ready-to-eat foods without significant input from employees at each location. FDB would like to provide the following guidance regarding the use of nacho cheese warming and dispensing units in retail locations.

1.  Management and employees should follow the instructions for each type of machine and product they use. Instructions for use may be included on the packaging of the 
bagged nacho cheese or included on the interior panels of the warming and dispensing unit. These directions may include pre-heating and the length of time a product can remain at elevated holding temperatures. In some cases the product may only be held above 135 deg. F. for 4-6 days.

2.  Management should ensure that records are maintained indicating when bagged cheese was last changed. This may be accomplished by writing the date the product was added to the warmer on the bag itself.

3.  Management should ensure that the warming and dispensing units are not turned off at night or plugged into a timer. These types of machines need to remain “on” at all times. This will ensure that appropriate temperatures are maintained in this ready-to- eat food.

4.  Management and employees should ensure that any supplied tools for opening the bags of cheese are used per the product directions. These devices need to be washed, rinsed, and sanitized between uses. In some cases these opening tools are only supplied with warming and dispensing unit.

5.  Management and employees should verify on a regular basis that the internal temperature of the hot held cheese product is being held at the proper temperature. The internal temperature can be measured by placing the cheese product in a cup with a thermometer to verify the product is maintaining the minimum hot holding temperature of 135 deg. F as required under the California Retail Food Code Section 113996 or hot holding temperature as recommended by the manufacturer.

CDPH hopes this information can be shared widely to ensure retail food facilities have current information and are taking appropriate measures to keep our food supply safe. Thank you for your consideration and ongoing collaboration with our Department.

In March 2017, the Centers for Disease Control and Prevention (CDC) and several state health departments attributed a multistate outbreak of Shiga toxin-producing Escherichia coli O157:H7 to I.M. Healthy brand SoyNut Butter manufactured by Dixie Dew and sold at retail on online outlets.[1]

Outbreak investigators collected open containers of SoyNut Butter from the homes of sick people, and unopened containers from retail locations. Containers of SoyNut Butter from lots #243162 and 244161 tested positive for E. coli. Whole genome sequencing revealed that the same strain of E. coli was found in clinical isolates from sick people and containers of I.M. Healthy SoyNut Butter. Epidemiologic investigation determined that 32 people ill with this strain of E. coli had been infected by eating or attending a facility that served I.M. Healthy SoyNut Butter. This included residents of Arizona (4), California (5), Florida (2), Illinois (1), Massachusetts (1), Maryland (1), Missouri (1), New Jersey (1), Oregon (11), Virginia (2), Washington (2), and Wisconsin (1).

The damage caused by this outbreak has been considerable. Twelve people were hospitalized due to their infection, and nine developed hemolytic uremic syndrome (HUS). HUS is a debilitating condition caused by E. coli that is commonly characterized by kidney failure, but may also lead to brain damage, seizures, and diabetes. Children less than 10 years of age are particularly at risk for developing HUS.

I.M. Healthy brand SoyNut Butter has been recalled, but given its long shelf life, it may still be in some people’s homes. This product, therefore, may continue to pose a threat to people’s health.  Several online retailers continued to sell the recalled product at least well into August 2017.

It is not as if in 2017, contaminated nut butters should not have been an issue for manufacturers, suppliers and retailers.

In November 2006, public health officials detected a substantial increase in reports of Salmonella Tennessee isolates. In February 2007, a multistate, case-control study linked the consumption of either Peter Pan or Great Value Peanut Butter brands with infection[2]. 715 people were sickened with 129 hospitalized.  Subsequently the same strain of Salmonella Tennessee was isolated from unopened jars of peanut butter and from environmental samples collected from the processing plant. The product was recalled, and new illness reports declined. Unsanitary conditions at the Sylvester, Georgia, processing plant were known about since 2004. On April 5, 2007, ConAgra announced inadvertent moisture from a leaking roof and sprinkler system could have promoted bacteria growth in the plant. Great Value brand was sold at Walmart stores.[3]

Beginning in November 2008, CDC PulseNet staff noted a small and highly dispersed, multistate cluster of Salmonella Typhimurium isolates. The outbreak consisted of two pulsed field gel electrophoresis (PFGE) defined clusters of illness. The first cluster displayed a unique primary enzyme (XbaI) restriction pattern and an uncommon secondary enzyme (BlnI) pattern. The second cluster had two closely related XbaI patterns that were very similar to the first cluster and a BlnI pattern that was indistinguishable from the first cluster. Illnesses continued to be revealed through April 2009, when the last CDC report on the outbreak was published. A total of 714 were sickened, with 171 hospitalized and at least nine deaths. Peanut butter and peanut butter containing products produced by the Peanut Corporation of America plant in Blakely, Georgia, were implicated. King Nut brand peanut butter was sold to institutional settings. Peanut paste was sold to many food companies for use as an ingredient. Implicated peanut products were sold widely throughout the USA, 23 countries and non-U.S. territories.[4]

On September 22, 2012, the CDC announced a multistate outbreak of Salmonella serotype Bredeney linked to Trader Joe’s Valencia Creamy Salted Peanut Butter. Collaborative efforts by local, state and federal public health and regulatory officials traced the product to Sunland, Inc. a Portales, New Mexico company. Sunland issued a recall of multiple nut butters and products made with nut butters. When the outbreak was declared over, a total of 42 people infected with the outbreak strain of Salmonella serotype Bredeney had been reported by 20 states. Among persons for whom information was available, illness onset dates ranged from June 14, 2012 to September 21, 2012. Ill persons ranged in age from less than 1 year to 79 years, with a median age of 7 years. Sixty-one percent of ill persons were children less than 10 years old. Among 36 persons with available information, 10(28%) patients had been hospitalized. The FDA confirmed that environmental samples collected at the Sunland facility had an DNA fingerprint that was indistinguishable to the DNA fingerprint found in outbreak associated patients.[5]

On August 21, 2014, the CDC announced a multistate outbreak of Salmonella Braenderup involving 6 people residing in Connecticut (1), Iowa (1), New Mexico (1), Tennessee (1), and Texas (2). Almond and peanut butter manufactured by nSpired Natural Foods, Inc. was named as the likely source of this outbreak. The outbreak was declared over on October 16, 2014. Illness onset dates range from January 22, 2014 to May 16, 2014. Among 5 ill persons with available information, one person reported being hospitalized. During inspections at the nSpired Natural Food facility in Ashland, Oregon, between January 2014 and August 2014, the FDA isolated Salmonella Braenderup from environmental samples. A search of the PulseNet database linked ill patients to the environmental isolates taken from the nSpired production plant. On August 19, 2014 nSpired Natural Foods issued a voluntary recall of certain lots of almond and peanut butters because of potential contamination with Salmonella. The recalled brands include Arrowhead Mills, MaraNatha, and specific private label almond and peanut butters.[6]

On December 2, 2015 JEM Raw Chocolate LLC (JEM Raw) of Bend, Oregon announced a recall of its full line of all nut butter spreads due to possible contamination with Salmonella. Health authorities at the FDA, Oregon Health Authority, Oregon Department of Agriculture and the CDC had linked illnesses in 13 persons who consumed nut spreads. Dates of onset ranged from July 18, 2015 to November 22, 2015. Cases were reported from California, Colorado, Georgia, Hawaii, Idaho, Illinois, Maine, North Carolina, New Jersey and Oregon.[7]

Dixie Dew and I.M. Healthly, and the entire supply chain, should have been aware of these outbreaks and taken precautions.

[1]           https://www.cdc.gov/ecoli/2017/o157h7-03-17/index.html

[2]           A 1996 Salmonella Mbandaka outbreak linked to peanut butter sickened at least 15 in Australia – Aust N Z J Public Health 1998 Scheil

[3]           https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5621a1.htm

[4]           https://www.cdc.gov/mmwr/preview/mmwrhtml/mm58e0129a1.htm

[5]           https://www.cdc.gov/salmonella/bredeney-09-12/

[6]           https://www.cdc.gov/salmonella/braenderup-08-14/

[7]           https://www.cdc.gov/salmonella/paratyphi-b-12-15/

The Ohio Department of Health, several other states, the Centers for Disease Control and Prevention (CDC), and the United States Department of Agriculture Animal and Plant Health Inspection Service (USDA-APHIS) are investigating a multistate outbreak of human Campylobacter infections linked to puppies sold through Petland, a national pet store chain.

The outbreak includes 39 people with laboratory-confirmed Campylobacter infections or symptoms consistent with Campylobacter infection who live in 7 states (Florida, Kansas, Missouri, Ohio, Pennsylvania, Tennessee, and Wisconsin) and were exposed to puppies sold through Petland stores; 12 are Petland employees from four states and 27 either recently purchased a puppy at Petland, visited a Petland, or visited or live in a home with a puppy sold through Petland before illness began.

Epidemiologic and laboratory evidence indicates that puppies sold through Petland stores are a likely source of this outbreak. Petland is cooperating with public health and animal health officials to address this outbreak.

Campylobacter can spread through contact with dog feces. It usually does not spread from one person to another.

Illnesses began on dates ranging from Sept. 15, 2016 through Aug. 12, 2017. The most recent illness was reported on September 1, 2017.

Ill people range in age from <1 year to 64 years, with a median age of 22 years; 28 (72%) are female; and 9 (23%) report being hospitalized. No deaths have been reported.

Epidemiologic and laboratory findings have linked the outbreak to contact with puppies sold through Petland stores. Among the 39 ill people, 12 are Petland employees from 4 states and 27 either recently purchased a puppy at Petland, visited a Petland, or visited or live in a home with a puppy sold through Petland before illness began.

Whole genome sequencing showed samples of Campylobacter isolated from the stool of puppies sold through Petland in Florida were closely related to Campylobacter isolated from the stool of an ill person in Ohio. Additional laboratory results from people and dogs are pending.

Live Science reports that several restaurants in the United States are serving up a raw chicken dish that’s referred to as either chicken sashimi or chicken tartare, according to Food & Wine Magazine. Though the “specialty” hasn’t caught on much in the U.S., it’s more widely available in Japan. Eating chicken sashimi puts a person at a “pretty high risk” of getting an infection caused by Campylobacter or Salmonella, two types of bacteria that cause food poisoning, said Ben Chapman, a food safety specialist and an associate professor at North Carolina State University.

Campylobacter infections are one of the most common causes of diarrheal infections in the U.S., according to the Centers for Disease Control and Prevention (CDC). The bacteria cause gastrointestinal symptoms including diarrhea, cramping and abdominal pain, and in some cases can also cause nausea and vomiting, the CDC says. There are an estimated 1.3 million cases in the U.S. each year and fewer than 100 deaths, on average, each year from the infection.

Salmonella infections also cause symptoms such as diarrhea, fever and abdominal cramps, according to the CDC. About 1.2 million people contract Salmonella each year, and about 450 people die from the infection, the CDC says.

Chapman noted that eating raw chicken is different from eating raw fish, which can be found in sushi dishes. With raw fish, the germs that are most likely to make a person sick are parasites, and these parasites can be killed by freezing the fish, he said. Salmonella, on the other hand, “isn’t going to be affected by freezing.”

In Japan, where the dish is more popular, the Ministry of Health, Labour and Welfare advised restaurants in June 2016 to “re-evaluate raw and half-raw chicken menus,” according to The Asahi Shimbun, a Japanese newspaper. The ministry urged restaurants to cook chicken to an internal temperature of 75 degrees Celsius (167 degrees Fahrenheit). The recommendation from the ministry came after more than 800 people said they were sickened several months earlier after eating chicken sashimi and chicken “sushi” rolls, The Asahi Shimbun reported.

Islamic State leaders are reportedly asking its followers to carry out terror attacks by poisoning food in Western supermarkets.  It is not like poisoning our food has not happened before and we certainly have been warned.  In 2011 Secretary of State Hillary Clinton warned of infectious disease outbreaks caused by pathogens falling into the wrong hands and into our food. She said:

“Unfortunately the ability of terrorists and other non-state actors to develop and use these weapons is growing. Therefore this must be a renewed focus of our efforts.”

“Because there are warning signs and they are too serious to ignore.”

“Al Qaeda in the Arabian Peninsula had urged brothers with degrees in microbiology or chemistry to develop a weapon of mass destruction.”

Sound familiar? It should. In 2004 Health and Human Services Secretary Tommy Thompson warned of food-related terrorist attacks. He said:

“For the life of me, I cannot understand why the terrorists have not attacked our food supply because it is so easy to do.”

It reminded me of an Op-ed I did for Forbes a year or so ago:

Imagine this: At 10:00 PM, after yet another story about Donald Trump, a foreign TV network begins airing a video taken inside a facility showing someone treating wash water in a cucumber packing house with an unknown liquid. There is a claim that this was the terrorist act that has so far sickened 341 and killed 2 in 30 states with Salmonella.

In the next 15 minutes, every network news operation is playing the video. The broadcast networks break into regular programming to air it, and the cable news stations go nonstop with the video while talking heads dissect it. The Donald fades into the distance.

Coming on a Thursday evening on the East Coast, the food terrorism story catches the mainstream Media completely off guard. Other than to say the video is being analyzed by CIA experts, and is presumed to be authentic, there isn’t much coming out of the government.

Far-fetched? Don’t count on it. I have been saying for years that a foodborne illness outbreak will look just like the terrorist act described above, but without the video on FOX News.

Tell that to the 751 people in Wasco County, Oregon—including 45 who required hospital stays—who in 1984 ate at any one of ten salad bars in town and were poisoned with Salmonella by followers of Bhagwan Shree Rajneesh. The goal was to make people who were not followers of the cult too sick to vote in county elections.

Tell that to Chile, where in 1989, a shipment of grapes bound for the United States was found laced with cyanide, bringing trade suspension that cost the South American country $200 million. It was very much like a 1970s plot by Palestinian terrorists to inject Israel’s Jaffa oranges with mercury.

Tell that to the 111 people, including 40 children, sickened in May 2003 when a Michigan supermarket employee intentionally tainted 200 pounds of ground beef with an insecticide containing nicotine.

Tell that to Mr. Litvenenko, the Russian spy poisoned in the UK with polonium-laced food.

Tell that to Stanford University researchers who modeled a nightmare scenario where a mere 4 grams of botulinum toxin dropped into a milk production facility could cause serious illness and even death to 400,000 people in the United States.

The reason I bring this up is not to mark another anniversary of 9/11. I raise the issue not because I actually think that food terrorism is the cause of this week’s Salmonella cucumber outbreak. However, I wonder if it would have made any difference in our government’s ability to figure out there was an outbreak, to figure out the cause, and to stop it before it sickened so many.

After 9/11, Health & Human Services Secretary Tommy G. Thompson said: “Public health is a national security issue. It must be treated as such. Therefore, we must not only make sure we can respond to a crisis, but we must make sure that we are secure in defending our stockpiles, our institutions and our products.”

Before Thompson’s early exit from the Bush Administration, he did get published the “Risk Assessment for Food Terrorism and Other Food Safety Concerns.” That document, now 5-years old, let the American public know that there is a “high likelihood” of food terrorism. It said

the “possible agents for food terrorism” are:

  • Biological and chemical agents
  • Naturally occurring, antibiotic-resistant, and genetically engineered substances
  • Deadly agents and those tending to cause gastrointestinal discomfort
  • Highly infectious agents and those that are not communicable
  • Substances readily available to any individual and those more difficult to acquire, and
  • Agents that must be weaponized and those accessible in a use able form.

After 9/11, Secretary Thompson said more inspectors and more traceability are keys to our food defense and safety. To date, we’ve made some, but not enough movement to ensure this.

Would the fact of terrorists operating from inside a manufacturing facility somewhere inside the United States bring more or effective resources to the search for the source of the Salmonella? If credit-taking terrorists were putting poison on our cucumbers, could we be certain Uncle Sam’s response would have been more robust or effective then if it was just a “regular” foodborne illness outbreak?

Absolutely not! The CDC publicly admits that it manages to count and track only one of every forty foodborne illness victims, and that FDA inspectors miss key evidence as outbreaks begin. The FDA is on record as referring to themselves as overburdened, underfunded, understaffed, and in possession of no real power to make a difference during recalls. If you are a food manufacturer, packer, or distributor, you are more likely to be hit by lightning than be inspected by the FDA. You are perfectly free to continue to sell and distribute your poisoned product, whether it has been poisoned accidentally or intentionally.

The reality is that the cucumber Salmonella outbreak is a brutal object lesson in the significant gaps in our ability to track and protect our food supply. We are ill prepared for a crisis, regardless of who poisons us.

So, what can we do?  Since we inspect only about 1% of imported food that food could be tainted with biological or chemical agents before entering the United States. Given, also the lack of inspections domestically, toxins could easily be introduced in food at the farm, in transit, at processing plant or in restaurants.

More and better inspections by FDA and FSIA inspectors at various points in our food supply are absolutely necessary, as is good intelligence work by those at the CDC and FBI. However, when a terrorist uses a biological or chemical weapon against the civilian population – in food or otherwise, how quickly the outbreak is detected, analyzed, understood and addressed would be the responsibility of state and local public health offices and the CDC. Surveillance would be the key to limiting the damage and bringing the terrorists to justice.

We need to invest in the science of epidemiology and the surveillance of biological and chemical illnesses. We need to increase our laboratory capacity for biological and chemical agents, and our ability to quickly track patterns of potential illnesses. And, we need to strengthen the teamwork between state, local and federal health officials so outbreaks are caught early.

Perhaps a foodborne bio-terrorism event cannot be stopped, but with investments in surveillance, the event can be minimized.

Food Safety News just reported that

Earlier today, Amazon.com was still selling I.M. Healthy soy nut butter that was recalled in March when federal officials traced an E. coli outbreak to the product.

No one from Seattle-based Amazon immediately responded to mid-morning requests for comment from Food Safety News, but by 11 a.m. Pacific time, the recalled peanut butter substitute had been pulled from the retailer’s website.

Officials with the Food and Drug Administration are investigating the situation, but were not able to provide details as of mid-afternoon.

Although the outbreak was declared over in May by the Centers for Disease Control and Prevention, that agency’s “final” report indicated additional illnesses were expected to be confirmed in relation to consumption of recalled soy nut butter products. The CDC cited the products’ long shelf life and the likelihood that some consumers still have unopened product in their homes as contributing factors to the lingering nature of the outbreak.

As of early May, the outbreak had sickened a confirmed 32 people across a dozen states. A variety of products made with soy nut butter produced by Dixie Dew Products Inc. remain under recall, including all varieties of I.M. Healthy “SoyNut Butter” products.

As of 9:45 a.m. Pacific time today, recalled I.M. Healthy brand “SoyNut Butter” was still available for purchase.

It is against federal law for anyone to sell or resell recalled products in any setting, including yard sales and thrift shops. The Consumer Product Safety Improvement Act, which became law in 2008, was used earlier this year by the Consumer Product Safety Commission against Home Depot. The big box home improvement retailer agreed to pay $5.7 million in relation to charges it sold recalled smoke detectors, light fixtures and other products.

The Amazon.com website does not appear to offer a list of recalled products that it has offered for sale, as do many retailers. Amazon provides a list of government recall links and a “recall policy” that includes the following statement:

“Amazon monitors public recalls alert websites and also learns of recalls directly from manufacturers and vendors. When we learn of a recall, we suspend all impacted product offerings from our website and quarantine any related inventory in our fulfillment centers. We also reach out to any customers that previously purchased impacted products (and any seller that may have offered such products) to inform them about the recall.”

Linda Harris, chair of the world renown Food Science and Technology Department at the University of California-Davis, said Monday that she ordered recalled I.M. Healthy SoyNut Butter from Amazon.com during Labor Day weekend. She received the $50 shipment of three jars of the recalled product in less than 24 hours.

“The story really is about recalls and the ability in today’s world of recovering all product when you have a recall,” said Harris, who is the immediate past president of the International Association for Food Protection.

“They have sophisticated programs that set prices and figure out complicated delivery schemes – they should be able to make sure recalled product isn’t available for sale.”

The Los Angeles County Department of Public Health (Public Health) warns consumers of possible hepatitis A exposure associated with produce that was possibly contaminated by a worker at a street-side fruit vendor who was infected with Hepatitis A. The fruit vendor was located on the corner of W Ave L and 20th Street West, in Lancaster, CA. Anyone who bought fruit from the vendor’s fruit cart (at this location) during the period of August 15 through August 22 may be at risk for hepatitis A.

The LA County Health Officer recommends that individuals who ate products from a fruit vendor at this location should receive an immune globulin (IG) shot or hepatitis A vaccination within the next week to prevent or reduce illness. Public Health will offer free vaccinations at the Antelope Valley Public Health Center from 8:00 a.m. – 4:30 p.m. beginning, Tuesday, September 5, for anyone who may have been exposed.

Where:

Antelope Valley Public Health Center
335-B East Avenue K6
Lancaster, CA 93535
(661) 471-4860

“We are actively investigating this situation. It is important that anyone who may have bought or consumed fruit from this vendor during the period of August 15 through August 22 should contact their doctor to discuss possible hepatitis A prevention and treatment options,” said Jeffrey Gunzenhauser, MD, MPH, Interim Health Officer, Los Angeles County. “Those who purchased this product should discard any remaining fruit if still found in their home.”

This new case may be linked to the outbreaks of hepatitis A infections occurring in San Diego and Santa Cruz counties. The large majority of those cases have occurred in persons who are homeless and/or use illicit drugs (injection and non-injection), with several cases also occurring among people who provide services to the homeless. The worker with hepatitis A who worked at the fruit stand had previously spent time in San Diego, has received care, and is no longer infectious.

Public Health has confirmed 3 cases of hepatitis A among high-risk individuals who lived in San Diego during their exposure period as well as 3 secondary cases that have occurred in a health facility in Los Angeles County. Public Health has not identified any new cases associated with the fruit cart.

HAV causes acute liver disease, which may be severe. It is transmitted by contact with the feces of a person who is infected – often through contact with food or water or during sex or other close contact. Signs and symptoms of acute HAV include fever, malaise, dark urine, lack of appetite, nausea, and stomach pain, followed by jaundice. Symptoms generally last for less than 2 months although some persons may have prolonged or more severe illness. Infection can be prevented in close contacts of patients by vaccination within 2-weeks of exposure or administration of immune globulin. If you experience these symptoms, contact your physician.

Persons who have been vaccinated against hepatitis A or have received IG within the last three months or have ever had laboratory confirmed infection with the hepatitis A virus also do not need an injection of IG.

For more information on Public Health clinics, visit http://publichealth.lacounty.gov/chs/phcenters.htm , or call the LA County Information line at 2-1-1 from any landline or cell phone within the county.