June 2011

The World Health Organization reported another death today in Germany and confirmed a death in the United Sates (CDC had previously suggested an Arizona death). The death toll now from the E. coli outbreak centered in Germany has risen to 50.

In addition, the Institut de veille sanitaire, France, published new figures for the continuing outbreak in Bordeaux. In total, eight E. coli cases and eight HUS cases were reported since June. E. coli O104:H4 infections have been confirmed in four cases. Also, Sweden reported a confirmed case of E. coli O104:H4 in southern Sweden in an adult male. None of the new cases in France or Sweden were in people who had travelled in Germany since May 2011 (below chart does not include newest German death and Swedish or France outbreak clusters).

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According to government officials and press reports, imported fenugreek seeds from Egypt may well be the source of the E. coli outbreaks according to initial investigations by European scientists. The German outbreak and a smaller cluster of E. coli centered in Bordeaux have both been linked to sprouted seeds. Experts from the Sweden-based European Center for Disease Prevention and Control (ECDC) and the Italy-based European Food Safety Authority (EFSA) said initial investigations suggested “the consumption of sprouts is the suspected vehicle of infection in both the French cluster and the German outbreak. “The tracing back is progressing and has thus far shown that fenugreek seeds imported from Egypt either in 2009 and/or 2010 are implicated in both outbreaks.”

There has been no information from the FDA if these seeds had been imported to the Untited States.

fenugreek seeds.jpgAP Health reports this morning that European health experts warned Thursday there could be more E. coli cases across Europe and elsewhere after finding recent deadly outbreaks were probably linked to contaminated Egyptian fenugreek seeds. They say the fenugreek seeds are likely to blame for a massive food poisoning outbreak in Germany beginning in May that killed 49 people and infected over 4,000, as well as a much smaller outbreak in France in June. A single E. coli case was also reported in Sweden, in a patient with no known links to Germany. More than 800 people have developed a life-threatening kidney complication after catching the bug.

My favorite quotes thus far:

“Sprouts are biological time bombs,” Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told the AP. “If they’re infected, once they’re rehydrated and distributed, they could take the bacteria anywhere.” Osterholm said the seeds could also cross-contaminate other products or be sold in a seed mix.

Osterholm said medical authorities should be increasing their surveillance and testing of potential E. coli patients, since cases could easily be missed. “Once seeds are sold from Egypt, they could be distributed all over the world,” he said. “There is no place in the world that’s safe from an outbreak like this.”

So, FDA, are the seeds in the US or not?

Our President set out the choices today:

if we choose to keep those tax breaks for millionaires and billionaires, if we choose to keep a tax break for corporate jet owners, if we choose to keep tax breaks for oil and gas companies that are making hundreds of billions of dollars, then that means we’ve got to cut some kids off from getting a college scholarship. That means we’ve got to stop funding certain grants for medical research. That means that food safety may be compromised. That means that Medicare has to bear a greater part of the burden. Those are the choices we have to make.

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Think about it – what would you choose?

According to the CDC, in the United States, five confirmed cases and one suspect case of STEC O104:H4 infections have been identified; one death has been reported. Of these six cases, five recently traveled to Germany, where they were likely exposed. The bacterial isolates from the three HUS cases reported in Massachusetts, Michigan and Wisconsin, and two cases with Shiga toxin-positive diarrheal illness reported in Michigan and North Carolina, have been confirmed as matching the outbreak strain. The Michigan case with Shiga toxin-positive diarrheal illness did not travel to Germany, but likely acquired this infection through close contact with the Michigan case with HUS. Arizona has reported one death in a HUS case with recent travel to Germany.

Here are the European numbers by country:

Screen shot 2011-06-29 at 6.16.31 PM.pngAs of today, trace-back investigations in both the German and French E. coli O104:H4 outbreaks are pointing to two lots of fenugreek seeds that were imported from Egypt (not sure what happened to the Italian/British connection of yesterday).

rupertmurdoch-frowning-tbi.jpgWhen I got a call last week from a Washington Post reporter that she was about to leave the food safety beat to cover education, I said congratulations until I learned than she would not be replaced. Then came the Tweet from the Dean of Ag reporters, Phil Brasher, that the Des Moines register was closing its D.C. Bureau. Losing two of the best reporters covering Ag and Food Safety issues is stunning–especially during a time when there are far more questions than answers about the safety and sustainability of our food supply. The Farm Bill is on the table and the Food Safety Modernization Act is on the chopping block and the public needs to be informed.

Even before the losses above, the lack of coverage of issues surrounding food safety prompted me to launch Food Safety News nearly two years ago. We have recently added some powerful pens to the needed discussion.

Andrew Schneider has spent his career uncovering secrets that corporations and the government don’t want you to know — often because they could or are hurting you. He broke the story of the asbestos poisoning of Libby, Montana, now infamous as the most deadly environmental disaster in the United States. His reporting led to the criminal indictment of W.R. Grace and some of its top executives — leading to the largest environmental crime case in U.S. history. Schneider also was the first to report that fumes released by heating diacetyl, a butter flavoring used in thousands of consumer products, were destroying the lungs of food factory workers, mom-and-pop confection store owners and chefs across the country.

He documented that seriously ill pilots were being allowed to fly commercial planes because the government looked the other way. He explained why scores of regular people–coal miner’s daughters and cops–were bypassed, and sometimes died, because the organs they were next in line for went to New York diamond merchants and wealthy foreigners. He showed why life flight helicopter rescues sometimes became death flights because competition for patients trumped flight safety. And he disclosed a global honey-laundering network that allows adulterated honey from China to be sold to unsuspecting U.S. consumers. Schneider’s investigative work has been recognized with dozens of journalism awards, including two Pulitzer Prizes.

Ross Anderson is a freelance journalist who writes about food safety as well as Pacific Northwest maritime culture and history. Previously he worked 30 years for the Seattle Times, where he covered politics and environmental issues. Now semi-retired in Port Townsend, Washington, he contributes to Food Safety News.

Ross has won many awards, including the 1990 Pulitzer Prize for national reporting which he shared with Times colleagues for coverage of the Exxon Valdez Oil Spill. More recently his waterfront column for the Port Townsend Leader has won several statewide awards from the Washington Newspaper Publishers Association.

Michele Simon will contribute periodic policy pieces for Food Safety News. Michelle is a public health lawyer who has been researching and writing about the food industry and food politics since 1996. She specializes in legal strategies to counter corporate tactics that harm the public’s health. Also an expert in alcohol policy, she is currently research and policy director for the Marin Institute, an alcohol industry watchdog group based in Northern California.

Michele Simon has taught Health Policy at the University of California, Hastings College of the Law, and lectures frequently on corporate tactics and policy solutions. She has written extensively on the politics of food, and her first book, “Appetite for Profit: How the Food Industry Undermines Our Health and How to Fight Back,” was published by Nation Books in 2006.

She has a master’s degree in public health from Yale University and received her law degree from the University of California, Hastings College of the Law.

And of course we have the “Lois Lane of food safety reporters” in D.C. Helena Bottemiller covers food policy, politics and regulation for Food Safety News from our nation’s capital. A self-described food policy wonk, Helena first delved into the world of food safety while writing her thesis on the U.S. Food and Drug Administration at Claremont McKenna College in Los Angeles. Helena has been featured on BBC World and in USA Today; her work also appears on Civil Eats and Obama Foodorama and is widely cited by mainstream and niche media.

In her daily reporting for Food Safety News, Bottemiller has reported, from the front lines, on the Gulf oil spill, the GE alfalfa Supreme Court case, the half billion Salmonella egg recall, school lunch reform, and the long and winding debate over the FDA Food Safety Modernization Act.

The Washington Post and the Des Moines Register are not doing the public or themselves any favors. Andrew, Ross, Michele, Helena, Dan, Mary, Gretchen and the rest of the Food Safety News team will do their best to pick up the slack.

fenugreekseeds.jpgAccording to CIDRAP (my second favorite source of Food Safety News) a trace-back investigations in both the German and French E. coli O104:H4 outbreaks are pointing to two lots of fenugreek seeds that were imported from Egypt (not sure what happened to the Italian connection of yesterday).  Sprouts from Egyptian fenugreek seeds are suspected in both a cluster of French E coli O104:H4 illnesses and the large outbreak in Germany involving the same strain, the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) said in a risk assessment today.

According to officials, the tracing back is progressing and has thus far shown that fenugreek seeds imported from Egypt either in 2009 and/or 2010 by the company AGA SAAT GMBH are implicated in both outbreaks. There is still much uncertainty about whether this is truly the common cause of all the infections as there are currently no positive bacteriological results. 

fenugreek-asprouting.jpgIn particular, the 2009 lot appears to be implicated in the outbreak in France and the 2010 has been considered to be implicated in the German outbreak. Furthermore, this link does not explain the most recent case in Sweden and Denmark, currently under investigation and in which, thus far, no consumption of sprouts has been implicated.   An investigation on the distribution of seeds from these lots throughout Germany and Europe by AGA SAAT has been urgently requested. AGA SAAT exported some of its seeds to Thompson & Morgan in the UK from where seeds were exported to France.  It is also noted that seeds sold for sprouting are often sold as seed mixes and that during re-packaging cross- contamination cannot be excluded.   Therefore, any advice to consumers should at this time cover all seeds and raw sprouts derived thereof. 

Jun 29 ECDC risk assessment report

Jun 29 ECDC outbreak update

My flight got cancelled today to Boston where I was to spend time with one of the six United States E. coli O104:H4 cases. As I passed through airport security before I headed back to the office, I thought about how difficult national and international travel has become post 9-11. Not so for bacteria.

Screen shot 2011-06-28 at 8.43.26 PM.pngAs of today the European Union reported 885 HUS cases, including 31 deaths, and 3,138 non-HUS cases, including 17 deaths, have so far been reported (total 48 deaths and 4,023 ill – likely far more) from the German E. coli O104:H4 outbreak. The latest known date of onset of diarrhea for cases is June 22 (likely secondary transmission from primary cases). The United States reported 5 illnesses (3 with HUS) and 1 possible death.

Last Friday, France reported a cluster of at least 12 patients with bloody diarrhea, who had participated in an event in the commune of Bègles around Bordeaux on June 8. As of June 27, nine people have been hospitalized. Eight of these have developed HUS. The ninth hospitalized case has bloody diarrhea but not HUS, and epidemiological investigations have shown no link with the event in Bègles.  In three cases, infection with E. coli O104:H4 (the German strain) has been confirmed.

Screen shot 2011-06-28 at 9.00.24 PM.pngFrench authorities are investigating this new cluster of STEC. Six of the cases reported having eaten sprouts at the event on June 8, and leftovers are currently being analyzed. These suspected sprouts were locally produced, and were not imported from the farm implicated in the outbreak in Germany, but from a British company, Thompson & Morgan who allegedly sourced seed from Italy (not known if Thompson & Morgan are in anyway connect to supplying seed to the German organic sprouter).

In addition, Swedish health authorities say they have identified the first domestic case of E. coli O104:H4 infection. The Swedish Institute for Communicable Disease Control says it’s the first case in Sweden without any direct link to Germany. It remains unclear how the patient was infected. The agency has now started an investigation to trace the source of the infection.

Also today, Danish health authorities said 23 people in Denmark have been infected, including a 24-year-old who had no direct link to Germany. The case was reported last month and it remained unclear how the patient was infected.

Still confusing as to the source of the E. coli O104:H4?  Ill workers, contaminated water, contaminated seed, secondary cases?  All vectors are still, unlike me, up in the air.

The CDC is collaborating with public health officials in many states and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of Salmonella Enteritidis infections linked to alfalfa sprouts and spicy sprouts.

As of June 27, 2011, a total of 21 persons with the outbreak strain of Salmonella Enteritidis have been reported from 5 states: Idaho (3), Montana (7), North Dakota (1), New Jersey (1) and Washington (9). Among persons for whom information is available, illnesses began between April 12 and June 7, 2011. Ill persons range in age from 12 years to 77 years old, with a median age of 35 years old. Seventy-one percent are female. Among the 10 ill persons with available information, 3 (30%) persons have been hospitalized. No deaths have been reported.

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Collaborative investigative efforts of local, state, and federal public health and regulatory agencies have linked this outbreak to Evergreen Produce brand alfalfa sprouts and spicy sprouts. The sprouts were distributed to various customers in Idaho, Montana, Washington State, and possibly to retailers in neighboring states. CDC, FDA, and state and local public health partners are continuing surveillance to identify new cases and trace potentially contaminated products. CDC will continue to update the public on the progress of this investigation as information becomes available.

To date Evergreen Produce has refused to recall it products.

Screen shot 2011-06-28 at 4.12.06 PM.pngAccording to a news release – The Alabama Department of Public Health continues its investigation of an E. coli O157:H7 outbreak in Lee County. Thirteen children and two adults who either played in the Splash Park or swam in the pool at the Opelika SportsPlex and Aquatic Center between June 4 and June 22 were identified with severe gastrointestinal illness. Five children have been confirmed positive for E. coli O157:H7 infection.

Four children were initially hospitalized and two remain hospitalized.

The Health Department has contacted the parents of children of seven day care centers that had children at the Splash Park during the period of concern. Symptoms of E. coli can appear up until 10 days after exposure.

“Based on the information that we have now, it appears that the common source of exposure was the Aquatic Center,” said State Health Officer Dr. Donald Williamson. “Because of the risk for outbreak of illness, it is essential that public pools and water parks follow Centers for Disease Control and Prevention guidelines for adequate chlorine and pH levels.”

Illnesses in recreational waters are caused by germs spread by swallowing, breathing in mists or aerosols or having contact with contaminated water in swimming pools, water parks, hot tubs, interactive fountains, water play areas, lakes, rivers or oceans. Infection may also occur by touching the environment in petting zoos and other animal exhibits or by eating food prepared by people who did not wash their hands well after using the toilet.

ADPH notified city officials of possible contamination on June 20. ADPH collected water samples for testing from the facilities at the Aquatic Center. The ADPH Bureau of Clinical Laboratories ran the initial tests which were negative for bacteria. Negative results do not guarantee that bacteria was not present. Additional water samples have been collected and sent to the CDC for testing and results are pending.

caot-facts.jpgI was struck by the press release on the FDA website that Nestle Purina PetCare was voluntarily recalling 870 bags of potentially Salmonella positive cat food shipped only to Colorado, Idaho and Oregon even though there had been no consumer complaints and no reports of illness. Nestle also posted this:

At Nestle Purina PetCare, the safety and efficacy of our products are our top priority. We apologize for any inconvenience due to this voluntary recall.

However, yesterday on the same FDA website was this dire warning (with no recall):

Do not eat Evergreen Produce brand alfalfa sprouts or spicy sprouts
- Sprouts may contain Salmonella Enteritidis

Today, June 28th, the CDC issued a statement, increasing the number of sick people to 21 with three having been hospitalized. The illnesses began April 12 and continued to be reported through June 7, the CDC reported. However, because of the two- to three-week lag time in reporting the agency said additional people may have become sick after June 9.

alfalfa-sprout.jpgAnd what has been Evergreen Produces’ response? Here are some of my favorites:

• Scharf said the FDA has asked her to recall the sprouts but that she doesn’t believe the agency has enough evidence to link the illnesses to her products. Most of the sprouts have probably been consumed anyway, she said.

• The FDA “inspected every nook and cranny, every part of our plant, and that was a week ago and they haven’t come up with anything yet,” Scharf said. “We’ll see. Maybe they will. Who knows.”

• “It’s all speculation, assumptions,” said Ms. Scharf, commenting about FDA’s link to the company’s products. “We do water testing three times a week and sample our products,” she said. The facility undergoes a third-party audit every three months to satisfy military buyers.

• The impact of the FDA investigation and outbreak is taking its toll on the 13-people company. “It’s really hurting us. We’ve cut production to one-fourth,” she said.

• While FDA asked Evergreen Produce to recall its alfalfa and spicy sprouts the week of June 20, Ms. Sharf said that she refused because orchestrating a recall would be “admitting guilt.” She added, “Fourteen families eat our sprouts every day and have never become sick.”

• “So far they haven’t offered one bit of concrete evidence that we have a problem,” she said. “Our company’s name has been smeared and it makes me think, the way they are going about this, that maybe they just want to shut us down.

• “The FDA encouraged us to do a recall but I said I needed to see hard evidence that our sprouts were involved,” Scharf said. “They are down to only three cases now. It started out that they thought 20 people were sick, then they dropped that number to six and now it’s down to three. And they say it will be a week before any tests results will be available.”

• “If I had the money I would be fighting what they (FDA and Idaho state health officials) have done,” Scharf said. “They have issued that statement and smeared us without any evidence.

My suggestion is that Evergreen Produce needs a new spokesperson or should start selling cat food.