Marler Blog - Providing commentary on food poisoning outbreaks & litigation

According to the Quad-City Times, the total of hepatitis A cases in the Quad-City region has grown by one, and the latest patient lives in Henry County. The Rock Island County Health Department has finished a series of free inoculation clinics to provide protection against the illness.

A total of 5,366 doses of either hepatitis A vaccine, or a product called immune globulin, were given out in public clinics run by Rock Island County. All of those receiving free inoculations had visited a McDonald's restaurant at 400 W. 1st St., in Milan during July 13-14.

Henry County reported an additional documented case of hepatitis A, raising that county's total to two. There are now at least 26 actual cases in the region, with 15 in Rock Island County, five in Mercer County, one each in Warren and Woodford counties, all in Illinois, as well as two cases in Scott County, Iowa. County officials have said the reported cases are part of the same outbreak and are connected to the Milan McDonald's.

The incubation period for Hepatitis A can be greater than one month, so the number of ill may well rise over the coming weeks.

A confidential settlement was reached this morning on behalf of twelve-year-old Rebecca Gosla, who was sickened in a 2007 E. coli O157:H7 outbreak linked to contaminated ground beef that were manufactured by United Foods. Rebecca’s illness stands apart from most E. coli O157:H7 infections, even for children who develop hemolytic uremic syndrome (HUS).  She was hospitalized for over a month, suffered weeks of dialysis, and her medical bills were nearly $200,000.

The severity and duration of her HUS-related complications, including the complete failure of kidney function as indicated by the lack of urine-production, makes Rebecca’s prognosis concerning. It is possible that her kidney-function will decline over time to a point that kidney transplantation or maintenance-dialysis will be necessary for her survival.

Rebecca’s Illness was a result of E. coli O157:H7-tainted hamburger that was part of a recall announced on June 3, 2007 by United Food Group, LLC (“United Foods”). 75,000 pounds of ground beef products was recalled after testing conducted by health departments in California and Colorado revealed contamination with E. coli O157:H7. The company reported that the ground beef had been produced on April 20, 2007 and shipped to retail distribution centers in Arizona, California, Colorado, Oregon, and Utah. Three days later, on June 6, 2007, United Foods expanded its recall to 370,000 pounds of ground beef. Investigation by the CDC and state health department had uncovered a link between United Foods’ ground beef and illnesses “in several states.” The expanded recall included products produced on April 13, in addition to April 20, 2007. Additional states were now also involved, including Idaho, Montana, Nevada, Washington, and Wyoming.

Three days later, on June 9, 2007, United Foods was again forced to expand its recall, this time dramatically enlarging its scope. More United foods fresh ground beef, not originally included in the recall, had tested positive for E. coli O157:H7 in Arizona. The strain of E. coli O157:H7 isolated was genetically indistinguishable from the strain that had led to the original recall. The newly recalled ground beef tested in the Arizona had been sold under a major grocery store label as opposed to a pre-packaged chub shipped from United Foods. At this time, United expanded its recall to include 5.7 million pounds of its ground beef. The recall now extended to both fresh and frozen ground beef. By this time, United Foods ground beef had been linked to fourteen culture-confirmed E. coli O157:H7 infections in the following states: Arizona (6); California, (3); Colorado (2); Idaho (1); Utah (1); and Wyoming (1).

It is time to prevent the next Rebecca.

Here is the bill that (I think) is to be voted on in about an hour:

Click above to download.

The Food Safety Bill is being debated on Capitol Hill as I write this post.  Hopefully the human cost of foodborne illness will weigh on our Representatives' minds as they vote.  The folks below have been involved.  They have visited Washington DC, met with members and have testified.

Lindsey Jennings (below, center) was a healthy 21-year-old starting medical school in the fall of 2008. After eating lettuce contaminated with E. coli O157:H7, she was hospitalized for 11 days. Her medical bills to date total $55,444.49.

In 2006, Ashley Armstrong (below), age 2, became infected with E. coli O157:H7 after eating Dole brand baby spinach. She was hospitalized for 43 days with hemolytic uremic syndrome (HUS). She suffered acute renal failure and pancreatitis and was on dialysis for nearly 4 months. She has a 95 to 100 percent chance of end stage renal disease, and is expected to require a kidney transplant within three to ten years. Ashley will require a combination of kidney dialysis and transplants throughout the rest of her life. Ashley’s medical bills during her acute illness exceeded $200,000, and the value of her projected future medical expenses and future economic losses total between $6 and $7.5 million.

Heather Whybrew (below, in cap and gown) is a 20-year-old college student pursuing a double major in biology and psychology. In 2008, she was hospitalized for 18 days after consuming romaine lettuce contaminated with E. coli O157:H7. Her medical bills to date are $113.959.04.

Mora Lou Marshall (below) was functionally independent before her Salmonella Tennessee illness, which she contracted as a result of eating Con Agra’s Peter Pan Peanut Butter. As a result of her illness, Mora was hospitalized for more than 30 days at Willis-Knighton Medical Center and Life-Care Hospital. Furthermore, to date, Mora has never able to return home to her family. Since her multiple hospitalizations and illness, Mora Lou Marshall has lived at the Garden Park Nursing Home in Shreveport, Louisiana. Her medical expenses currently total $352,960.

Clifford Tousignant (below, with granddaughter) was a highly decorated Korean War veteran. He received 3 purple hearts and faithfully served his country for over 22 years. Mr. Tousignant became sick with Salmonella Typhimurium in December of 2008, as a result of eating peanut butter products manufactured by King Nut and the Peanut Corporation of America. Mr. Tousignant was hospitalized because of his infection and illness for 6 days at St. Joseph’s Hospital in Brainerd, Minnesota. As a result of his illness, Mr. Tousignant died on January 12, 2009. His medical expenses totaled $42,853.

In 2002, in the middle of the recall of 21,000,000 pounds of E. coli O157:H7-tainted ConAgra beef that sickened 50 Americans and killed one grandmother, I wrote an Op-Ed saying that it was time to “put me out of business.” People generally hate trial lawyers like me, and I said that the best way to get rid of me would be to stop poisoning people with contaminated food. My entire practice would evaporate overnight, and I’m fine with that. In fact, it’s been my goal for 16 years.

Since that outbreak in 2002, millions more have been sickened and permanently disabled by food tainted with Salmonella, E. coli O157:H7, Listeria, Campylobacter, and other pathogens. Thousands have lost their lives. In that same time period Congress has had more than 20 hearings on food safety - many attended by my clients - but hasn’t enacted comprehensive legislation. Industry has done even less.

There is now a bill up for a vote on the House floor today, HR 2749, which would change that. The bill would greatly strengthen the FDA’s power to regulate 80% of food economy. It unanimously passed the House Energy and Commerce Committee in June. HR 2749 would give the FDA the power to order food recalls and set record-keeping standards for food facilities, as well as and mandate an increased frequency of inspections. What it certainly will do is reduce the enormous number of foodborne illness outbreaks, keep kids out of ICUs and off dialysis, and increase the overall safety of our food.

It is time to step up and pass the first meaningful food safety legislation in 50 years. It’s time for the left to stop making perfect the enemy of good. It’s time for the right to get out of the way of consumer protection in the name of industry protection. It’s time for all of us to acknowledge that ensuring safety in a sprawling, global food system is not free, or without pain. It is past time for every part of the food economy – regardless of size - to become part of the system, to share in the costs of the system, and to promote the safety of the system.

There is a great deal of resistance from smaller food producers, who feel that the bill will unfairly burden them. Here is my promise: if the effects of the bill turn out to be onerous for small food producers – those that sell food to neighbors or at farmer’s markets - I will personally take up the effort to amend the bill.

In the mean time, I urge everyone who cares about safe food to call his or her Congressperson and urge passage of HR 2749. It really is long past time to “put me out of business.”

The incubation period (time from exposure to onset of symptoms) is 15-50 days, with an average of 30 days. Thus far at least 25 people have contracted Hepatitis A and over 10,000 or more were exposed. 5,000 have received IG or Hepatitis A vaccines to hopefully prevent illness onset.  It appears the second Ill McDonald’s employee last worked on July 13 or 14. That means that the number of ill may well rise over the next month during the height of the incubation period.

The Rock Island County Health Department will conduct walk-in clinics at its office at 2112 25th Ave., Rock Island, from 8 a.m. to 4:30 p.m. Monday and Tuesday. These additional dates are being made available for those who went to the Milan, Ill., McDonald's on July 13 or 14. If they went there previous to these dates, receiving either of these shots may be beyond the time period to provide protection from potential exposure.

A second dose of hepatitis A vaccine, administered six months after the first one, will provide additional effectiveness against the disease. Second doses will be available at the health department, but they will not be free as the first-dose clinics have been. The cost of the second dose will be $45 for adults and $15-$25 for pediatric patients, depending upon income guidelines.

Once again contaminated food products are shipped to US grocery stores and consumers become ill.  The US pubic continues to be the "canary in the coal mine."  As FSIS reports:

As a result of an ongoing investigation into an outbreak of Salmonella Typhimurium DT104 associated with ground beef products, the Colorado Department of Public Health and Environment (CDPHE) notified FSIS of the problem. Epidemiological investigations and a case control study conducted by CDPHE and the Centers for Disease Control and Prevention (CDC) determined that there is an association between the fresh ground beef products and 14 illnesses reported in Colorado.

Recall Release CLASS I RECALL
FSIS-RC-039-2009 HEALTH RISK: HIGH

King Soopers, Inc., a Denver, Colo., establishment, is recalling approximately 466,236 pounds of ground beef products that may be linked to an outbreak of salmonellosis, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today. The products subject to recall include:

* 1-pound chubs of (93/7) ground beef. Each package bears the identifying case code "69558."
* 1 - 1.25-lb. tray packs of (96/4) ground beef. Each package bears the identifying case code "67164."
* 1 - 1.25-lb. tray packs of (96/4) ground beef. Each package bears the identifying case code "67664."
* 1 - 1.25-lb. tray packs of (93/7) ground beef. Each package bears the identifying case code "67663."
* 1 - 1.25-lb. tray packs of (93/7) ground beef. Each package bears the identifying case code "67163."
* 2.5 - 3-lb. tray packs of (93/7) ground beef. Each package bears the identifying case code "67654."
* 6-pack trays of (93/7) ground beef patties. Each package bears the identifying case code "67106."
* 4-pack trays of (93/7) ground beef patties. Each package bears the identifying case code "67115."

The ground beef chub products bear a use-by/sell-by date between "05/31/09" and "06/21/09;" the tray packs of ground beef bear a use-by/sell-by date between "06.02.09" and "06.23.09;" and the ground beef patty products bear a use-by/sell-by date between "06.01.09" and "06.22.09."

The ground beef products were produced on various dates ranging from May 23, 2009 through June 13, 2009 and bear the establishment number "EST. 6250" within the USDA Mark of Inspection, which is printed on the front of the packages. The ground beef products were distributed to retail establishments in Colo., Kan., Mo., Neb., N.M., Utah and Wyom.

From a Company Press Release:

FOR IMMEDIATE RELEASE
July 21, 2009

Tanimura & Antle, Inc. of Salinas, Calif. is voluntarily recalling one lot of romaine lettuce because it has the potential to be contaminated with Salmonella. No illnesses have been reported to date, and the company is working with FDA to inform consumers of this recall.

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis. The recall comes after a random test conducted by the Wisconsin Department of Agriculture tested positive.

Within hours of being notified yesterday, Tanimura & Antle, Inc. traced back the entire lot of romaine and advised all customers who received the recalled product of the test result. Tanimura & Antle, Inc. has instructed these customers to destroy the product. Although the recalled product is past its shelf life, the company is issuing this voluntary recall out of an abundance of caution to ensure that any product purchased by consumers will also be destroyed. Consumers who have purchased the recalled romaine as described above should not consume it, and should destroy the product.

The cartons of bulk or wrapped romaine being recalled are marked with the lot code 531380 and were harvested June 25 - July 2. This recall includes only this single lot of romaine; no other products are involved.

The recalled romaine was sold to retail, wholesale and food service outlets in Canada, Puerto Rico and the following 29 states: Alabama, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Texas, Massachusetts, Louisiana, Pennsylvania, Tennessee, North Carolina, Michigan, Missouri, Nebraska, New Hampshire, New Mexico, Nevada, Ohio, Oregon, Utah, Virginia, Wisconsin, Wyoming.

My daughter is 17 and took a partime job busing tables as a local restaurant.  Can you imagine being a parent and urging your kid to get a Summer job at McDonald's?  Here is an email I received tonight:

My son Dillon is 16 and had to be hospitalized because he caught Hepatitis A after he took back an application for a job and ate at McDonald's in Illinois.  He was admitted on a Thursday and hasn't eaten since Sunday while running a fever.  He became very jaundice and wasn't released from the hospital till Sunday evening. Thank you for your time.

Goodness!

Case No. 09 L 0089 – Judge Vandewiele

Thousands of people are lining up in southern Illinois to receive Immunoglobulin (IG or Immune Globulin or Gamma Globulin) shots. IG is pooled/plasma-containing antibodies against a number of diseases like measles, rubella, varicella, and Hepatitis A. For protection against Hepatitis A after exposure, it must be given within two weeks of exposure and should be given concurrently with Hepatitis A to develop active immunity. A second dose of Hepatitis A is required six months later.

Side effects after receiving IG may include: muscle stiffness, redness, warmth, pain and tenderness at injection site. Fever, chills, headache, weakness and nausea may occur. If these symptoms continue beyond 48 hours or become bothersome, contact your physician. If skin rash, swelling of hands/feet or face, or trouble breathing develop, contact your doctor immediately. IG may interfere with the immune response to live vaccines, so discuss this with your physician before taking it. If you take IG, you will not be able to donate blood for several months.

In the last several years, the need to get IG shots because of infected restaurant employees or food has happened at a far too frequent rate. Here are some examples of cases we have been involved in where we filed Class Actions on behalf of those that were required to get IG shots:

Carl’s Jr. Hepatitis A Outbreak – Washington – 1,300 IG shots given

Chi-Chi’s Hepatitis A Outbreak – Pennsylvania – 9,000 IG shots given (we also represented the state of Pennsylvania in securing reimbursement for the cost of giving free shots)

D’Angelo’s Deli Hepatitis A Outbreak – Massachusetts – 1,600 IG shots given

Friendly’s Hepatitis A Exposure – Massachusetts – 3,800 IG shots given

Houlihan’s Hepatitis A Exposure – Illinois – 3,000 IG shots given

Quizno’s Hepatitis A Exposure – Massachusetts – 850 IG shots given

Sweet Superior Fruit LTD. Co. of McAllen, Texas, is recalling 104 crates of fresh cilantro (coriander) because the product has the potential to be contaminated with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonellaoften experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

The recalled fresh cilantro (coriander) was sold July 13-16, 2009 in 15 pound, black plastic crates to individuals and companies through cash sales at Sweet Superior Fruit LTD. Co., 2501 W. Military Hwy., Suite #A-5 and A-6, McAllen, Texas. The product may have been further sold through direct retail sales in McAllen, Texas and surrounding areas or used as an ingredient to manufacture additional products.

No illnesses have been reported to date in connection with this problem.

The potential for contamination was revealed through testing by the U.S. Food and Drug Administration which found the presence of Salmonella in the product.

Individuals and companies who purchased fresh cilantro (coriander) from Sweet Superior Fruit LTD. Co., July 13-16, 2009, should immediately discontinue use of the product. Companies should make efforts to recall the product from customers and consumers who may have purchased the product and ask them to return or throw it away.

Consumers who have purchased fresh cilantro (coriander) in McAllen, Texas and surrounding areas since July 13, 2009 should determine from the store they purchased the product whether or not the fresh cilantro (coriander) they purchased is involved in this recall.

Media reports, press releases and comments from the Rock Island County Health Department, Illinois Department of Health and the McDonald’s in Milan at 400 W. 1st St. on U.S. 67 franchise owner are a bit light, but we know that at least 19 patrons of the restaurant are ill with Hepatitis A - 11 have been hospitalized.

First reports of illnesses were on July 15, 2009 - although oddly, Illinois Department of Health published a press release on the 13th urging families in the State to vaccinate against Hepatitis A. There are rumors that there are at least 2 ill employees.

The restaurant is on U.S. 67, near Highway. 280, and near the Quad-City Airport. You must wonder how many customers may have been exposed to Hepatitis A and where they are now.

From our site www.about-hepatitis.com:

Hepatitis A is a communicable (or contagious) disease that spreads from person to person. It is transmitted by the “fecal – oral route,” generally from person-to-person, or via contaminated food or water.

Food contaminated with the virus is a common vehicle transmitting hepatitis A. The food preparer or cook is the individual most often contaminating the food. He or she is generally not ill: the peak time of infectivity (i.e., when the most virus is present in the stool of an infectious individual) is during the 2 weeks before illness begins.

Symptoms typically begin about 28 days after contracting the hepatitis A virus, but can begin as early as 15 days or as late as 50 days after exposure (Koff, 1998), and include muscle aches, headache, anorexia (loss of appetite), abdominal discomfort, fever, and malaise. After a few days of the aforementioned symptoms, jaundice (also termed “icterus”) sets in.

Hepatitis A is TOTALLY PREVENTABLE. Although outbreaks continue to occur in the United States, outbreaks NEED NOT OCCUR if responsible preventive measures are taken. Responsible restaurant managers will exclude ill food-handlers from work, with pay. Food-handlers must also be taught to always wash their hands with soap and water after using the bathroom, changing a diaper, and certainly before preparing food.

After a known exposure to the hepatitis A virus, administration of a shot of Immune Globulin (IG) should be considered. IG is 80%-90% effective in preventing hepatitis A infection if it is administered within 2 weeks of the exposure.

It appears that the Rock Island Health Department is going to begin IG shots for the public on Monday – seems a bit odd it would not start sooner? Did they have adequate supplies of the IG shots?

Some other questions that need to be answered:

1. When was the first reported case of Hepatitis A linked to this McDonalds reported to the Rock Island Health Department?
2. When did McDonalds have notice if an employee was in fact ill?
3. What are McDonalds hand-washing and glove policies and were they being used?
4. Assuming that the illness originated with an ill employee, how many customers were served during the period of time the employee worked – and where are the customers now?
5. Did the ill employees and customers become so at the same time? If so, this may well point to a food product as the source.

More questions than answers at this point.

As of Thursday afternoon, there are 19 confirmed Hepatitis A cases. 13 are in Rock Island County, and six more are being reported in Henry, Mercer, Warren and Woodford Counties.

John David at WQAD has reported: that “Lunch customers coming to the Milan McDonalds on Thursday found the doors locked. Drive-up customers were being turned away. According to investigators, an outbreak of Hepatitis-A may be linked to employees or someone who ate there.”

I guess lightening does strike at least twice. In March of 1998, the Skagit County Health Department (SCHD ) in Washington State received a number of reports that residents had been diagnosed with hepatitis A and began an investigation into what appeared to be a hepatitis A outbreak. During its investigation into the outbreak’s source, SCHD determined that the outbreak had occurred among patrons of the McDonald’s restaurant located on Riverside Drive in Mt. Vernon, Washington, who had eaten at the restaurant in mid-February, 1998. Through its investigation, SCHD learned that an assistant manager at the McDonald’s had worked while infected with hepatitis A and had contaminated food.

Hepatitis A is one of five human hepatitis viruses (hepatitis A, B, C, D, and E) that primarily infect the liver and cause illness. An estimated 80,000 cases occur each year in the U.S., although much higher estimates have been proposed based on mathematical modeling of the past incidence of infection. Each year, an estimated 100 persons die as a result of acute liver failure in the U.S. due to hepatitis A, but the rate of infection has dramatically decreased since the hepatitis A vaccine was licensed and became available in the U.S. in 1995.

Hepatitis A is a communicable (or contagious) disease that spreads from person-to-person. It is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. Food contaminated with the virus is the most common vehicle transmitting hepatitis A. The food preparer or cook is the individual most often contaminating the food, although he or she is generally not ill at the time of food preparation. The peak time of infectivity, when the most viruses are present in the stool of an infectious individual, is during the two weeks before illness begins. Although only a small percentage of hepatitis A infections are associated with foodborne transmission, foodborne outbreaks have been increasingly implicated as a significant source of hepatitis A infection.

In the last ten years we have been involved in a dozen Hepatitis A cases around the country. Most, if not all could have been prevented if restaurant or field workers had received a Hepatitis A shot BEFORE serving the customer.

Carl’s Jr. Hepatitis A Outbreak - Washington
Chi-Chi’s Hepatitis A Outbreak - Pennsylvania
Chipotle Grill Hepatitis A - San Diego, California
D’Angelo’s Deli Hepatitis A Outbreak - Massachusetts
Friendly’s Hepatitis A Exposure - Massachusetts
Houlihan’s Hepatitis A Exposure - Illinois
Maple Lawn Dairy Hepatitis A Outbreak - New York
McDonald’s Hepatitis A Outbreak - Washington
Quizno’s Hepatitis A Exposure - Massachusetts
Soleil Produce Hepatitis A Outbreak - California
Subway Hepatitis A Outbreak - Washington
Taco Bell Hepatitis A Outbreak - Florida

Hepatitis A can be severe.  In one case, in late October 2003, Beaver County ER doctors reported an alarming number of Hepatitis A cases. Investigators from the Pennsylvania Department of Health initiated an investigation immediately and discovered that many, if not all, cases had eaten at Chi Chi’s restaurant in Monaca, Pennsylvania’s Beaver Valley Mall. Along with the health department, the federal Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) conducted further studies of the outbreak. Preliminary analysis of a case-control study suggested that green onions were the probable source of the outbreak. The onions had been shipped to the restaurant in boxes and were stored and refrigerated in buckets of ice. They were eventually chopped up and served in various dishes at the restaurant, often uncooked, as in the preparation of mild salsa. “Preliminary trace-back information indicated that the green onions supplied to Chi Chi’s had been grown in Mexico.” Ultimately, over 650 people were sickened in the outbreak. The victims included at least thirteen Chi Chi’s employees and numerous residents of six other states. Four people died from their injuries, and more than 9,000 people obtained immune globulin shots as protection against the virus. This is the story of one of those cases.

Nearly two weeks ago, the CDC and FSIS reported that 23 persons infected with a strain of E. coli O157:H7 with a particular "DNA fingerprint" have been reported from 9 states. Of these, 17 have been confirmed by an advanced DNA test as having the outbreak strain; confirmatory tests are pending on others. The number of ill persons identified in each state is as follows: California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6).

In light of the illnesses, FSIS issued a notice about a recall of 41,280 pounds of beef products from JBS Swift Beef Company that may be contaminated with E. coli O157:H7. On June 28, the recall was expanded to include 380,000 pounds of assorted pieces of beef (beef primal products) from the same company.

Samples from unopened packages of ground beef recovered from a patient's home were tested by the Michigan Public Health Laboratory yielded an E. coli O157:H7 isolate that matched the "DNA fingerprint" of the outbreak strain.

It appears, however, that the outbreak may well be larger – more ill people - perhaps an expanded recall? 

We have been retained by several families in this outbreak and have already filed suit on behalf of a New Mexico boy who suffered HUS.  Yesterday we were contacted by a Washington State family whose child suffered severe HUS (weeks hospitalized on dialysis) that may well be linked to this outbreak after the purchased JBS Swift meat at [an unnamed store]. What we know thus far is:

[The] PulseNet database team has checked the profile against our database and it does seem to be indistinguishable from EXHX01.0074/EXHA26.0569 which is the pattern combination associated with 0906WIEXH-1 and the JBS Swift Company recall. Since this pattern combination is common, all isolates with this pattern combination are subtyped by MLVA and only isolates indistinguishable by both PFGE and MLVA are considered as possibly being outbreak related.

More to come today I imagine.

I am honored to be a speaker again this year and to lend my support to what is truly becoming one of the world best food safety conferences.  From the Conference Website:

When it comes to protecting food, good governance is good for business. For anyone committed to enhancing food safety, the 3rd annual China International Food Safety & Quality Conference + Expo allows you to stay on top of the latest trends and developments.  Whether you are interested in learning about novel intervention, prevention or detection strategies, efficient risk management, science based solutions, innovative food safety management, emerging microbial hazards, harmonization of standards, or capacity building, you'll find these topics and more on CIFSQ's 2009 educational program.

Speakers include leading world food safety authorities and specialists who will share their knowledge and insights with you on a broad range of contemporary issues. An accompanying exhibition offers a comprehensive selection of cutting-edge technologies, services and products to solve your most challenging food safety problems.

Come join Asia's largest meeting of industry professionals and regulatory officials responsible for food safety and quality assurance, inspection, testing, auditing, science, research, law, microbiology and the entire food production chain. In 2008, CIFSQ attracted over 750 delegates from 17 countries and territories.

See you in Beijing.

I had a long talk with Carolyn Lochhead, San Francisco Chronicle Washington Bureau Reporter about her article, “Crops, ponds destroyed in quest for food safety” that appeared this morning. It is a good opening discussion of the balance that we somehow have to forge between food safety, consumer convenience, industrialized agriculture and the environment.  The discussion reminds me a bit of a post I did nearly four years ago - "Bagged "Pre-Washed" Lettuce: Is Convenience Worth the Risk?"  Much to discuss. Here is part of the article:

Seattle trial lawyer Bill Marler, who represented many of the plaintiffs in the 2006 E. coli outbreak in spinach, said, "If we want to have bagged spinach and lettuce available 24/7, 12 months of the year, it comes with costs."

Still, he said, the industry rules won't stop lawsuits or eliminate the risk of processed greens cut in fields, mingled in large baths, put in bags that must be chilled from packing plant to kitchen, and shipped thousands of miles away.

"In 16 years of handling nearly every major food-borne illness outbreak in America, I can tell you I've never had a case where it's been linked to a farmers' market," Marler said.

"Could it happen? Absolutely. But the big problem has been the mass-produced product. What you're seeing is this rub between trying to make it as clean as possible so they don't poison anybody, but still not wanting to come to the reality that it may be the industrialized process that's making it all so risky."

Ms. Lochhead added in a few of the major outbreaks (all of which I am squarely in the middle of). I added in one she missed, corrected a date and added a bit – all in bold.

June 2009: E. coli O157:H7 linked to JBS Swift meat sickening 23 in nine state, two with acute kidney failure. FISS instituted a recall of 420,000 pounds of meat.

June 2009: E. coli O157:H7 found in Nestle Toll House refrigerated cookie dough manufactured in Danville, Va., resulted in the recall of 3.6 million packages. Seventy-two people in 30 states (now seventy-four in 32 states) were sickened. No traces found on equipment or workers; investigators are looking at flour and other ingredients.

February 2009: Salmonella found in peanut butter from a Peanut Corp. of America plant in Georgia. Nine people died, and an estimated 22,500 were sickened. Criminal negligence was alleged after the product tested positive and was shipped.

June 2008: Salmonella Saint Paul traced to Serrano peppers grown in Mexico. More than 1,000 people were sickened in 41 states, with 203 reported hospitalizations and at least one death. Tomatoes were suspected, devastating growers.

April 2007: E. coli O157:H7 found in beef, sickening 14 people. United Food Group recalled 5.7 million pounds of meat (at least four suffered acute kidney failure).

December 2006: E. coli O157:H7 traced to Taco Bell restaurants in New Jersey and Long Island, N.Y. Green onions suspected, then lettuce. Thirty-nine people were sickened, some with acute kidney failure.

September 2006: E. coli O157:H7 found in Dole bagged spinach processed at Earthbound Farms in San Juan Bautista (San Benito County). The outbreak killed four people (actually five), sent 103 to hospitals, and devastated the spinach industry (devastated over 30 families with hemolytic uremic syndrome).

John Munsell, known to the readers of Mother Jones as – “Meatpacking Maverick - Montana meatpacker John Munsell's against-the-odds struggle for improved food safety” - by Michael Scherer, and to the readers of Marler Blog, one of its most consistent commentators.  John is an unlikely American Hero.

I met John - well talked to him in the early spring of 2002. I had been blitzing the USDA and FSIS with Freedom of Information Act requests (FOIA’s) about all of their E. coli O157:H7 recalls in 2001 into 2002. Because that information was not readily available to the pubic (and many health departments) I posted it on www.fsis-pfge.org - and still do. In my sweep of all recalls I received the information about a very small recall (270 pounds), with no reported illnesses, from Munsell’s and his father’s Montana Quality Foods of Miles City Montana. I paid it no mind until John’s call.

I now remember the call like it was yesterday. I was sitting in my corner office high above the Seattle skyline. John’s call came in and the first thing he asked was “did my product hurt anyone?” A bit taken aback - because an owner of a business was calling me directly (I usually hear from some lawyer) – I answered, “No, I am not aware of any reported illnesses.”

John then told me his story – much better told by Mr. Scherer below. But, the thing I recall the most is when he said, “Mr. Marler, the E. coli contaminated meat came from ConAgra’s Greely plant. It was contaminated before it came to us.” He then said, “USDA is after me when they should be paying attention to ConAgra before something happens.” He offered to send me documents proving that the contaminated meat was really ConAgra’s. I said sure.

A few days later I got a pile of documents as John promissed. I set them on a table in my office. John called a few times more that spring, but I ignored him – and his documents.

Months later, I was driving back from a family vacation on July 5, with my seven-year-old asleep in the car when my cell phone rang. It was counsel for ConAgra. You see (although I did not know it then) on June 30, 2002, the USDA Food Safety and Inspection Service (FSIS) announced the recall of 354,200 pounds of ground beef manufactured at the ConAgra Beef Company plant in Greeley, Colorado. He asked if ConAgra could retain my firm to represent them in a “bit of an E. coli problem.” I said, “Thanks for the offer, but let me check to see if we are already representing victims.”

Both a bit stunned by the call from ConAgra and missing the recall, I called the office and found that we had already been called by a family whose young daughter was still hospitalized struggling against E. coli O157:H7 induced Hemolytic Uremic Syndrome.  I declined ConAgra's offer.

I then remembered John Munsell’s call and the documents still sitting in my office that I, like the USDA and FSIS, had ignored.

By July 12, the Colorado Department of Public Health and Environment (CDPHE) disclosed that 17 Colorado residents had been infected with E. coli O157:H7. Several other cases were subsequently reported in neighboring states. Three days later, on July 15, the Centers for Disease Control and Prevention (CDC) announced that the strain of E. coli O157:H7 that had infected the 17 sickened individuals was genetically indistinguishable from the strain isolated from the recalled ConAgra beef. On July 19, 2002, FSIS expanded the ConAgra ground beef recall to 18.6 million pounds of ground beef. In the weeks that followed the nationwide recall, more than 45 people in 23 states reported illnesses linked to the contaminated ground beef.

Reports indicated that ConAgra received 31 violations in the 13 months before its June and July 2002 ground beef recalls, and a September 13, 2002 letter issued by the following congressional members: Representatives Mary Kaptur, Rosa DeLauro, Henry Waxman and Senator Richard Durbin demanded to know why the USDA and ConAgra had failed to alert the public to possible contamination until more than two months after they knew there was contamination at the plant. Moreover, they intimated that ConAgra hindered the USDA investigation by refusing to turn over information about its Greeley slaughterhouses. On November 15, 2002, the USDA shut down the ConAgra plant in Greeley (known as Swift and Co.), due to repeated failures to prevent fecal contamination of carcasses. The plant has since reopened.

I eventually represented most of the victims of the E. coli outbreak, which led to at least 46 illnesses and one death. Among the victims were an Ohio childcare worker, a Colorado security officer who was battling forest fires, and young children in Colorado, Nebraska, and South Dakota. Several of them were hospitalized with hemolytic uremic syndrome, a frightening complication of E. coli O157:H7 infection that can lead to kidney failure and neurological impairment.

John, I am sorry that I did not pay attention to you when you called and do something to avoid the outbreak. I think about this everyday.

Months into the outbreak I met with John, his dad and John's wife.  I flew into Rapid City, South Dakota and drove through Sturgis, Spearfish on to Miles City, Montana.  His dad made me pancakes along with what was left of his crew.  John cooked a great steak that night.  He said the prayer over dinner.

For lawyer readers, see the Trial and Appeals Court Decisions.

Read the full Mother Jones Article Below:

After inspecting the Danville Plant on 06/18/2009(Thu), 06/19/2009(Fri), 06/22/2009(Mon), 06/23/2009(Tue), 06/24/2009(Wed), 06/25/2009(Thu), 06/26/2009(Fri), 07/07/2009(Tue), 07/08/2009(Wed), and 07/09/2009(Thu), the FDA posts a 1, yes, 1 page "483" online last night, or early this morning - yes, even I sleep sometimes.  Here are the 2, yes, 2 Observations.  Looks like I am heading to Danville soon.

OBSERVATION 1

The workmanship of equipment does not allow proper cleaning.  Specifically, inside the "Toll House" brand cookie dough preparation room, dry ingredients are placed inside hoppers. The dry ingredients are gravity fed to blending mixers through gate valves that are installed on the hoppers. As a result of this investigation, the firm disassembled all gate valves from all hoppers on production lines 8, 10, 11, and 12. The gate valves appear to have food contact surfaces that are not easily cleanable as evidenced by rough, pitted and discolored cast metal alloy.

OBSERVATION 2

Lack of appropriate design to enable manufacturing systems to be maintained in an appropriate sanitary condition. Specifically, as "Toll House" brand cookie dough was mixed on 6-18-09, ice build-up surrounded pipes that transport a processing aid to mixers on production lines 8, 10, 11, and 12. On line 8, condensate from the ice dripped onto a metal rake that personnel then used to scrape cookie dough from the mixer into a dough trough for transport to the filling line.

Click on image to download:

I know, I know, a trial lawyer who reads the Wall Street Journal? Yes, a bit counter-intuitive, but you have to love Bill Tomson’s article today – “U.S. Beef Safety Plan Languishes Amid New Illnesses,” and getting some juicy quotes by an “R” I admire, Richard “Dick” Raymond. Now retired, but until last October, USDA Undersecretary of FSIS - SEND DICK RAYMOND BACK TO WASHINGTON - You know, the one Obama and Vilsack cannot seem to fill despite my resume sitting on their desks! Here is the poop, errr, E. coli:

A June beef recall by JBS Swift & Co. for deadly E.coli contamination could have been prevented if a plan devised during the Bush administration to build new barriers between the bacteria and the public had been enacted.

The proposed safety measures would have had U.S. Department of Agriculture inspectors testing more beef, a move the meat industry argued was unnecessary. Inspectors now routinely test ground beef for the E. coli bacteria and any meat that is designated to be turned into ground beef -- usually the part of the carcass called "trim," but nothing else.

That's a mistake and people continue to get sick because of it, former USDA Food Safety Under Secretary Richard Raymond told Dow Jones Newswires in an interview. "We first tested ground beef and now we're testing trim. We need to start testing whole cuts."

More than a year ago, USDA officials began warning that primal cuts -- the large chunks of beef from which whole cuts that produce steaks and roasts come -- can be dangerous sources of E. coli contamination. Although steaks are considered safe even if the bacteria is present, portions of the primals they come from are often used to also make ground beef, which has been sickening consumers.

Steaks and the whole cuts they come from aren't considered dangerous to human health, or "adulterated," even if E. coli bacteria is present because, unlike ground beef, steaks don't provide bacteria access into the meat below the surface.

But those whole cuts and other primal beef often get turned into ground beef even though that wasn't the intended purpose of the meat, especially in summer months when grilling weather drives up consumer demand for hamburger meat.

The USDA has been considering for more than a year a policy change that would allow whole beef cuts to be considered "adulterated" -- and thus subject to recall -- even if they aren't "intended for use in ground beef," according to Daniel Engeljohn, a deputy assistant administrator for USDA's Food Safety and Inspection Service, or FSIS.

The policy change is still under consideration, he said.

Also still under consideration is a method devised last year by the USDA for slaughterhouses to detect unacceptable levels of E. coli in the primals they are producing.

In an August 2008 draft "guidance guideline" for slaughterhouses, FSIS suggested that when four out of 91 trim tests show a positive result for E. coli in beef trim -- the material primarily used to make ground beef -- that should be considered a "high-event day." If that happens, Engeljohn said, all of the beef -- not just the trim -- could be dangerous.

However, the decision on whether to treat primals as a potential source of E. coli poisoning and whether to allow them into commerce is still up to the producers, Engeljohn said, and that won't change unless policy is changed.

"That issue didn't get changed in the prior administration, and so now it comes to this new administration," Engeljohn said.

American Meat Institute Foundation President Jim Hodges said there was no need to divert primals away from the raw market, just because E. coli was found in the carcass trim.

Primals are much more valuable to the producer when they can be sold and turned into raw beef cuts like the steaks sold by retailers. The alternative is to sell the beef to processors that produce only pre-cooked meat products.

Administering antimicrobial treatments to those primals at the slaughterhouse is sufficient to kill the bacteria before they are sold for further processing, he said.

In events leading up to the JBS Swift & Co. June 24 recall, the company's Greeley, Colo., plant detected E. coli in carcass trim, Chandler Keys, the company's vice president of government affairs & industry relations told Dow Jones Newswires. Back in April, the trim was diverted for the production of cooked product, as the cooking process kills the bacteria, but the steak- and roast-producing primals were not. They were supposed to have been treated to kill the bacteria, but for reasons that remain unclear, that didn't happen. Several weeks later, the recall was initiated.

Primals, or parts of them, were recalled in late June by JBS Swift & Co. after at least 18 illnesses were connected to the beef. The company recalled 41,280 pounds of beef, all of which was "intact cuts of beef" that are "typically used for steaks and roasts rather than ground beef."

Even though primals aren't considered a health threat, or adulterated, even in the event of E. coli contamination, JBS Swift & Co. voluntarily recalled the meat because people were getting sick.

Another separate but related safety gap is a lack of government testing for E. coli in "bench trim," which is the leftover material once steaks and roasts and other cuts are produced from beef primals. That bench trim is often turned into ground beef, but it isn't the original trim from the slaughterhouse that FSIS and company inspectors focus on for E. coli detection.

Representatives of the U.S. meat packing industry like the AMI have fought the USDA's FSIS "tooth and nail" since officials there began talking about allowing whole beef cuts to be considered adulterated with E. coli and government testing for bench trim, according to Tony Corbo, the senior lobbyist for the nonprofit consumer organization Food & Water Watch.

The JBS Swift & Co. recall, Corbo said, is an example of why the industry is wrong.

I spent the morning on the phone with two young fathers whose children are both victims of Hemolytic Uremic Syndrome caused by E. coli O157:H7 that has been linked by the CDC to Nestle Toll House Cookie Dough.  One child, an 8-year-old from Michigan has been hospitalized for nearly a week and has received at least one blood transfusion.  The other child is a 4-year-old from South Carolina.  She was recently released from an Atlanta Rehab center after three and a half weeks.  This is on top of nearly two months in the hospital, weeks on dialysis and suffering from a stroke.

I also followed up with a Nevada woman, who too has been linked to the outbreak, and who is still hospitalized after over two months in the hospital.  She has suffered the removal of a portion of her large intestine and was on dialysis until the last few days.  A week ago she was just learning how to walk again.  E. coli O157:H7 is a very, very nasty bug.  

The new CDC numbers also came out today:

* 74 cases from 32 states - all match by PFGE testing

* Onset ranges from March 16 to June 11

* 72% female, age range 2-65 years (median age 15)

* 34 Hospitalizations

* 10 with Hemolytic Uremic Syndrome (HUS)

Mr. E. coli (aka Brian Hartman) once again scoops all in the ongoing Cookie Dough caper. Here is part of his story:

Federal investigators have linked at least three different kinds of E. coli to Nestle’s cookie dough but remain stumped about how the bacteria got into the product, ABC News has learned.

The U.S. Food and Drug Administration has completed DNA testing of E. coli recently found in an unopened package of cookie dough at Nestle’s plant in Danville, Va.

Those tests, according to sources familiar with the investigation and confirmed by the FDA, determined the genetic fingerprint of the E. coli found at the plant is different than E. coli that has been linked to a 30-state outbreak that has sickened at least six dozen people.

Sources also say an altogether different strain of E. coli was found in dough recovered from the home of a victim, meaning at least three different types of E. coli have been found in cookie dough made by Nestle.

It is my understanding that E. coli O157:H7 found in the stools of the 72 people in 30 states share the same PFGE pattern (outbreak strain) and that 51 of those have been linked by advanced testing methods (MLVA). Interestingly, but not surprisingly (1), a separate E. coli O157:H7 PFGE pattern was found in a retained sample of Nestle Cookie Dough for in the Danville Plant.

In addition, one of our client’s (a Minnesota Family) leftover Cookie Dough tested positive for a separate Shiga-toxin E. coli – E. coli O124. However, both sick children tested positive for the outbreak strain.

(1)  Proctor ME, Kurzynski T, Koschmann C, et. al. Four strains of Escherichia coli O157:H7 isolated from patients during an outbreak of disease associated with ground beef: importance of evaluating multiple colonies from an outbreak-associated product.  J Clin Microbiol. 2002 Apr;40(4):1530-3.

OK, so the CDC likely would not even recognize that they know me or that what I do is useful, but I must say, this post (unauthorized here) on the CDC Blog is perhaps the best explanation of why we need a CDC and Epidemiologists.  Plus the author is kinda hot - for a Doctor.  Here is her post:

Contaminated raw cookie dough wasn’t on anyone’s mind as my public health colleagues and I were searching for the cause of a multistate outbreak of E. coli infections.

I’m one of the Epidemic Intelligence Service officers in CDC’s Enteric Diseases Epidemiology Branch, which monitors and investigates foodborne diseases together with CDC’s Enteric Disease Laboratory Branch and state health departments. On any given day we are working on several clusters and outbreaks of illness.

In mid-May, CDC’s PulseNet Team alerted us about a cluster of E. coli O157 infections. We began working with state and local health departments to investigate these infections. We originally suspected ground beef, which is one of the “usual suspects” for E. coli O157, along with leafy greens and sprouts. As the labs in states and at CDC found more and more people infected with the same strain, the demographics shifted; patients were generally young and female, which isn’t what is normally seen with ground beef-associated outbreaks.

We got copies of the interviews on standard questionnaires that state investigators did with ill people and looked through them for other suspicious food sources, but nothing was conclusive. None of the food items implicated in past E. coli O157 outbreaks appeared to be associated with this one. Therefore, we decided to conduct what we call “open-ended hypothesis-generating interviews,” in which we call the people affected and just talk about everything that they had eaten and done the week before they became ill, looking for things in common among them. Standard questionnaires are useful, but they are only asking for answers to a series of questions. Sometimes something with a broader scope, like this sort of wide-ranging interview, is needed to find things that are unusual and might not be asked on our questionnaires.

Washington State was kind enough to let CDC do the interviews on their five patients. Mark Sotir and I reached the mother of the first patient on a Saturday. She mentioned that her child had eaten raw prepackaged cookie dough during the days before he got sick. On Sunday, I reached a second patient, and she told me she had eaten at an ice cream shop and had ice cream with cookie dough and brownie mix-ins.

Nestle toll house package.

Cookie dough? When cases three, four, and five all confirmed that they ate raw cookie dough, it appeared we had a surprising new possible culprit in our outbreak. (It wasn’t until later that we learned that the second patient also had eaten raw cookie dough at home.)

During an outbreak investigation, we hold a series of multistate conference calls in which CDC and affected states share what we’re finding. Representatives from many of the affected states were on our June 16, 2009 conference call, and I mentioned my cookie dough hypothesis. On the face of it, cookie dough was the most unlikely culprit, but epidemiologists in several other states said, “Oh, yes, I had a case mention that, too”. It became a “Eureka” moment for the group.

At the end of the call we agreed that cookie dough, strawberries, fruit roll-ups, apples, and ground beef were all possible causes. Time to go back to the cases and ask more questions!

A lot of our work is like that. Our branch chief, Patricia Griffin, sometimes says there is a certain “head banging quality” to what we do. It can take many, many interviews and requires a wide-ranging curiosity to consider all the possibilities.

There are no short cuts. We talk to the patients, we look at the combined information, and we generate hypotheses about the cause. Then we can refine our questions and go back to the patients again to see which hypothesis holds true.

I was watching again this morning the Vice President and Secretaries Vilsack and Sebelius talking about the Food Safety Working Group as I was responding to emails from people concerned about yet another recall of a staple food product. This time the Plainview Milk Products Cooperative Salmonella Recall.

According to the FDA, Plain is voluntarily recalling instant nonfat dried milk, whey protein, fruit stabilizers, and gums (thickening agents) that it has manufactured over the past two years, because they might be contaminated with Salmonella. Plainview has stopped production of these products and has notified its customers of the recall.  During an investigation of the Plainview facility, FDA found that some of the equipment was contaminated with Salmonella. At this time, the Centers for Disease Control and Prevention has not linked any human illnesses to potentially contaminated products from the Plainview facility. But how do they know that? Given that FDA, USDA and/or CDC presumably has the Salmonella positive milk product test result? Has a Genetic Fingerprint (PFGE) been done? Has it been compared to ill people in the United States? Have those ill people been linked to the consumption of Plainview Milk Products?

So, how does PFGE work? When a sample is taken from either a piece of meat or poultry that is contaminated with a dangerous form of bacteria, such as Salmonella, it can be cultured to obtain and identify the bacterial isolate. If a person consumes some of the contaminated product, and becomes infected as a result, a stool sample can then be cultured to obtain and identify the bacterial isolate. These bacterial isolates are then broken down into their various component parts creating a DNA "fingerprint".

The process of obtaining the DNA fingerprint is called Pulse Field Gel Electrophoresis, or PFGE. This technique is used to separate the DNA of the bacterial isolate into its component parts. It operates by causing alternating electric fields to run the DNA through a flat gel matrix of agarose, a polysaccharide obtained from agar. The pattern of bands of the DNA fragments — or “fingerprints” — in the gel after exposure to the electrical current is unique for each strain and sub-type of bacteria. By performing this procedure, scientists can identify hundreds of strains of Salmonella as well as strains of pathogenic bacteria.  The PFGE pattern of the bacteria can then be compared and matched up to the PFGE pattern of the strain of infected persons who consumed the contaminated product. When PFGE patterns match, they, along with solid epidemiological work, are proof that the contaminated product was the source of a person's illness.

So, where is the PFGE?

Plainview Milk Cooperative Ingredient Recall Product List. Information current as of noon July 06, 2009 - 
56 entries in list

CDC acts to expedite foodborne data sharing

Such single-point reporting may be a weakness of the new system, because it cannot establish trends in the way that multi-year analyses do, said prominent food-safety attorney Bill Marler of Seattle. "It you looked just at 2006, you would think that produce is a terrible risk, but in 2007 and 2008 there were fewer outbreaks in produce and many more in meat," he said.  Marler and other food-safety advocates, though, applauded the move to get data out to the field more quickly.

Administration Urged to Boost Food Safety Efforts

"Part of the problem with how we currently deal with food-borne illness cases is we wait until people get sick and die and then we announce an outbreak," said Bill Marler, a veteran food safety litigator who writes a blog about the issue. "It seems that the focus here is a bit on preventing it before we have sick and dead people as opposed to counting the bodies after salmonella or E. coli is out of the barn."

Suit Says NM Boy Was Sickened By JBS Swift Beef

Their lawyer, Bill Marler, said Tuesday that Alex developed hemolytic uremic syndrome, a type of kidney failure, after eating shish kabobs made from the meat in May. Marler's firm also represents a California client who developed the illness after eating the meat.

N.M. teen sues Swift over E. coli

Roerick's family ate the same meat, but he had more than the others, said his attorney, William Marler.  Of concern is that Roerick was sicked by whole muscle meat, not ground beef, as is typically the case with E. coli.  "It just shows how virulent the bacteria is," Marler said. "This is more than just a hamburger problem."

The President’s Food Safety Working Group will announce today at 1:30 Eastern Time that the Food and Drug Administration and the Agriculture Department will adopt new standards targeted at combating foodborne illnesses in the United States. According to a pre-release, under the new rules:

• The FDA will help the food industry establish better tracing systems to track the origins of a bacterial outbreak.
• A new network will be established to help the many agencies that regulate food safety to communicate better.
• Egg and poultry producers will have to follow new standards designed to reduce salmonella contamination.
• The Food Safety Inspection Service, the Agriculture Department agency that inspects meat, will increase sampling of ground beef ingredients in an effort to better find E. coli contamination.
• The FDA will recommend ways that producers of leafy greens, melons and tomatoes can reduce disease strains, and require stricter standards in those industries within two years.
• The FDA and the Agriculture Department also will create new positions to better oversee food safety.

It will be interesting to see and hear the presentation. The group certainly has bitten off quite a large food safety meal.

The first lawsuit stemming from the current E. coli O157:H7 (E. coli) recall by JBS Swift Beef Company of Greeley, Colorado that has been linked to 23 E. coli illnesses in California, Maine, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York and Wisconsin was filed today on behalf of an Albuquerque-area child who was infected with E. coli after eating kabobs prepared by his grandmother on Mother’s Day. The lawsuit was filed on behalf of the family of 14 year old Alex Roerick by his attorneys, William Marler of the Seattle-based foodborne illness law firm Marler Clark and Kara Knowles of the Denver firm Montgomery, Little, Soran, & Murray.

Alex ate dinner with his grandma on May 10, 2009. He began to experience flu-like symptoms including fatigue, fever, nausea, diarrhea, and vomiting by May 13. Alex’s symptoms worsened and he was admitted to Presbyterian Hospital on May 15. He was released several days later, before being rushed back again due to severe bloody diarrhea. His doctors determined that Alex had developed hemolytic uremic syndrome, or HUS, a devastating complication of his E. coli O157:H7 infection. The genetic fingerprint of the E. coli found in Alex’s stool matches that of others sickened in the nationwide outbreak tied to recalled JBS Swift Beef. He continues to experience effects of his illness.

“JBS Swift and the FSIS were much too slow about releasing information on where the beef was distributed,” said Marler. “Even with widespread consumer pressure, the information was only released a day before the 4th of July holiday, not nearly enough time to get the word out to families that might have the contaminated meat in their homes. Our government agencies need to work faster in recall situations to prevent more people from suffering what Alex and his family have experienced.”

In the early morning hours of Sunday, June 28, the JBS Swift Beef Company expanded its earlier recall of 41,280 pounds of beef contaminated with the highly toxic pathogen E. coli to include an additional 380,000 pounds. The beef recalls are FSIS (Food Safety and Inspection Service) Class I, meaning that the "use of the product will cause serious, adverse health consequences or death." After years of large recalls, focused efforts by meat regulators brought down E. coli contamination recalls to a low of 182,000 pounds in 2006. Recalls shot up again in 2007, and in the ensuing years (2007-2009), over 41 million pounds of beef have been recalled due to contamination with E. coli.

ABOUT MARLER CLARK: William Marler has been a major force in food safety policy in the United States and abroad. His food safety blog, Marler Blog, is read by over 1,000,000 people around the world every year. He and his partners at Marler Clark have represented thousands of individuals in claims against food companies whose contaminated products have caused serious injury and death. His advocacy for better food regulation has led to invitations to address local, national, and international gatherings on food safety, including recent testimony to US Congress Committee on Energy and Commerce. In 1998, Mr. Marler formed the not for profit, Outbreak Inc. He spends much of the year speaking on how to prevent foodborne illnesses.

We have had very warm and dry weather over the last six weeks and the garden has exploded!  We have already eaten lettuce, peas, carrots, beet greens, basil and radishes.  The corn is well over knee high well before the 4th of July.  We will soon be overwhelmed by tomatoes of every color and type.

Batch/UPC Code:  Anaheim peppers sold since June 11, 2009.

Reason for Recall:  Wegmans has removed fresh Anaheim peppers from its Produce departments due to the possibility of salmonella contamination. The FDA is currently investigating the situation.

If you still have Anaheim peppers, please throw them away. Do not return them to the store. You may go to the service desk for information on receiving a refund.

No indication of illnesses yet.

It really is a bit hard to imagine what today was like for JBS Swift and the FSIS - checking the list of retailers that might have received the 210 Tons of E. coli O157:H7 meat.  This morning a few names trickled out - this evening a torrent, tomorrow a flood?  Here is the most recent list:

Price Chopper

Hannaford

Stop & Shop

Food 4 Less

Fry's

Smith's

Costco

Sams Club

Kroger

SAV a Lot

Knight Super Foods #4

Weldon's Meat Market

Jasper Mercantile

Keeney's Food Mart

Sweetbay

All DAY AM PM MART

Hobby's Hoagies Produce

SHRTN HTL Produce

Giant

Here is the most recent list (sure to expand in the coming days):

We have been retained by 20 of these linked cases (4 HUS) and have thus far filed suit in 3 cases.  We have not filed any suits this week waiting to see if Nestle will offer to pay the acute phase medical expense and wage loss of its customers.  From the CDC last night:

72 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 30 states. Of these, 51 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (6), Connecticut (1), Delaware (1), Georgia (1), Iowa (2), Illinois (5), Kentucky (2), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).

Ill persons range in age from 2 to 65 years; however, 65% are less than 19 years old; 71% are female. Thirty-four persons have been hospitalized, 10 developed hemolytic uremic syndrome (HUS); none have died. Reports of these infections increased above the expected baseline in May and continue into June.

In an epidemiologic study, ill persons answered questions about foods consumed during the days before becoming ill and investigators compared their responses to those of persons of similar age and gender previously reported to State Health Departments with other illnesses. Preliminary results of this investigation indicate a strong association with eating raw prepackaged cookie dough. Most patients reported eating refrigerated prepackaged Nestle Toll House cookie dough products raw.

On June 29, 2009, the U.S. Food and Drug Administration announced that a culture of a sample of prepackaged Nestle Toll House refrigerated cookie dough currently under recall yielded E. coli O157:H7. The contaminated sample was collected at the firm on June 25, 2009. Further laboratory testing is underway to determine whether the E. coli strain in the product matched the strain causing the outbreak.

On June 24, FSIS issued a notice about a recall of 41,280 pounds of beef products from JBS Swift Beef Company that may be contaminated with E. coli O157:H7. On June 28, the recall was expanded to include 380,000 pounds of assorted pieces of beef (beef primal products) from the same company.

The CDC reports today that twenty three persons infected with a strain of E. coli O157:H7 with a particular "DNA fingerprint" have been reported from 9 states. Of these, 17 have been confirmed by an advanced DNA test as having the outbreak strain; confirmatory tests are pending on others. The number of ill persons identified in each state is as follows: California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6).

Among 17 ill persons for whom hospitalization status is known, 12 (70%) were hospitalized. Two patients developed a type of kidney failure called hemolytic uremic syndrome (HUS).

Now, a week into the recall FSIS and JBS Swift Beef has not disclosed the names of all stores that received the E. coli-tainted beef.  Why?  As I said to ABC News:

But Bill Marler, an attorney focused on food poisoning cases with the Seattle-based law firm Marler Clark, said if the FSIS waits 10 days, the information would be of little help to consumers who have already prepared for the holiday weekend -- even if the FSIS is following the rule.

"It just seems inconceivable to me that they can't release this information more timely so people who have this in their refrigerator know what to do with it or know what not to do with it," Marler said.

"Whether they're absolutely following the rule or not, this is the kind of information that JBS Swift should have at their fingertips," he added.

The good/bad thing about hitting 50ish, and litigating food poisoning cases for 16 years, is the institutional memory that I have developed regarding bad food and bad commercials.

Coming days before the 4th of July barbeque's, JBS Swift Beef Company expanded the approximately 40,000 pounds of “assorted beef primals” recalled on June 24 to include another approximately 380,000 pounds of “assorted beef primals" due to E. coli O157:H7 contamination.  Somewhere between 18 and 24 Illnesses have been reported in what is believed to be Arizona, California, Colorado, Florida, Illinois, Michigan, Minnesota, Nebraska, Oregon, South Carolina, Tennessee, Utah and Wisconsin?  As reported by the Food Safety and Inspection Services (FSIS):

The beef products were produced on April 21, 2009 and were distributed both nationally and internationally.  Each box bears the establishment number "EST. 969" inside the USDA mark of inspection as well as the identifying package date of "042109" and a time stamp ranging from "0618" to "1130." However, these products were sent to establishments and retail stores nationwide for further processing and will likely not bear the establishment number "EST. 969" on products available for direct consumer purchase. Customers with concerns should contact their point of purchase.

The recalled products include intact cuts of beef, such as primals, sub-primals, or boxed beef typically used for steaks and roasts rather than ground beef. FSIS is aware that some of these products may have been further processed into ground products by other companies. The highest risk products for consumers are raw ground product, trim or other non-intact product made from the products subject to the recall.

So, where is the recalled beef?

On August 18, 2008 after years of hand wringing, the FSIS finally put public health before “proprietary” business interests when it made the following rule:

9 C.F.R. § 390.10 Availability of Lists of Retail Consignees during Meat or Poultry Product Recalls

The Administrator of the Food Safety and Inspection Service will make publicly available the names and locations of retail consignees of recalled meat or poultry products that the Agency compiles in connection with a recall where there is a reasonable probability that the use of the product could cause serious adverse health consequences or death.

The full rule can be reviewed at: http://www.fsis.usda.gov/OPPDE/rdad/FRPubs/2005-0028F.pdf

The Bottom Line:

The FSIS is now supposed to make available to the public names and locations of retail consignees (grocery stores, etc.) of meat and poultry products recalled by a federally-inspected meat or poultry establishment if the recalled product has been distributed to the retail level.  The rule will only apply to Class I recalls (like the JBS Swift ones). The information is supposed to be posted on the FSIS website, generally within three (3) to ten (10) working days, following the announcement of the recall. 

So, where is the recalled beef?