Marler Blog - Providing commentary on food poisoning outbreaks & litigation

South View - Eagle Harbor with tomatoes, peas, beans, lettuce, spinach, carrots, beets, strawberries, peppers and corn.

North View

This is our second year with this garden.  I grew up with a big garden and cows, horses, pigs, sheep, chickens, turkeys, rabbits and a few too many cats and dogs.  Now, a small garden and a lazy dog and a crabbie cat.

“As evidenced by the recent widespread contamination's in our food supply, including E. coli in spinach, Salmonella in peppers, and the most recent outbreak of Salmonella in peanut butter, it is clear that we must act now.”

These were the words used by Representative Frank Pallone, Jr., Chair of the Health Subcommittee, in a press release regarding the Food Safety Enhancement Act of 2009. The proposed bill (still in draft form) is the latest in a string of food safety proposals currently in Congress. The Food Safety Enhancement Act is largely based on H.R. 759, the Food and Drug Administration Globalization Act of 2009. As stated, the aim of the bill is, “To amend the Federal Food, Drug, and Cosmetic Act to improve the safety of food in the global market, and for other purposes.” (Hmm… I wonder what these mysterious ‘other purposes’ are…)

The Food Safety Enhancement Act is divided into two titles: Food Safety and Miscellaneous. The ‘Food Safety’ title includes four subsections: Prevention, Intervention, Response, and Miscellaneous. The highlights of the bill are as follows:

• Requires all facilities operating within the U.S. or importing food to the U.S. to register with the FDA annually.

• Requires registered facilities to pay an annual registration fee of $1,000 in order to generate revenue for food safety activities at the FDA; requires registered facilities to pay for FDA’s costs associated with re-inspections and food recalls; allows FDA to charge a fee to domestic firms requesting export certificates for exported food.

• Sets a minimum inspection frequency for all registered facilities. High-risk facilities would be inspected at least once every 6 to 18 months; low risk facilities would be inspected at least once every 18 months to three years; and warehouses that store food would be inspected at least once every three to four years. Refusing, impeding, or delaying an inspection is prohibited.

• The FDA would be required to issue regulations that require food producers, manufacturers, processors, transporters, or holders to maintain the full pedigree of the origin and previous distribution history of the food and to link that history with the subsequent distribution history of the food; and to establish an interoperable record to ensure fast and efficient trace-back (current law permits facilities to hold a record in any format—paper or electronic—making efficient tracing of foods difficult for FDA).

• Regarding imported food, the bill allows the FDA to require food to be certified as meeting all U.S. food safety requirements by the government of the country from which the article originated or by certain qualified third parties. Third party certifying entities must meet strict requirements to protect against conflicts of interest with the firm seeking certification.

• Strengthens criminal penalties and establishes civil monetary penalties that FDA may impose on food facilities that fail to comply with safety requirements.

• Grants FDA “quarantine” authority under which the agency may restrict or prohibit the movement of unsafe food products from a particular geographic area.

• Requires FDA to establish and maintain a corps of inspectors to monitor foreign facilities producing food, drugs, devices, and cosmetics for American consumers.

Whether the Food Safety Enhancement Act, if enacted, will actually reduce food-borne illness outbreaks remains to be seen. Even if it does, one has to wonder what toll will it take on the small farm movement whose resources may be limited. At least on the surface, the sponsors of the bill appear to have good intentions. As Representative Betty Sutton stated, “Americans need to know that the food on their family’s table and in their children’s lunchboxes will be safe.” Let’s hope this isn’t just political lip service.

Andrew Schneider over at www.andrewschneiderinvestigates.com allowed me to co-post this great story.

Scientists worry that the “new,” “completely safe” butter flavoring used on popcorn and in other foods may be as dangerous as the lung-destroying chemical, called diacetyl, that it replaced.

Diacetyl-linked jury verdicts of tens of millions of dollars for injured flavoring workers and the diagnoses of lung damage in at least three popcorn-loving consumers forced popcorn packers and other food processors to stop using the chemical butter-flavoring two years ago.

Orville Redenbacher rose from the grave to proudly announce in a TV ad that the company’s popcorn was now diacetyl-free. And other manufacturers plastered that message in large type on the side of their packages.

When asked in the last two years how they were getting the buttery flavor consumers want without diacetyl, the largest popcorn makers answered with a “no comment,” saying the secret flavoring was safe, but proprietary.

Fortunately, a group of government health investigators at the National Institute of Occupational Safety and Health have begun lifting the veil of corporate secrecy.

“Two possible substitutes are starter distillate and diacetyl trimmer,” NIOSH Drs. Kathleen Kreiss and Nancy Sahakian just wrote in a newly released book, “Advances in Food and Nutrition Research.

“The distillate is a diacetyl-containing product of a fermentation process. The trimmer is a molecule containing three diacetyl molecules,” they wrote. “The inclusion of these alternative substances neither eliminate diacetyl nor assure safety for workers.’’

Kreiss, chief of NIOSH’s Field Studies Branch, also talked about the popcorn advertisements in informal remarks prepared for the American Thoracic Society conference earlier this month in San Diego.

“The wording here (no added diacetyl) is telling,” said Kreiss, whose team of worker health and safety investigators were the first to respond to the reports of disease at Midwest popcorn plants.

In the presentation to the specialists in respiratory disease, Kreiss discussed the flavoring to which many food producers had switched.

“The easiest substitute for the chemical diacetyl is starter distillate, a fermentation product of milk which contains up to 4 percent diacetyl. The chemical may not be added, but diacetyl is still in butter-flavored popcorn,” she explained.

She said some of the substitutes are better able to penetrate to the deepest parts of the lung and are unlikely to be safer to inhale than the original diacetyl.

Physicians, scientists and industrial hygienists at NIOSH’s Division of Respiratory Disease Studies are working hard on multiple efforts to investigate the possible toxicity of butter flavoring chemicals being used as a substitute for the diacetyl.

“We’re trying to identify the mechanism of diacetyl-induced injury. And if that happens, it will help us identify other potentially hazardous compounds workers may be exposed to in the flavoring industry,” said Dr. Ann Hubbs, a veterinary pathologist in NIOSH’s Health Effects Laboratory Division.

Hubbs told me last week, “We are trying hard to answer the question of why diacetyl — and potentially the related substances — are so very toxic,”

Kreiss and her team have responded to plants using flavorings throughout the country. They have watched patiently as OSHA first ignored and then moved haltingly to comply with congressional orders and union pleas to develop diacetyl exposure standards that would protect workers.

But even though President Obama’s new team at the Labor Department promised speedy action on diacetyl standards, many public health and occupational medicine experts worry that it may be too little, coming too late.

“As regulatory action develops, the flavor industry has introduced diacetyl substitutes, which might not be regulated by a diacetyl standard now on the drawing board,” Kreiss said in notes accompanying her slide presentation to the chest doctors.

Dr. Celeste Monforton and her colleagues at George Washington University’s Department of Environmental and Occupational Health have been following the diacetyl issue for years.

She echoes NIOSH and says that OSHA and the Food and Drug Administration must pay attention to the substitutes in its rulemaking if workers and consumers are to be protected.

“We know far too little about the the substitutes to diacetyl or reformulated diacetyl-compounds that food manufacturers are now using, or planning to use,” she told me this week.

As a part of its rule making, OSHA must insist that the manufacturers provide information on the chemical composition and toxicity testing of their substitutes, she said.

“We are dealing with the safety of workers and consumers and secrecy cannot be justified,” Monforton said.

“This potential danger goes well beyond just popcorn.”

So, what are adequate consumer warnings on bottles of Raw Milk?  What if you contrast it to blog posts and videos by the manufacturer touting the miraculous benefits of Raw Milk?  What about the endorsements by Weston Price (goodness - exposure to liability there)?  Raw Milk, like any food product - If a manufacturer wants to hide from liability with a defense of adequate warning or the consumer should have known better, the manufacturer (and organizations like Weston Price) better watch what they write or say.  Thoughts?

Abigail Fenstermaker's family is asking for help, after their 7-year-old died from E. coli complications last week. 

A fundraiser is being held on Abby's behalf on Friday, May 29th from 7 - 11 p.m. It will take place at The Clevelander, 834 Huron Rd. Cleveland, by Jacobs Field.  For more information on the fundraiser, see this link.

My daughter, Sydney, turned 10 in April.

I wonder if the manufacturers of hamburger in this county take the time to look at this picture?

I. THE OUTBREAK

On October 2, 2008, the California Department of Public Health (CDPH) issued a report linking an outbreak of Campylobacter illnesses to unpasteurized milk from Alexandre Eco Farms Dairy. The report was the result of an investigation commenced on July 14, 2008, when Dr. Thomas Martinelli, the County Health Officer for Del Norte County, California reported four cases of laboratory confirmed Campylobacter infections and five additional cases of diarrhea in Del Norte County residents. Eight of the original nine sick individuals were members of the Alexandre Eco Farms “cow-leasing” program. Eight of these individuals had consumed milk produced on the farm. The ninth sick individual worked with cattle on the Alexandre Eco Farms Dairy. One of the eight individuals who were sick, Mari Tardiff, had already been hospitalized with GBS, following the onset of acute gastroenteritis after consumption of the milk.

As part of the investigation, health department officials retrieved a refrigerated carton of partially consumed Alexandre Eco Farms milk from Mari Tardiff’s home. Mari had consumed a portion of the milk before her illness. The specimen tested positive for Campylobacter jejuni DNA using a test called polymerase chain reaction (PCR). Testing indicated that multiple strains of Campylobacter jejuni were present in the milk. Del Norte County officials eventually identified 16 cases of Campylobacter jejuni associated with the outbreak. Fifteen of those were persons who consumed milk from Alexandre Eco Farms Dairy. The 16th case was the farm employee. CDPH and Del Norte county officials concluded that “the available epidemiologic and laboratory data support the conclusion that this cluster of acute diarrheal illness in Del Norte County was an outbreak of C. jejuni infections caused by consumption of unpasteurized milk from [Alexandre Eco Farms Dairy.]”

The causal link between Alexandre Eco Farms Dairy and Mari’s illness was so clear, and her injuries so remarkable, that the physicians that treated her published a report on her case in the medical journal. “Investigation of the First Case of Guillain-Barre Syndrome Associated with Consumption of Unpasteurized Milk – California, 2008.” Amy K. Earon, T. Martinelli, W. Miller, C. Parker, R. Mandrell, D. Vugia. The authors explained the laboratory methods used in investigating Mari’s illness:

We reviewed the patient’s medical record and interviewed her husband to assess her symptoms and exposures. We used polymerase chain reaction (PCR) and multilocus sequence typing (MLST) to test a six-week old unpasteurized milk sample, obtained from the cow leasing-program and partially consumed by the patient, for genes encoding the bacterial membrane component lipooligosaccharide (LOS) in GBS-associated Campylobacter jenuni.

In addition to the DNA testing, the authors also tested Mari’s blood for anti-bodies to GBS. The authors then explained that the PCR and MLST testing of the milk detected Campylobacter jejuni gene. In addition, the blood test was positive for anti-bodies that indicated the presence of GBS. The authors concluded, “Combined laboratory and epidemiologic evidence established the first reported association between GBS and unpasteurized milk consumption.”

II. MARI TARDIFF’S ILLNESS

On the weekend after Mari drank raw milk, she developed flu-like symptoms, including diarrhea and vomiting. By Thursday, June 12, the food poisoning was overwhelming her body with an amazingly swift force. First her vision blurred. Then her hands went numb. Mari went to an emergency room, and there lab work was done and abdominal X-rays were taken. But doctors could not determine what was wrong. On Friday, Peter took Mari to a neurologist. An MRI was normal but the doctor and radiologist mentioned a frightening possibility – Guillain-Barré syndrome, or GBS, a potentially fatal inflammatory disorder.

Hours later Mari’s legs were on fire, searing with pain that, ironically, only hot water helped to soothe. Her legs hurt so much that she soon retreated to bed, wrapping her legs in warm towels and a heating blanket. During that night, Mari awoke and realized she could not move. Peter bear-hugged her to lift her to the toilet and then carried her back to bed. In the early hours of the morning, he called for help, which led to an ambulance ride to the small Sutter Coast Hospital, and then a medivac flight to the Intensive Care Unit at the larger, better-equipped Rogue Valley Medical Center (RVMC) in Medford, Oregon. She remained hospitalized for two and one-half months.

Mari was moved to Redding Rehabilitation Hospital and was finally able to come home on November 1, 2008. Today, Mari lives in her family room, which now is equipped with a hospital bed, portable toilet, a Hoyer lift and a stand-up frame, all purchased by the Tardiffs. Using their own resources, they also renovated a downstairs half-bath and laundry room into a handicapped-accessible bathroom and shower. The Tardiffs pay two nurses $10.50 an hour to care for Mari from 7:30 A.M. until 7:00 P.M. five days a week while Peter is at work. Home health physical and occupational therapists also come to the house five days a week.

Mari works very hard at therapy but it is a slow, painful process. Peter has found it so upsetting that he no longer can watch. Every improvement is celebrated, but he knows how much discomfort and frustration goes into each minute, regained movement. Mari may never walk again. She lost her job, she lost her dreams and plans that she held dear. The illness has been a long, arduous journey for Mari, her family and friends, and while she has made progress, there remains a long way to go.

READ MORE ON CAMPYLOBACTER AND GULLAIN BARRE SYNDROME

Over the last several years, other members of the firm and I spend nearly as much time speaking out on safe food as we do litigating food poisoning cases. Here is a partial list of places I have been in the last several months.  In part we try and explain how and why we do what we do and to convince companies why it is a bad idea to poison your customers.

British House of Lords and Royal Institute of Public Health - 05.13.2009

Bill Marler travels back to the UK to present at the Royal Institute of Public Health E. coli Conference.

Conference of the Candian Institute of Public Health Inspectors (CIPHI) - 05.06.2009

Bill Marler will present a keynote address at the 75th Annual conference of CIPHI, being held in Kananaskis, Alberta.

GMA Food Claims & Litigation Conference - 02.25.2009

Bill Marler travels to Rancho Mirage to the conference, which is focused on Emerging Issues in Food-Related Litigation

National Meat Association (NMA) Meatxpo - 02.22.2009

Bill Marler travels to Las Vegas to take part in a roundtable discussion on the FSIS.

International Association for Food Protection’s Raw Milk Symposium - 02.05.2009

Bill Marler will take part in a panel discussion following the film Denied? The Fight for Corporate Accountability. The event is taking place here in Seattle.

Super Lawyers CLE - 12.10.2008

Bill Marler will present to the Super Lawyers CLE in Seattle.

ACI Food-borne Illness and Contamination Litigation - 12.04.2008

Bill Marler will travel to Phoenix to present to the ACI Food Borne Illness & Contamination Litigation Conference.

Louisiana State Bar Association (LSBA) Mass Tort Symposium – 10.17.2008

Bill Marler will travel to New Orleans to present to the LSBA Class Action/Mass Tort Symposium

Third International Conference for Food Safety and Quality - 10.08.2008

Bill Marler will present the keynote address at the Third International Conference for Food Safety and Quality in San Francisco, CA.

China International Food Safety and Quality Conference (CIFSQ) - 09.24.2008

Bill Marler will be in Beijing, China to present a keynote address to the International Food Safety and Quality Conference.

Food Safety Council Meeting - 07.09.2008

Bill Marler travels to Omaha, Nebraska to speak at the Food Safety Council Meeting

Food Network Wales - 06.18.2008

Bill Marler will be in Cardiff, Wales presenting to the Food Network Wales Conference.

British Food Journal (BFJ) Inaugural Lecture - 06.17.2008

Bill Marler travels to London to take part in the Inaugural Lecture series of the British Food Journal (BFJ) at the Royal Institute of Public Health.

Food Safety: Farm to Table - 05.28.2008

Bill Marler will give the keynote address, in Moscow, ID presenting an Update on Outbreak Trends 2006-2008.

Food: Safety, Risk, and Technology - 05.06.2008

Bill Marler will speak at the University of Minnesota College of Agriculture, Food, and Environmental Sciences on Food Safety and Litigation.

In the first major hamburger recall since 2002, on June 9, 2007, United Food Group voluntarily expanded its June 3 and 6 recalls to include a total of approximately 5.7 million pounds of both fresh and frozen ground beef products produced between April 6 and April 20 because it was contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service announced.

An investigation carried out by the California Department of Health Services and the Colorado Department of Health, in coordination with the Centers for Disease Control and Prevention, preceded the recall of June 3. Illnesses occurred in Arizona (6), California (3), Colorado (2), Idaho (1), Utah (1) and Wyoming (1). Illness onset dates ranged between April 25 and May 18.

Four of those illnesses were children who developed Hemolytic Uremic Syndrome (HUS).

Their stories, like the stories of other victims of HUS linked to hamburger consumption, began with that all-American past time of eating a hamburger then lead to an acute illness where death was a real possibility. Now, it is a lifetime of risk of kidney failure.

We have been able to settle three of the four HUS cases. It will be interesting to see what a jury says about the other case. See some of the client videos to see what these families have experienced.

Since the Jack in the Box E. coli Outbreak of 1993, I have been involved in every E. coli Outbreak and have represented the most seriously injured cases.  There have been far too many deaths.

* AFG / Supervalu E. coli Outbreak - Minnesota
* AgVenture Farms Petting Zoo E. coli O157:H7 Outbreak Litigation - Florida
* Aunt Mid’s Lettuce E. coli outbreak - Michigan, Illinois, and Ontario
* Bauer Meat E. coli Litigation - Georgia
* BJ’s Wholesale Club E. coli Litigation - New York and New Jersey
* Captain’s Galley Seafood Restaurant E. coli Outbreak - North Carolina
* Cargill E. coli Outbreak - Nationwide
* Carneco / Sam’s Club E. coli Outbreak - Wisconsin & Michigan
* CCC Alternative Learning Daycare E. coli Outbreak - Texas
* China Buffet E. coli Outbreak - Minnesota
* ConAgra Ground Beef E. coli Outbreak - Nationwide
* Country Cottage Restaurant E coli O111 Outbreak - Oklahoma
* Crossroads Farm Petting Zoo E. coli Outbreak - North Carolina
* Dee Creek Farm E. coli Outbreak - Washington & Oregon
* Dole Lettuce E. coli Outbreak - Minnesota, Wisconsin, and Oregon
* Dole Spinach E. coli Outbreak - Nationwide
* Emmpak E. coli Outbreak - Wisconsin
* Excel E. coli Outbreak - Georgia
* Finley Elementary School E. coli Outbreak - Washington
* Flanders Provision Co. E. coli Outbreak - Colorado, Nationwide
* Forest Ranch Fire Department Fundraiser E. coli Outbreak - California
* Fresno Meat Market E. coli Outbreak - California
* Gold Coast Produce E. coli Outbreak - California
* Golden Corral E. coli Outbreak - Nebraska
* Habaneros E. coli Outbreak - Missouri
* Interstate Meat E. coli O157:H7 Outbreak - Oregon, Washington & Idaho
* Ixtapa Mexican Restaurant E. coli outbreak - Washington State
* Jack in the Box E. coli Outbreak - Western States
* Jimmy John’s Gourmet Sandwiches E Coli Outbreak - Colorado
* Karl Ehmer Meats E. coli Outbreak – New Jersey
* KFC E. coli Outbreak - Ohio
* Kid’s Korner Daycare E. coli Outbreak - Missouri
* Kindercare E. coli Outbreak - California
* King Garden Restaurant E. coli Outbreak - Ohio
* Lane County Fair E. coli Outbreak - Oregon
* Nebraska Beef E. coli Litigation - Minnesota
* Nebraska Beef E. coli Outbreak - Nationwide
* Odwalla E. coli Outbreak - Western States
* Olive Garden E. coli Outbreak - Oregon
* Organic Pastures E. coli Outbreak - California
* Parsley E. coli Outbreak - Washington & Oregon
* Peninsula Village E. coli Outbreak - Tennessee
* PM Beef Holdings, Lunds & Byerly’s E. coli Outbreak - Minnesota
* R & S Meats E. coli Cases - New York
* Robeson Schools E. coli Outbreak - North Carolina
* Robinswood Pointe Senior Living Facility E. coli Outbreak - Washington
* Rochester Meat Company E. coli Outbreak - Wisconsin, California
* S & S Foods - Goshen Boy Scout Camp E. coli Outbreak - North Carolina
* Sizzler E. coli Outbreak - Wisconsin
* Sodexho Spinach E. coli Outbreak - California
* Spokane Produce E. coli Outbreak - Washington, Oregon, Idaho
* Stop & Shop E. coli Case - New Hampshire
* Taco John’s E. coli Outbreak – Iowa and Minnesota
* Topps and Price Chopper E. coli Case - New York
* Topps Meats E. coli Outbreak - Nationwide
* Totino’s and Jeno’s Pizza E. coli Outbreak
* United Food Group E. coli Outbreak - Western States
* Valley Meats E. coli Outbreak - Ohio, Illinois, Pennsylvania
* Washington County Fair E. coli Outbreak - New York
* Wendy’s E. coli Outbreak - Oregon
* Wendy’s E. coli Outbreak - Utah
* White Water Water Park E. coli Outbreak - Georgia

In a 483 Inspection Report released today, FDA inspectors identified multiple food-safety shortcomings at the Setton Pistachio of Terra Bella California that was linked to a Salmonella outbreak earlier this year:

1. The company detected the bacteria in roasted pistachios in October but did not change its processing procedures until March

2. In one instance, the company re-roasted pistachios that had tested positive for Salmonella and blended them together with other nuts for sale.

3. Inspectors identified a "failure to manufacture, package and store foods under conditions and controls necessary to minimize the potential for growth of microorganisms and contamination."

4. Specific physical problems ranged from a rusty hole in the roof above one pistachio roaster to "thick layers of dust and debris" in a packaging room.

5. Procedural shortcomings included failure to monitor roasting temperatures and allowing raw and roasted pistachios to potentially come into contact.

6. Between October 2008 and March 2009, the report noted that "there were at least eight reported Salmonella-positive test results" coming out of the Terra Bella plant. When the firm learned of the private laboratory test results, inspectors said, there were no "procedures in place" to respond appropriately.

7. Prior to January, inspectors added, the Terra Bella plant did not monitor roasting temperatures, roasting times or the depth of pistachios placed on the roasting conveyor belts.

8. Inspectors checked records for 14 lots of roasted pistachios. In a potentially dangerous step, 10 of these lots had raw pistachios packed on the same packaging equipment prior to the roasted pistachios being run.

Does this not sound just a bit like the 483 Inspection report at the Peanut Corporation of America?  Setton is just lucky they did not sicken and kill people or they may too be facing bankruptcy and jail time.  When are companies going to get a clue?

The Cleveland Ohio Health Department said moments ago that a 6 or 7-year-old girl died from E. coli O157:H7 last weekend and that the death (likely due to Hemolytic Uremic Syndrome) appears linked to E. coli O157:H7 illnesses in Ohio, Pennsylvania, and Illinois that have led FSIS and CDC health investigators to ground beef produced by Valley Meats, LLC of Coal Valley, Illinois.

According to Misti Crane of THE COLUMBUS DISPATCH:

The Ohio Department of Health contacted the U.S. Department of Agriculture with a report of three genetically linked cases of E. coli O157:H7 in the Cleveland area earlier this month.  All three were sickened in mid-April, but do not have any connection to one another, said ODH spokesman Kristopher Weiss.  They were classified as a cluster when the genetic fingerprints of the bacteria that had infected each person matched, he said. The illnesses were then linked to products containing meat from Valley Meats.  The people who were sickened were a 3-year-old girl, a 24-year-old man and a 71-year-old man. Two of the three were hospitalized and all have since recovered, Weiss said.

Leila Atassi and Harlan Spector of the CLEVELAND PLAIN DEALER are also covering the story:

Health officials did not identify the girl or provide details of the circumstances that led to her death. But Cleveland Health Director Matthew Carroll said the case might be the latest in a cluster of E. coli infections traced to Valley Meats LLC, of Coal Valley, Ill.

The company pulled nearly 100,000 pounds of hamburger patties after a U.S. Department of Agriculture investigation confirmed that three Cleveland-area residents were infected by eating the same tainted ground beef. Carroll said two local restaurants, one of them in Cuyahoga County, might also be involved and will be investigated.

The three who grew ill - a 3-year-old girl, a 24-year-old man and a 71-year-old man - have recovered, said Kristopher Weiss, spokesman for the Ohio Department of Health. Health officials determined the cases originated from a common source when they found matches among the genetic fingerprints of the bacteria that infected each person, Weiss said. The state reported its findings to the USDA on May 13. The brands included in the recall are 3-S, Grillmaster, J and B, Klub, Thick 'n Savory, Ultimate, and more than a dozen generic brands.

A few weeks ago I wrote "E. coli O157:H7 Season is Nearly Upon Us - Will it be 2005 and 2006 or 2007 and 2008?"

From 1993 - 2003 we represented over 1,000 people sickened and families who suffered losses due to E. coli O157:H7-tainted hamburger.  From 2003 - spring of 2007, the number of ill and the number of recalls dropped significantly.  In fact, in 2006, less that 200,000 pounds of E. coli-tainted hamburger was recalled.  However, since the Spring of 2007 nearly 42,000,000 pounds of hamburger has been recalled.  Clearly, there is a problem.  Earlier this year I wrote "Open Letter to a New Under Secretary for Food Safety - FSIS - The End of E. coli Conservatism," in part to start a discussion about why we are again seeing E. coli illnesses and deaths and in part to encourage the new administration to act.  The new administration is taking new steps, but much more needs to be done.

For an explaination of the movie clip above:

FSIS announces the first CLASS I RECALL after E. coli O157:H7 illnesses linked in Ohio, Pennsylvania, and Illinois of the season - more to follow?

ILLINOIS FIRM RECALLS GROUND BEEF PRODUCTS DUE E. COLI O157:H7 CONTAMINATION

Valley Meats LLC, a Coal Valley, Ill., establishment is recalling approximately 95,898 pounds of ground beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.  The problem was discovered through an epidemiological investigation of illnesses. On May 13, 2009, FSIS was informed by the Ohio Department of Health of a cluster of E. coli O157:H7 infections. Illnesses have been reported in Ohio, Pennsylvania, and Illinois.

For more information about E. coli O157:H7, see, www.about-ecoli.com and for complications like Hemolytic Uremic Syndrome, see, www.about-hus.com.

The products subject to recall include:

Overview of Medical Impacts of E. coli O157:H7

After a susceptible individual ingests a sufficient quantity of E. coli O157:H7, the bacteria attach to the inside surface of the large intestine and initiate an inflammatory reaction. This reaction is believed to be due to chemicals secreted by the bacteria, and results in the bloody diarrhea and abdominal cramps characteristic of the intestinal illness. The incubation period is usually about 3 to 8 days, but slightly more or less is common. A wide spectrum of disease is possible from mild diarrhea without blood, to life-threatening and severe bloody diarrhea with excruciating abdominal pain. In most infected individuals the intestinal illness lasts about a week and resolves without any long-term sequelae. Antibiotics do not improve the illness and some believe these medications might even increase the risk of complications. Apart from good supportive care, which should include close attention to hydration and nutrition, there is no specific therapy. About 5 to 10% of individuals go on to develop hemolytic uremic syndrome (HUS), a severe life-threatening complication of the intestinal illness.

HUS was first described in 1955 and is recognized as the most common cause of kidney failure in childhood. E. coli O157:H7 is responsible for over 90% of the cases of HUS that develop in North America. When HUS follows a diarrhea illness the correct terminology is diarrhea-associated HUS (D+HUS) to distinguish the disease from a less common variety of HUS that occurs as a familial, recurrent, or isolated form associated with other clinical situations.

D+HUS is believed to develop when the E. coli O157:H7 enters into the circulation through the inflamed bowel wall and releases a specific chemical known as shiga-like toxin (SLT). SLT, and most likely other chemical mediators, attach to receptors on the inside surface of blood vessel cells (endothelial cells) and initiate an inflammatory reaction that damages the organs supplied by these tiny arteries. Some organs seem more susceptible, perhaps due to the presence of increased numbers of receptors (kidney, pancreas, and brain). Red blood cells and platelets are also damaged, either directly by the SLT or secondarily due to the clotting process in damaged blood vessels. By definition, when fully expressed, D+ HUS presents with the triad of hemolytic anemia (red blood cells break down), thrombocytopenia (low platelet count), and acute renal failure (loss of the filter function of the kidney).

There is no known therapy to halt the progression of D+HUS. The active stage of the disease usually lasts one to two weeks during which a variety of complications are possible. D+HUS is a frightening illness that even in the best American centers has a mortality rate of about 5%. By comparison, the mortality rate in the developing world is over 75%. About 50% of patients require dialysis due to kidney failure, 25% develop pancreatitis, 25% experience seizures, and 5% suffer from diabetes mellitus. The majority requires transfusion of blood products and develops complications common to the critically ill. The illness is a living nightmare for the patients and families, and leaves a painful memory that lingers long after the acute illness.

Among survivors, about 5% will eventually develop end stage kidney disease with the resultant need for dialysis or transplantation, and another 5 to 10% will develop neurological or pancreatic problems which significantly impair quality of life. Since the longest available follow-up studies of D+HUS are about 20 years, an accurate lifetime prognosis is not available, and as such, lifetime medical follow-up is indicated for even the mildest affected.

Prognosis Features

1. Tonshoff B., Sammet A., Sanden I., Mehls O., Waldherr R., Scharer K., Outcome and prognostic determinants in the hemolytic uremic syndrome of children.

“The rate of recovery correlated with the degree of oligoanuria…. The proportion of patients who recovered was lower in the presence of severe hypertension during the acute phase…. The degree of CNS involvement was a strong predictor of [bad] outcome.”

2. De Jong M., Monnens L. Haemolytic-uremic syndrome: A 10 year follow-up study of 73 patients.

“All six patients belonging to the third group (oliguria for more than 14 days or anuria for more than 7 days) had late sequelae: two started dialysis more than 10 years after the initial phase; three had decreased GFR and concentrating capacity.”

3. Gagnadoux MF., Habib R. Long-term prognosis of childhood HUS.

“after follow up of 15 to 20 years, about 25% of patients affected with typical HUS in their childhood present with some degree of renal impairment. 10% being in advanced renal failure.”

4. Kelles A., VanDyck M., Proesman W. Childhood HUS: long-term outcome and prognostic features.

“severe hypertension, anuria lasting more than 7 days and central nervous system involvment have all been said to be associated with poor outcome that means early death and end-stage renal failure.”

5. Tonshoff B., Sammet A., et al. Outcome and prognostic determinats in the HUS of Children.

“The degree of CNS involvement was a strong predictor of [bad] outcome…. The most important difference in the rate of recovery of our patients was the degree of oligoanuria.”

6. Siegler R., Pavia A., et al. At 20 year population based study of post-diarrheal HUS in Utah.

“severe disease was significantly associated with… prodromal anuria and white blood cell count greater than 20,000…. Seizures or other neurological findings during the acute illness were also strongly associated with bad outcome.”

7. Gianantonio CA., Vitacco M., et al. The hemolytic uremic syndrome.

“One peculiar feature of the HUS is the striking association of severe renal damage and erthrocyte destruction with notable neurologic abnormalities…. Anuria of more than 4 days duration is also a sign of poor prognosis.”

8. Rowe PC. Epidemiology of HUS in Canadian children from 1986 to 1988.

“all patients with oliguria exceeding 15 days or anuria persisting for more than 8 days were left with chronic disease…. None of our patients with oliguria that lasted more than approximately 2 weeks or anuria that persisted more than approximately 1 week escaped chronic disease.”

9. Sprizzirri, Francisco D, Rahman, Ricardo C., Bibiloni, Norma, Ruscasso, Javier D., Amoreo, Oscar R. Childhood hemolytic uremic syndrome in Argentina: long-term follow-up and prognostic features.

“the severity of acute renal failure – as determined by the days of anuria – and the presence of proteinuria one year after the acute phase, were the most useful prognostic indicators [of bad outcome].”

10. Caletti, Maria G., Gallo, Guillermo, and Gianantonio, Carlos. Development of focal segmental sclerosis and hyalinosis in hemolytic uremic syndrome.

“These observations also confirm that prolonged oligoanuria during the acute stage of HUS frequently results in an unfavorable long-term prognosis…. The severe form was defined as anuria more than 7 days…. Proteinuria appeared after a proteinuria-free interval…

11. Schlieper, A., et al. Sequelae of haemolytic uraemic syndrome.

“HUS patients had numerically lower cognitive and achievement scores and higher behavioural problems ratings than their controls on every measure…. The results of this investigation provides preliminary indications of a post-HUS deficit in verbal intelligence and in the verbally based skills of reading comprehension and vocabulary use, as well as behaviour.”

12. Orme, S., Clark, E., Siegler, R.L., Neuropsychological sequele of post-diarrheal hemolytic uremic syndrome encephalopathy.

“HUS subjects consistently scored lower than controls on verbal intelligence, reading comprehension and vocabulary and behavior…. the data suggests that children who suffer from encephalopathy during HUS may have persistent cognitive problems…. The present data show a pattern of relative weakness in problem solving, visual-spatial reasoning, motor speed, memory, mathematical reasoning and spelling.”

13. Robson, Wm. Lane M. M.D., F.R.C.P., Leung, Alexander K.C. M.D., F.R.C.P. Kaplan, Bernard, S. M.B., B.Ch. Hemolytic-Uremic Syndrome.

“The following factors are reported to be associated with a poor prognosis in D+ HUS: Elevated WBC count, Prolonged anuria, Severe prodromal illness, Severe hemorrahagic colitis, Severe multisystem involvement…. The longer the duration of anuria, the less the recovery in GFR that can be expected.”

14. Thomson, Peter D. HUS in Johannesburg, South Africa: Epidemiology and Long-term Follow-up.

“We recommend that all severely affected cases of HUS should be followed for up to 20 years.”

15. Lopez, Eduardo L., Gianantonio, Carlos A., Cleary, Thomas G. The Hemolytic Uremic Syndrome in Argentina.

“A poor prognosis has been associated with oliguria of more than 3 weeks duration and/or anuria of more that 4 days duration.”

I just finished a day at the Louvre, walking along the Seine and trying to find the French I learned in college, as I ordered a meal with my daughter at a cafe on a busy avenue.  I then was brought back to what Spring is really all about - another Cantaloupe recall due to Salmonella. 

Apparently, a North Carolina company is recalling whole cantaloupes sold this week in Wal-Mart stores across North and South Carolina and in South Hill, Virginai, because they could be contaminated with Salmonella.  L&M Companies Inc. says the cantaloupes all came from the same small farm where a melon tested positive for the organism this week. No illnesses from eating the cantaloupes had been reported as of Friday.  Officials say the cantaloupes were sold at Wal-Mart stores from Sunday through Friday. Anyone who bought cantaloupes from those stores during that time should destroy them.

Over the last several years, it seems each Spring we hear of yet another recall.  Many have invloved severe illnesses and even deaths.  Let's hope this testing and recall catches it before it becomes a problem again.  There are three that I recall in the last few years:

Cantaloupe Salmonella Litchfield Outbreak, 2008 - Nationwide

In March of 2008, the Food and Drug Administration (FDA) announced that a Salmonella outbreak had been identified among residents of Arizona, California, Colorado, Georgia, Illinois, Missouri, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Tennessee, Utah, Washington, and Wisconsin. In all, 50 people had been linked to the outbreak; 14 were hospitalized.

Susie Cantaloupe Salmonella Outbreak, 2002 - Nationwide

On May 13, 2002 the Food and Drug Administration (FDA) issued a press release reporting that an outbreak of Salmonella serotype Poona had been traced to the consumption of Susie Brand cantaloupes distributed in the United States and Canada by the I. Kunik Company of McAllen, Texas. FDA reported that the cantaloupe was sold in retail stores, restaurants, and possibly used in other institutions. FDA investigators determined that dozens of people had been sickened after eating the contaminated cantaloupe, and detained all cantaloupe imported by I. Kunick from Mexico.

Viva Cantaloupe Salmonella Outbreak, 2001 - Nationwide

On May 25, 2001 the FDA issued a press release warning consumers that Viva brand imported cantaloupe had been identified as the source of a Salmonella poona outbreak. FDA stated that the cantaloupe had been sold by S.P.R. De R.I. Legumbrera San Luis and S.P.R. De R.I. Los Arroyoas of Mexico and imported by Shipley Sales Service of Nogales, Arizona. Illnesses associated with the consumption of the contaminated cantaloupe had been identified in Arizona, California, Connecticut, Georgia, Hawaii, Massachusetts, Minnesota, Missouri, New Mexico, Nevada, New York, Oregon, Tennessee, and Washington State.

Bruce Clark, my law partner and Patti Waller, my Epidemiologist, were in Argentina this week.  The conference topics were:

 - STEC/VTEC epidemiology from around the world

- Reservoirs. Sources and routes of transmission

- Pathogenesis. Host response to STEC/VTEC infections. Animal models of HUS

- Virulence factors. Genomics

- Clinical and diagnostic aspects of STEC/VTEC infections and HUS

- Strategies of control and prevention

I wish I could have attended, but I was in London at another E. coli Conference.  I will get Patti and Bruce to write something up on their experiences.  Here is part of what Bruce and Patti presented at teh Conference:

We have completed a portion of the first year’s tests and are in the process of compiling the data. We hope to publish the results in the next month. (See Abstract):

PREVALENCE OF NON-O157 ENTEROHAEMMORRHAGIC ESCHERICHIA COLI IN RETAIL GROUND BEEF IN THE UNITED STATES

Non-O157 STEC are capable of causing the same debilitating triad of diseases as E. coli O157:H7, including hemorrhagic colitis, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura. Infection with the non-O157 STEC can result in death in children, the elderly and the immunocompromised. According to the U.S. Centers for Disease Control and Prevention, the number of reported cases of illnesses caused by this group of pathogenic E. coli has been steadily increasing over the past several years. Despite this, Non-O157:H7 STEC is not considered an adulterant under current law in the U.S. That needs to change.

Non-O157:H7 STEC are also known to occur in imported beef from several trading partners, yet the U.S. Department of Agriculture Food Safety and Inspection Service (FSIS) has not required that imported beef be free of these pathogens. The Agency has also failed to devise steps to measure and control the presence of these pathogens in domestic beef production and the ground beef supply, at the slaughterhouse or the grocery store.

I had dinner tonight with Lord Soulsby of Swaffham Prior and a dozen others, including my 14 year old daughter Olivia, in one of the House of Lords dining chambers. The whole place reminded me a bit of Hogwarts out of Harry Potter. The food below was adequate, not fancy, but likely safe, as most of the ministers and professors had something to do with food safety.  Gave my talk tonight about food safety, or the lack thereof in the US.  Spoke for 20 minutes and had about 40 minutes of questions.  It is amazing how so many people in the world look to us for leadership.  We actually should give them some.  Anyway, on dinner:

Dover Sole, Spinach and Potatoes for Dinner

Cheesecake and Coffee for Desert with House of Lords Chocolates

Poor Bill Baldwin of Forbes – his Editorial “Needed: Tort Lawyers” in this week's Forbes – has been printed and reprinted on other lawyer blogs and websites to tout their bona fides as food lawyers. Funny thing, all of them missed this part of Mr. Baldwin’s editorial:

Meet William Marler, a 52-year-old Seattle attorney whose career was launched with a $15.6 million settlement against Jack in the Box. (This victim survived but lost her large intestine.) Sixteen years later he can brag that his firm, Marler Clark, has extracted just shy of half a billion dollars in settlements from food vendors. This suggests cumulative revenues of maybe $150 million for a small firm (seven lawyers, one full-time epidemiologist). But letting lawyers get rich has a nice side effect. The settlements get the attention of food producers. Bill Marler is not shy about using the Web, press releases and Capitol Hill testimony to publicize what he's doing.

The “newbie” lawyers into food litigation believe that if they put up a few Google ads and post a few blogs, the glitter of it all will attract people poisoned by the food they and their children have eaten to their firms. They then think they can cash in on the victims injuries.

But these “newbie” lawyers are mistaken it is not about the money – victims of foodborne illness today can tell the real from the fake, from the glittery website site and dazzling smile to 21 years of 24/7 365 day advocacy. Those clients, like Heather Wybrew, Carl Ours and Mari Tardiff profiled in the New York Times this Monday in “Health experts say food supply is safer today than a decade ago, but recalls raise new concerns,” understand the differences. They get it. As I said to the New Your Times:

The paradox is that even as food has grown safer, contamination scares and recalls keep coming to light. William Marler, a Seattle lawyer who specializes in representing victims of food-borne illness, said that every time his business appeared to slow from a drop-off in cases, some new type of contamination would crop up.

"It's like the Dutch boy putting his finger in the dike," Marler said. "When you put your finger in one hole, another emerges."

The clients understand that it is not about the money, the glitz or the glitter – it is about hard work, dedication and caring. Well, time to board the plane to London. I need to put another finger in the dike.

Off to London Sunday and plan to revisit the site of what many consider to be the birth of Epidemiology – SOHO, the Broad Street Pump and the works of Dr. John Snow, who in 1854 determined that the cholera outbreak sweeping the area was related to the water coming from the Broad Street Pump. The handle was removed, and the rest is history. Last year I gained membership in the John Snow Society. Founded in 1993, the John Snow Society aims to promote the life and works of Dr John Snow as anesthetist and pioneer of epidemiological methods. In 2001, the Society became part of the Royal Institute of Public Health, London.

Hopefully, we in the States will honor Dr. Snow's work by actually funding Local, State and Federal food and water borne disease surveillance.

The recall of Salmonella-tainted peanuts and peanut products processed and produced by the Peanut Corporation of America has caused one of the largest food recalls in US history; almost 4000 products made by hundreds of companies have been withdrawn, and the number is still growing. The 700 culture-confirmed cases of Salmonella indicate a much higher number of unreported illnesses – the actual number is probably close to 25,000. At least nine lost their lives. Beyond this terrible human toll, the financial toll on businesses and the American food supply has been staggering.

How did it happen? How did a single peanut processor in rural Georgia cost the American economy over a billion dollars? The two factories run by PCA only processed 2.5% of the annual US peanut crop, but their actions had huge repercussions. The investigations into the actions of the Peanut Corporation of America have revealed that PCA repeatedly retested product until a clean sample was obtained, shipped product that they knew was contaminated, and did not act on recommendations from the FDA to clean up their act.

It’s too easy to point to the company as a “bad actor” - an isolated case. There was a similar widespread outbreak of Salmonella in peanut butter two years earlier, centered not 75 miles from the Georgia plant. Unbelievably, this did not appear to affect how PCA ran its business, or how they were inspected or regulated so it can - and may - happen again.

Let’s start with the human toll, which is what I know best. My firm represents over 100 people who were sickened by the Salmonella and two families who lost a family member to it. One of our clients, Clifford Tousignant, won three purple hearts in the Korean War, but lost his life to peanut butter. Another family’s three-year-old son got sicker and sicker as his pediatrician allowed him his favorite food during his illness - the peanut butter crackers that later turned out to be the source of his infection. Hundreds of families spent time and money in emergency rooms and Intensive care units as their family members struggled with their illnesses. Although no one can put a price tag on human suffering and loss, these claims will probably settle in the range of 30-35 million dollars. That’s serious money, but most of it will be covered by insurance. Those settlements will be, well, peanuts, compared to the other costs surrounding the nationwide recall.

Recalling tainted food is the right thing to do – for legal and ethical reasons as well as basic public relations. But recalls come with astounding costs. One of my good friends in the food-processing industry estimates that the peanut recall will cost well over $500 million. It’s impossible to assign precise numbers, but you can start with the costs of tracking down, retrieving and transporting millions of items, most of which have already found their way onto retail shelves and kitchen cabinets. Kellogg, just one of the companies that recalled products recently, has estimated those costs at $75 million – for just one company.

Then there are the lost sales – not just of the tainted products themselves, but also of related peanut products that may be completely safe. The tomato-Salmonella recall last year resulted in $100 million in lost tomato sales – even though the real culprit proved to be peppers. In 2006, E. coli-tainted spinach cost that industry over $175 million - even though the outbreak was linked to just one fifty-acre farm in California. Peanut sales already have plummeted by more than 25 percent. Demand is down and peanut fields are lying fallow. The peanut industry estimates the loss is over one billion dollars in lost production and sales.

Let’s not forget the costs of advertising and public relations aimed at restoring consumer confidence. We have already seen expensive newspaper ads from peanut butter-makers, reassuring readers that their product is safe. What about the cost of restoring tainted brands?

Those in the chain of distribution are feeling the effects as well. Suppliers may or may not have to reimburse retail stores for lost sales. Large retailers like Wal-Mart include such reimbursement in their contracts; small businesses probably don’t do that, but suppliers may reimburse them anyway. And, then there are the losses to stock prices. One major food processor lost $1 billion in stock value following an E. coli outbreak. Imagine what’s happening to peanut stocks these days.

The Big Guys – the Kelloggs and ConAgras and Jack-in-the-Boxes – can sustain those losses. Not so the smaller retailers. My heart goes out to mom-and-pop businesses like Betsy Sanders of Santa Clara, California whose small business supplies cookies for local Parent Teacher Association and marching band fundraisers, and who now has to reimburse her customers for recalled products that contained peanut butter from PCA.

Is anyone keeping track of the math? Let’s call it $1.5 billion - just because of the actions of one small player in the peanut industry. The likely costs of compensating their sickened customers are a tiny part of that number; virtually none of the rest of that $1.5 billion will be covered by insurance. In an economy already battered by failing banks, lost jobs and scarce credit, people will be driven out of business. And, it was preventable.

As I was preparing this speech, the Food and Drug Administration announced that President Obama’s 2010 proposed budget included an increase of almost 20% for the FDA, including almost $260 million for better food safety. That sounds like big money, but if it can prevent a single billion-dollar recall and prevent citizens from being sickened, it’s a step in the right direction. However, there are a few other things that I would suggest.

First, be honest with the American Public. With 76,000,000 foodborne illness cases yearly, 325,000 hospitalizations and 5,000 deaths, our food supply might be safer than some – but it is not safe enough.

Second, put food safety on the “front burner” and turn up the heat. It is time that we commit to the American Public to get animal feces out of our food. How to do it - Here are my “top ten” ideas to combat this recurring epidemic:

- Improve surveillance of bacterial and viral diseases. First responders - ER physicians and local doctors - need to be encouraged to test for pathogens and report findings directly to local and state health departments and the CDC promptly.
- These same governmental departments, whether local, state or federal, need to learn to “play well together.” Turf battles need to take a back seat to stopping an outbreak and tracking it to its source. That means resources need to be provided and coordination encouraged so illnesses can be promptly stopped and the offending producer - not an entire industry - are brought to heal.
- Require real training and certification of food handlers at restaurants and grocery stores. There also should be incentives for ill employees not to come to work when ill.
- Stiffen license requirements for large farm, retail and wholesale food outlets, so that nobody gets a license until they and their employees have shown they understand the hazards and how to avoid them.
- Increase food inspections. While domestic production has continued to be a problem, imports pose an increasing risk, especially if terrorists were to get into the act. Points of export and entry are a logical place to step up monitoring. We need more inspectors - domestically and abroad - and we need to require that they receive the training in how to identify and control hazards.
- We need to reform federal, state and local agencies to make them more proactive, and less reactive. This too requires financial resources and accountability. We also need to modernize food safety statutes by replacing the existing collection of often conflicting laws and regulation with one uniform food safety law of the highest standard.
- There are too few legal consequences for sickening or killing customers by selling contaminated food in the US. We don’t need to impose the death penalty, as China did recently. But, we should impose stiff fines, and even prison sentences, for violators, and even stiffer penalties for repeat violators.
- We need to use our technology to make food more traceable so that when an outbreak occurs authorities can quickly identify the source and limit the spread of the contamination and stop the disruption to the economy.
- We need to promote university research to develop better technologies to make food safe and for testing foods for contamination.
- We need to provide tax breaks for companies that push food safety research and employee training.
- And, we need to improve consumer understanding of the risks of foodborne illness.

Last year I testified before the US Congress and laid out the above 11 points. I told them the time has come to act and not continue simply to react. Consumers, Farmers, Suppliers, Manufacturers, Retailers, Regulators and Politicians need to work together to make our food supply safe, profitable and sustainable. When a quarter of our population is sickened yearly by contaminated food, when thousands die, we do not have the “safest food supply in the world.” We should, must, and can do better.

From the MMWR Today - Since February 1, a total of 228 cases have been reported from 13 states: Nebraska (110 cases), Iowa (35), South Dakota (35), Michigan (18), Kansas (eight), Pennsylvania (seven), Minnesota (five), Ohio (three), Illinois (two), West Virginia (two), Florida (one), North Carolina (one), and Utah (one) (Figure 2). Patients range in age from <1 year to 85 years (median: 29 years); 69% are female. Among patients with available information, 4% reported being hospitalized. No deaths have been reported.

On February 24, 2009, the Nebraska Department of Health and Human Services identified six isolates of Salmonella serotype Saintpaul with collection dates from February 7--14. Salmonella Saintpaul is not a commonly detected serotype; during 2008, only three Salmonella Saintpaul isolates were identified in Nebraska. This report summarizes the preliminary results of the investigation of this outbreak, which has identified 228 cases in 13 states and implicated the source as alfalfa sprouts produced at multiple facilities using seeds that likely originated from a common grower. On April 26, the Food and Drug Administration (FDA) and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts, until further notice. On May 1, FDA alerted sprout growers and retailers that a seed supplier was withdrawing voluntarily from the market all lots of alfalfa seeds with a specific three-digit prefix.

For this investigation, a case was defined as illness in a person whose stool culture on or after February 1, 2009, yielded Salmonella Saintpaul with the outbreak strain pulsed-field gel electrophoresis (PFGE) patterns (XbaI JN6X01.0072, JN6X01.0252, JN6X01.0340, JN6X01.0709, JN6X01.0712, JN6X01.0718, or JN6X01.0719). During January 1, 2008 to January 31, 2009, only four cases of the outbreak strain of Salmonella Saintpaul were identified by PulseNet.

By March 19, a total of 186 cases had been identified in Illinois, Iowa, Kansas, Minnesota, Nebraska, and South Dakota. Of the 156 patients with completed interviews, 114 (73%) reported alfalfa sprout consumption.

In mid-April, 42 additional case-patients with onset of illness beginning after March 15 were identified from Florida, Iowa, North Carolina, Michigan, Minnesota, Nebraska, Ohio, Pennsylvania, Utah, and West Virginia. At least 20 of these case-patients reported recently eating sprouts. Alfalfa sprouts eaten by these case-patients were traced back to growing facilities in Michigan, Minnesota, and Pennsylvania that received seed lots identified with prefix 032 from Caudill Seed Company. Alfalfa sprout irrigation water collected on March 10 from a growing facility in Wisconsin grew Salmonella Saintpaul indistinguishable from the outbreak strain. These sprouts also were grown from a seed lot identified with prefix 032 received from Caudill Seed Company. No human illnesses have been linked to the Wisconsin facility. Preliminary findings indicate that the implicated seed lots were sold in many states and might account for a large proportion of the alfalfa seeds that were being used by sprout growers during this outbreak.

We presently have nearly a dozen clients from several states.  Four Lawsuits have been filed.

So, what is the big deal? President Obama ordered a medium-well burger for himself and the VP, and ordered medium burgers for the press – in a restaurant with a spotty food safety record that does not use, or may not even have, a thermometer. Forgoing the phrase “teachable moment” for a bit, I would like to get right to the “meat” of the matter. What Obama did was foolish - in the view of many food safety experts - but it is something that many consumers do every day; they order a burger from their favorite restaurant or cook it themselves on the backyard grill.

Food safety professionals inside and outside government will tell you that medium or medium-well means nothing in the food safety world – temperature is the key. Pink or brown color is not a good indicator of “doneness.” Temperature on the inside of the burger (at several places) of 155 to 160 degrees (rules vary a bit state to state) is the only way to assure that the burger is safe. Yet less that 2% of consumers use or own a thermometer. Restaurants are required to have thermometers, but not necessarily use them. So, why do consumers - including the President - ignore the advice of experts who are trying to protect them from the bacteria and viruses lurking in their cheeseburgers that can sicken or kill them or their children?

What consumers believe, including the President apparently, is what they hear every day from Government officials and the Beef Industry – “Our Food Supply Is The Safest In the World”. Compared to China? Great! Clearly, any food safety message is missed, because of lack of honesty (hamburger really may contain animal feces that can sicken or kill you!) and lack of education (why don’t we teach kids how to cook safely in addition to teaching them to wear seatbelts and shun smoking?)

So, what is a President to do - avoid hamburgers? Well, I do (and so does my family) ever since the Jack in the Box E. coli O157:H7 Outbreak of 1993 that sickened nearly 600, caused acute kidney failure in 50 and killed four children - but that is just me.

Full disclosure, I am a trial lawyer who represents victims of foodborne illness. I have seen too much misery, and yes, death, caused by failures in food production at every stage of the food supply. If you do not think our food supply is dangerous, then just open a newspaper, turn on the radio or TV or surf the Internet. Foodborne illness outbreaks linked to all types of food (including hamburger) are nearly a daily occurrence. However, the Government and Industry keep telling us its safe and we seem to believe it.

So, what is a President to do?

First call the head of Food Safety Inspection Services (actually, a spot yet to be filled) and ask him why there is cow feces in hamburger meat in the first place. Also, while you have him on the phone, ask about Salmonella, Listeria, MRSA and all the other bugs that may have been in the hamburger you ate the other day.

Next, be honest with the American Public. With 76,000,000 foodborne illnesses cases yearly, 325, 000 hospitalizations and 5,000 deaths, our food supply might be safer than China’s – but it is not safe enough.

Third, put food safety on the “front burner” and turn up the heat. It is time that we commit to the American Public to get animal feces out of our food. How to do it:

A. Revise food regulations to criminalize manufacturers who sell food that poisons consumers. I am not suggesting the “China Method,” but it is time to impose stiff fines, and jail sentences for businesses that kill kids;

B. Give tax credits and other incentives to businesses that invest in safe food methods and technology. Remind me, how many billions have we given the banks? Perhaps it is time to invest in those who will actually invest in us;

C. Increase the surveillance of foodborne diseases. Right now, for every one person counted in an outbreak, we miss another 20 to 40. This causes delays in determining what food product is sickening our neighbors allowing hundreds of others to become sick before we figure out what product to pull;

D. Fully fund Local, State and Federal Health and Food Inspectors and give them the legislative and financial tools to get the job done.

The “teachable moment” is simply that the hamburger that the President ordered on Monday should not put him at risk for getting sick on Thursday. That is true for all of us and all the food that we eat. The “teachable moment” has passed, the real question is, “did we learn anything?’

Today we amended our complaint on behalf of “Daniel Krim, 49, [who] became ill after eating alfalfa sprouts on a turkey sandwich he purchased from a La Vista restaurant in late February. His flu-like symptoms worsened, forcing him to go to the emergency room at Midlands Hospital in Papillion. Days later, his doctor confirmed he had been infected with the Salmonella St. Paul strain, according to his lawsuit, filed last week in Sarpy County District Court.”

According to Leia Baez of the Omaha World-Herald, “Krim is suing CW Sprouts, Inc., whose SunSprouts products were linked to the outbreak in Nebraska, Iowa, Kansas, Colorado and South Dakota. He also is suing Caudill Seed and Warehouse Co. of Louisville, Ky., the company that manufactured and sold alfalfa sprout seeds to CW Sprouts."

I am working on revising my keynote address to the 75th annual gathering of the Canadian Institute of Public Health Inspectors in the morning.   Below is the PowerPoint.  The embedded videos (and others) can be found HERE

People ask me why I do these speeches (for free) to governments in the US, Canada, China, Australia and England.  Well, the answer is I keep hoping a warmer Island Nation asks me next.  The real answer is that in 16 years of litigating nearly every major foodborne illness outbreak in the US, I have learned too much about the horrors of these diseases and the impacts on families.  Giving of my time is nothing if you compare that to what my clients have gone through.  Preventing the next illness, the next outbreak, should be each of our goals.

OK, it is 2:00 AM and the power is out after a wind a rain and storm on Bainbridge Island. Fortunately, my laptop has batteries and I have a wireless card. I am also wondering where my passport is since I leave for Canada in 12 hours. But, hopefully the morning will find it – somewhere.

So, I was reading up on the recent pronouncements about Swine Flu (politically correct H1N1 virus) and kept bumping into Dr. Richard Besser, acting head of CDC. Doing a little research on him at 2:00 AM uncovered this article about his research into an E. coli O157:H7 outbreak linked to unpasteurized apple juice, two years before the outbreak of E. coli O157:H7 linked to Jack in the Box restaurants. There began my connection.

Back to unpasteurized juice – Interesting to note that the CONCLUSIONS below show how we learn – a bit slowly – to protect ourselves from the next outbreak by actually investigating and learning from past outbreaks. Goes to show why surveillance of foodborne illness outbreaks is so important in preventing the next one. Now, if only we can do the same with the Flu.

An outbreak of diarrhea and hemolytic uremic syndrome from Escherichia coli O157:H7 in fresh-pressed apple cider.  Besser RE, Lett SM, Weber JT, Doyle MP, Barrett TJ, Wells JG, Griffin PM.

Escherichia coli O157:H7 causes hemorrhagic colitis and the hemolytic uremic syndrome. In the fall of 1991, an outbreak of E coli O157:H7 infections in southeastern Massachusetts provided an opportunity to identify transmission by a seemingly unlikely vehicle.  Case-control study to determine the vehicle of infection. New England cider producers were surveyed to assess production practices and determined the survival time of E coli O157:H7 organisms in apple cider.  Illness was significantly associated with drinking one brand of apple cider. Thirteen (72%) of 18 patients but only 16 (33%) of 49 controls reported drinking apple cider in the week before illness began (odds ratio [OR], 8.3; 95% confidence interval [CI], 1.8 to 39.7). Among those who drank cider, 12 (92%) of 13 patients compared with two (13%) of 16 controls drank cider from cider mill A (lower 95% CI, 2.9; P < .01). This mill pressed cider in a manner similar to that used by other small cider producers: apples were not washed, cider was not pasteurized, and no preservatives were added. In the laboratory, E coli O157:H7 organisms survived for 20 days in unpreserved refrigerated apple cider. Addition of sodium benzoate 0.1% reduced survival to less than 7 days.

CONCLUSIONS--Fresh-pressed, unpreserved apple cider can transmit E coli O157:H7 organisms, which cause severe infections. Risk of transmission can be reduced by washing and brushing apples before pressing, and preserving cider with sodium benzoate.  Consumers can reduce their risk by only drinking cider made from apples that have been washed and brushed.

An outbreak of Escherichia coli O157:H7 infections and haemolytic uraemic syndrome associated with consumption of unpasteurized apple cider.  Hilborn ED, Mshar PA, Fiorentino TR, Dembek ZF, Barrett TJ, Howard RT, Cartter ML.

During October 1996, an outbreak of Escherichia coli O157:H7 infections among Connecticut residents occurred. An epidemiologic investigation included enhanced surveillance and a case-control study. Clinical isolates of Escherichia coli O157:H7 were typed by pulsed-field gel electrophoresis (PFGE). Implicated cider samples were analysed by culture and polymerase chain reaction (PCR). Consumption of implicated cider was associated with illness; (matched odds ratio = undefined, 95 % confidence interval = 3.5-infinity). Ultimately, a total of 14 outbreak-associated patients were identified. All isolates analysed by PFGE yielded the outbreak-associated subtype. Escherichia coli O157:H7 was not cultured from three cider samples; PCR analysis detected DNA fragments consistent with Escherichia coli O157:H7 in one. This outbreak was associated with drinking one brand of unpasteurized apple cider. PFGE subtyping supported the epidemiologic association. PCR analysis detected microbial contaminants in the absence of live organisms.

CONCLUSIONS - Washing and brushing apples did not prevent cider contamination.

An outbreak of Escherichia coli O157:H7 infection from unpasteurized commercial apple juice.  Cody SH, Glynn MK, Farrar JA, Cairns KL, Griffin PM, Kobayashi J, Fyfe M, Hoffman R, King AS, Lewis JH, Swaminathan B, Bryant RG, Vugia DJ.

Escherichia coli O157:H7 infections have traditionally been associated with animal products, but outbreaks associated with produce have been reported with increasing frequency. In fall 1996, a small cluster of E. coli O157:H7 infections was epidemiologically linked to a particular brand (brand A) of unpasteurized apple juice.  To define the extent of the outbreak, confirm the source, and determine how the apple juice became contaminated.  Descriptive epidemiologic study and traceback investigation.  Western United States and British Columbia, Canada.  Patients with E. coli O157:H7 infection who were exposed to brand A apple juice.  Clinical outcome and juice exposure histories of case-patients, pulsed-field gel electrophoresis of case and juice isolates, and juice production practices.  Seventy persons with E. coli O157:H7 infection and exposure to brand A unpasteurized apple juice were identified. Of these persons, 25 (36%) were hospitalized, 14 (20%) developed the hemolytic uremic syndrome, and 1 (1%) died. Recalled apple juice that was produced on 7 October 1996 grew E. coli O157:H7 with a pulsed-field gel electrophoresis pattern indistinguishable from that of case isolates. Apple juice produced on 7 October 1996 accounted for almost all of the cases, and the source of contamination was suspected to be incoming apples. Three lots of apples could explain contamination of the juice: Two lots originated from an orchard frequented by deer that were subsequently shown to carry E. coli O157:H7, and one lot contained decayed apples that had been waxed.

CONCLUSIONS - Standard procedures at a state-of-the-art plant that produced unpasteurized juices were inadequate to eliminate contamination with E. coli O157:H7.  This outbreak demonstrated that unpasteurized juices must be considered a potentially hazardous food and led to widespread changes in the fresh juice industry.

My connection, I represented most of the hemolytic uremic syndrome cases in the Jack in the Box E. coli Outbreak and the "Commercial" (a.k.a Odwalla) E. coli Outbreak.  Well, I wish Dr. Besser well and I hope I find my passport.

My guess is that Cinco de Mayo is Lou Dobbs favorite holiday.  I know, he seems to make such a big deal about those damn "illegal immigrants," but he knows that you can count on one hand how many foodborne illness outbreaks have been caused by imported Mexican, or for that matter any imported foreign food product.  The bottom line is that US Corporations do a wonderful job of poisoning our own citizens. 

However, in the flavor of the day, here is a list of foodborne illness outbreaks linked to Mexican food - most which was prepared and served in the USA.

Multistate Outbreak of E. coli O157 Infections linked to Taco Bell - Eastcoast

This outbreak was clearly linked to Taco Bell restaurants in the northeastern United States. As of 12 PM (ET) December 14, 2006, Thursday, 71 persons with illness associated with the Taco Bell restaurant outbreak have been reported to CDC from 5 states: New Jersey (33), New York (22), Pennsylvania (13), Delaware (2), and South Carolina (1). States with Taco Bell restaurants where persons confirmed to have the outbreak strain have eaten are New Jersey, New York, Pennsylvania, and Delaware. (The patient from South Carolina ate at a Taco Bell restaurant in Pennsylvania). Other cases of illness are under investigation by state public health officials. Among these 71 ill persons, 53 (75%) were hospitalized and 8 (11%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS). Illness onset dates have ranged from November 20 to December 6.  California Lettuce.

Habaneros E. coli Outbreak – Missouri

In late August of 2003, staff in the Communicable Disease (CD) section at the St. Clair County Health Department (SCCHD) conducted a foodborne outbreak investigation and found that of 64 persons, including seven employees, who had eaten at Habaneros between August 15, 2003 and September 5, 2003, thirty (47%) reported having diarrheal symptoms; ten sought medical care.  An extensive food consumption history was obtained from each person interviewed, but no specific food-item was statistically associated with illness.  Five individuals were laboratory-confirmed with E. coli O157:H7. All five ate at Habaneros on either August 23 or August 24.   Pulsed field gel electrophoresis (PFGE) analysis of the five isolates obtained from culture-confirmed patients revealed that all five had an indistinguishable PFGE pattern, indicating that they were infected with the same strain of E. coli O157:H7.  On September 18, IDPH received a report that E. coli O157:H7 had been cultured from a sample of pico de gallo obtained from Habaneros.

Taco John’s E. coli Outbreak – Iowa and Minnesota

In December 2006, Iowa and Minnesota health officials investigated an E. coli O157:H7 outbreak among patrons at Taco John’s restaurants in Ceder Falls, Iowa, and Albert Lea and Austin, Minnesota.  As of December 13, 2006, the Iowa Department of Health had confirmed that at least 50 Iowans had become ill with E. coli infections after eating at Taco John’s, and the Minnesota Department of Health had confirmed that at least 27 Minnesotans were part of the outbreak.  Lettuce was grown in California

Chi-Chi’s Hepatitis A Outbreak – Pennsylvania

In late October of 2003, Pennsylvania health officials learned of a potential hepatitis A outbreak from emergency room doctors treating patients in Beaver County.  The Beaver County Health Department (BCHD) and Pennsylvania Department of Health (PDOH) began investigating the apparent outbreak, and learned through interviews that all case patients had eaten at the Chi Chi’s restaurant at the Beaver Valley Mall in the weeks before becoming ill. PDOH, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), conducted an epidemiological study of the outbreak, and determined that green onions imported from Mexico were the source of the outbreak.  The FDA issued a statement dated December 9, 2003, affirming that this outbreak was associated with eating raw or undercooked green onions.

Ultimately, over 650 confirmed cases of hepatitis A, both primary and secondary, were linked to consumption of green onions at the Beaver Valley Mall Chi-Chi’s.  The victims included at least 13 employees of the restaurant, and numerous residents of six other states.  Four people died as a consequence of their hepatitis A illness.  In addition, more than 9,000 people who had eaten at the restaurant during the period of potential exposure, or who had been exposed to ill Chi-Chi’s customers, obtained immune globulin shots to prevent hepatitis A infection.

Chili’s Salmonella Outbreak – Illinois

In late June of 2003, the Lake County Health Department (LCHD) was contacted by health care providers who had treated patients for Salmonellosis, and customers who had experienced a diarrheal illness after eating at the Vernon Hills, Illinois, Chili’s Grill & Bar.  LCHD sent investigators to inspect the restaurant for food safety violations. During the inspection, investigators discovered:

- The restaurant’s dishwashing machine was broken and corroded; the tube that fed chlorine into the machine was plugged, preventing proper sanitization of dishes.  Employees told investigators that the machine had not worked properly for at least a week;
- Food was not stored at proper temperatures in the cooler;
- Three employees and a manager had called in sick that day with flu-like symptoms.

LCHD continued to receive reports of Salmonella infection from local hospitals and restaurant patrons throughout the next several days.  During the course of investigating the outbreak, investigators discovered that thirteen employees had been allowed to work despite suffering from diarrhea and other symptoms, and learned that Chili’s had operated despite having no water for part of one day, and no hot water for at least one full day.   Food safety regulations require that hot water be available at all times during a restaurant’s operation.

In mid-July, LCHD concluded its investigation, and reported that over 300 individuals had been sickened as a result of consuming contaminated food at a Chili’s.  Of those, 141 customers and 28 employees had tested positive for Salmonella, while 105 other infected individuals met the LCHD’s definition of a probable case.  LCHD issued a preliminary report that concluded the outbreak was caused by infected employees who contaminated food with Salmonella as a result of poor sanitary practices and improper food-handling.

Viva Cantaloupe Salmonella Outbreak – Nationwide

On May 25, 2001 the FDA issued a press release warning consumers that Viva brand imported cantaloupe had been identified as the source of a Salmonella poona outbreak.  FDA stated that the cantaloupe had been sold by S.P.R. De R.I. Legumbrera San Luis and S.P.R. De R.I. Los Arroyoas of Mexico and imported by Shipley Sales Service of Nogales, Arizona.  Illnesses associated with the consumption of the contaminated cantaloupe had been identified in Arizona, California, Connecticut, Georgia, Hawaii, Massachusetts, Minnesota, Missouri, New Mexico, Nevada, New York, Oregon, Tennessee, and Washington State.  The cantaloupe was sold in retail stores and restaurants and possibly served in health care facilities.  FDA detained all cantaloupe imported by Shipley Sales Service and took steps to prevent the importation of any additional contaminated cantaloupe.   FDA outbreak investigators determined that 50 residents of California (28), Washington (8), Nevada (7), Arizona (6), and Oregon (1) had become ill with a genetically indistinguishable strain of Salmonella poona during the outbreak.  Nine patients were hospitalized and two died.

Senor Felix 5-Layer Dip Shigella Outbreak - Western States

On January 5, 2000, Public Health – Seattle & King County issued a notice to Washington residents that three people had been confirmed ill with Shigella infections after eating five-layer dip manufactured by Senor Felix Gourmet Mexican Foods and sold under several brand names.   Two other cases were pending confirmation in Washington, and more illnesses had been reported in California and Oregon.  The Food and Drug Administration (FDA) issued a nationwide warning regarding the contaminated dip on January 27, 2000, and announced that 49 cases of Shigellosis associated with the consumption of Senor Felix dips had been reported in California, Oregon, and Washington; five patients had been hospitalized.  Health officials ultimately identified 406 people with Shigella infections who had eaten the dip in the week prior to illness.  Cases were reported in ten states. An environmental investigation of the processing facility revealed numerous problems with manufacturing practices and quality control at the Senor Felix facility.

Viva Mexico Shigella Outbreak – California

In October of 2000, the California Department of Health Services (CDHS) was notified that several Redwood City, California, residents had become ill with confirmed Shigella infections.   San Mateo County Communicable Disease Control staff conducted a case-control study, and learned that there was a statistically significant association between consuming the salsa prepared at Viva Mexico and illness. CDHS conducted an environmental assessment of the restaurant on October 24, noting multiple food code violations, and San Mateo County sanitarians closed the restaurant.  Violations cited included:

- No soap in the women’s restroom;
- No sanitizer on the premises;
- On site thermometer was reading temperatures 10°F off;
- Improper cooling of foods – meat, poultry, and beans – with core temperatures from 50-70°F after 18 hours of cooling;
- Cross contamination of foods – meat residue on knives used to cut produce.

When the outbreak investigation was complete, CDHS had identified 221 people who had eaten at Viva Mexico between October 19 and October 24 and had become ill with Shigella infections.   Seventy people were culture-confirmed with Shigella, and one person died as a result of her illness.

On May 7, Denis Stearns will be making a presentation in New Orleans at the GMA Foodborne Illness Litigation Conference. The title of his presentation is Lessons Learned Recent Outbreaks and Recalls, with a subtitle of 2007-2008, The Salmonella Years & The Lessons We Learned. In the presentation, Denis will discuss how the recent Salmonella mega-outbreaks involving contaminated Veggie Booty snacks, frozen pot pies, and peanut butter have revealed how outbreak have demographics just like products do. Moreover, understanding these demographics is crucial to the effective representation of the victims, including decisions about how best to communicate with clients, and to manage expectations about the legal process and likely outcomes. The presentation will also look at the unsuccessful attempts by some plaintiff attorneys to use class actions to handle the injury claims arising from these mega-outbreaks.

The WHO reports this morning that a farm worker in Canada has infected a herd of pigs with swine flu, the first documented case of the virus being passed from humans to animals.  The herd of pigs tested positive for the H1N1 virus after the worker returned from Mexico with the disease. The herd has been quarantined (and the worker?).  Up to 200 pigs had been infected at the Alberta Farm, and that both the man and pigs are recovering, adding that the virus did not seem to have spread. 

The case adds to growing international concern about the safety of eating pork products, with Russia, China, Indonesia, Ukraine, Philippines and Serbia introducing partial or total import bans of pork from the US.  The UN and WTO said on Saturday that there is no justification for such anti-pork trade measures as a result of the swine flu epidemic.

I think a "Market Withdraw" is like being "a little pregnant."  But, it is not a Recall - or, is it?

The FDA just reported that preliminary epidemiology regarding the ongoing outbreak of illness from Salmonella Saintpaul in people who had eaten alfalfa sprouts was shared with the supplier of the seeds associated with illness. Based on this information the seed supplier made the decision to voluntarily withdraw from the market all of the alfalfa seeds bearing six digit lot numbers that start with “032.”

All seeds involved in this market withdrawal came from Italy. The seeds are in 50-pound white bags that are either paper or woven from a synthetic material, and the lot numbers in question begin with “032,” followed by a hyphen and three more digits. The bags carry a computer-generated white or yellow label, on which is printed “Distributed by Caudill Seed Company., 1402 W. Main St., Louisville KY 40203” and the lot number.

FDA has no evidence that alfalfa seeds from other lots, or sprouts grown from them, are affected by this market withdrawal. Retailers, restaurateurs, and personnel at other food-service facilities should ask their suppliers to verify that the alfalfa sprouts or seeds being provided do not come from an affected lot before buying or serving them. Suppliers who can verify that their products were not sourced from the affected lots may wish to notify their customers; likewise, retailers, restaurateurs, and food-service facilities who have verified the sources of their alfalfa products may wish to notify their customers.

Seeds from the affected lots, lot numbers beginning with 032, and sprouts grown from them, should be safely discarded, as should other products that contain the sprouts, such as sprout blends. Growers who have used seeds from the potentially contaminated lots should clean all equipment and other surfaces that came into contact with them. They should also safely discard any water that came into contact with the sprouts, and disinfect receptacles or equipment that came into contact with the water.

We have already filed three lawsuits against the sprouters.  It looks like soon they will have company in the litigation.

In June of 2007, United Food Group, LLC (UFG) recalled 5.7 million pounds of ground beef products after a joint investigation into an E. coli O157:H7 outbreak by Colorado and California health officials in conjunction with the Centers for Disease Control and Prevention (CDC) led to the conclusion that UFG ground beef was the source of the outbreak.  The California Department of Health Services, Colorado Department of Health, and CDC reported 14 illnesses associated with the outbreak: 6 in Arizona, 3 in California, 2 in Colorado, 1 in Idaho, 1 in Utah, and 1 in Wyoming.

Marler Clark filed suit against United Food Group (UFG) on June 14, 2007 on behalf of a four-year-old California child who became ill with E. coli O157:H7 and hemolytic uremic syndrome (HUS) after eating UFG ground beef. The firm represented several other families who were impacted by the UFG ground beef E. coli O157:H7 outbreak and recall, including three others who developed HUS.  In total, Marler Clark represented nine cases. To date, eight have been settled.

In 2007 Public health officials from several states collaborated to determine the source of the outbreak, and the Centers for Disease Control and Prevention (CDC) officially announced that a Salmonella serotype I 4,5,12:i:-* outbreak had been traced to the consumption of ConAgra pot pies on October 9th. At the time, ConAgra did not initiate a recall.

The CDC report summarized the results of the investigation, which determined that 401 cases of salmonellosis occurred in 41 states during 2007, with 32% of ill persons hospitalized. In October 2007 the illnesses were finally associated with consumption of Banquet® brand frozen, not-ready-to-eat pot pies. Further investigation determined that 77% of patients who ate these pies cooked them in microwave ovens and that consumer confusion regarding microwaving instructions might have resulted in a failure to cook the product properly.