Marler Blog - Providing commentary on food poisoning outbreaks & litigation

Michael Hauser died last week after a heroic struggle against Listeria. He left his loving wife and family.

PDF Complaint.

So says Jimmy himself:

“I agree wich ya, we no longer serve sprouts, sprout supplies were inconsistent.”

I guess so.

Multistate Jimmy John's Restaurants Raw Clover Sprouts 2011

14 Sickened (possibly 19) - On February 15, 2012, the Centers for Disease Control announced an ongoing investigation into illnesses linked to the consumption of raw clover sprouts consumed at Jimmy John's Restaurants in several states. The number of ill persons identified in each state is as follows: Iowa (5), Missouri (3), Kansas (2), Michigan (2), Arkansas (1), and Wisconsin (1). Among 11 ill persons with information available, 10 (91%) reported eating at a Jimmy John's sandwich restaurant in the 7 days preceding illness. Ill persons reported eating at 9 different locations of Jimmy John's restaurants in 4 states in the week before becoming ill. One Jimmy John's restaurant location was identified where more than one ill person reported eating in the week before becoming ill. Among the 10 ill persons who reported eating at a Jimmy John's restaurant location, 8 (80%) reported eating a sandwich containing sprouts, and 9 (90%) reported eating a sandwich containing lettuce. Currently, no other common grocery stores or restaurants are associated with illnesses. Preliminary traceback information has identified a common lot of clover seeds used to grow clover sprouts served at Jimmy John's restaurant locations where ill persons ate. FDA and states conducted a traceback that identified two separate sprouting facilities; both used the same lot of seed to grow clover sprouts served at these Jimmy John's restaurant locations. On February 10, 2012, the seed supplier initiated notification of sprouting facilities that received this lot of clover seed to stop using it. Investigations are ongoing to identify other locations that may have sold clover sprouts grown from this seed lot. http://www.cdc.gov/ecoli/2012/O26-02-12/index.html

Sprouters Northwest, Jimmy John's Restaurants Clover Sprouts 2010

7 Sickened - Sprouters Northwest of Kent, Washington, issued a product recall after the company's clover sprouts had been implicated in an outbreak of Salmonella Newport in Oregon and Washington. At least some of the cases had consumed clover sprouts while at a Jimmy John's restaurants. Jimmy John's Restaurants are a restaurant chain that sells sandwiches. Concurrent with this outbreak, a separate Salmonella outbreak (Salmonella, serotype I 4,5,12,i- ; see Multistate Outbreak, Tiny Greens Organic Farm, Jimmy John's Restaurants), involving alfalfa sprouts served at Jimmy John's restaurants was under investigation. The recall of Northwest Sprouters products included: clover; clover & onion; spicy sprouts; and deli sprouts. The Sprouters Northwest products had been sold to grocery stores and wholesale operations in Washington, Oregon, Idaho, Alaska, British Columbia, Saskatchewan, and Alberta. The FDA inspection found serious sanitary violations. http://www.foodsafetynews.com/2011/01/jimmy-johns-will-switch-to-clover-sprouts/, http://www.oregonlive.com/business/index.ssf/2011/01/jimmy_johns_switches_to_clover.html, http://www.thepacker.com/opinion/fresh-produce-opinion/jimmy_johns_sprout_switch_remains_puzzling_122028204.html

Multistate Outbreak, Tiny Greens Organic Farm, Jimmy John's Restaurants Alfalfa Sprouts 2010

140 Sickened - On December 17, the Illinois Department of Health announced that an investigation was underway into an outbreak of Salmonella, serotype I4,[5],12:i:-. Many of the Illinois cases had eaten alfalfa sprouts at various Jimmy John’s restaurants in the Illinois counties of: Adams, Champaign, Cook, DuPage, Kankakee, Macon, McHenry, McLean, Peoria, and Will counties. The sprouts were suspected to be the cause of the illnesses. On December 21, Jimmy John Liautaud, the owner of the franchised restaurant chain, requested that all franchisees remove sprouts from the menu as a "precautionary" measure. On December 23, the Centers for Disease Control revealed that outbreak cases had been detected in other states and that the outbreak was linked with eating alfalfa sprouts while at a nationwide sandwich chain. On December 26, preliminary results of the investigation indicated a link to eating Tiny Greens’ Alfalfa Sprouts at Jimmy John’s restaurant outlets. The FDA subsequently advised consumers and restaurants to avoid Tiny Greens Brand Alfalfa Sprouts and Spicy Sprouts produced by Tiny Greens Organic Farm of Urbana, Illinois. The Spicy Sprouts contained alfalfa, radish and clover sprouts. On January 14, 2011, it was revealed that the FDA had isolated Salmonella serotype I4,[5],12:i:- from a water runoff sample collected from Tiny Greens Organic Farm; the Salmonella isolated was indistinguishable from the outbreak strain. The several FDA inspections of the sprout growing facility revealed factors that likely led to contamination of the sprouts. http://www.cdc.gov/salmonella/i4512i-/122810/index.html

CW Sprouts, Inc., SunSprout Sprouts, "restaurant chain (Chain A)," a.k.a. Jimmy Johns 2009

256 Sickened - In February, Nebraska Department of Health and Human Services officials identified six isolates of Salmonella Saintpaul. Although this is a common strain of Salmonella, during 2008, only three cases had been detected in Nebraska and only four subtypes of this outbreak strain had been identified in 2008 in the entire USA. As additional reports were made, a case control study was conducted; alfalfa sprout consumption was found to be significantly related to illness. The initial tracebacks of the sprouts indicated that although the sprouts had been distributed by various companies, the sprouts from the first cases originated from the same sprouting facility in Omaha, Nebraska. Forty-two of the illnesses beginning on March 15 were attributed to sprout growing facilities in other states; these facilities had obtained seed from the same seed producer, Caudill Seed Company of Kentucky. The implicated seeds had been sold in many states. On April 26, the FDA and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts. In May, FDA alerted sprout growers and retailers that a seed supplier, Caudill Seed Company of Kentucky, was withdrawing all alfalfa seeds with a specific three-digit prefix.  Many of the illnesses occurred at "restaurant chain (Chain A)." http://www.cdc.gov/salmonella/saintpaul/alfalfa/, http://www.whas11.com/news/iteam/Salmonella-Outbreak-Linked-to-Louisville-Seed-Company-83577137.html, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5818a4.htm, See PDF linking outbreak to Jimmy John's a.k.a. "restaurant chain (Chain A)"

Jimmy John's Restaurant Alfalfa Sprouts and Iceberg Lettuce 2008

28 Sickened - Several University of Colorado students from one sorority became ill with symptoms of bloody diarrhea and cramping. Additional illnesses were reported. E. coli O157:NM(H-) was determined to be the cause. Consumption of alfalfa sprouts at the Jimmy John's Restaurants in Boulder County and Adams County were risk factors for illness. In addition, the environmental investigation identified Boulder Jimmy John's food handlers who were infected with E. coli and who had worked while ill. The health department investigation found a number of critical food handling violations, including inadequate handwashing. The fourteen isolates from confirmed cases were a genetic match to one another. http://www.thedenverchannel.com/news/17669936/detail.html

Special Concerns of the Elderly

The occurrence of bacterial infection is a function of several major variables: (1) the virulence of the bacterial pathogen, that is, its ability to cause severe disease; (2) how the pathogen is transmitted to the “host”—for example, whether it is airborne, foodborne, blood borne, etc.; and (3) host susceptibility—i.e. how well the host can defend itself against the bacterial pathogen. Increased susceptibility, in turn, may result from two different processes: a bigger infectious dose in a given case of disease may cause a more severe infection, and physical characteristics particular to an individual host may render him or her less able to limit the spread of infectious microorganisms from the intestinal tract to the bloodstream.

Morbidity and mortality in the elderly from infectious disease is far greater than in other populations. For instance, death rates for infectious diarrheal disease alone are five times higher in people over 74 years of age than in the next highest group, children under four years of age, and fifteen times higher than the rates seen in younger adults. Published studies attribute the elderly’s heightened risks, both of infection and mortality due to enteric infectious disease, to several factors: (1) the aging of the gastrointestinal tract (reduced gastric acidity/reduced gastric mobility); (2) a higher prevalence of underlying medical disorders (co-morbidity factors); and (3) malnutrition and a decline in the immune response that leaves the host less able to defend itself against infectious agents.

Aging of the Gastrointestinal Tract—An Invitation to Infection

Inflammation and shrinkage of the gastric mucosa increase with age. These changes lead to low gastric acidity. In patients with gastric ulcer disease, the drugs used to treat the condition further block gastric acid production. Because stomach acids play an important role in limiting the number of bacteria that enter the small intestine, low gastric acidity increases the likelihood of infection if a pathogen is ingested with food or water.

Gastrointestinal mobility (peristalsis) decreases with age. Peristalsis, which is the mechanism that propels the stomach contents through the intestinal tract, is also the mechanical means for removing ingested, life-threatening pathogens. The risk of infection by potentially invasive pathogens corresponds with the duration of contact between the pathogen and the intestinal mucosa. Thus, a decrease in peristalsis delays the clearance of the pathogen from the intestinal tract and contributes substantially to the increased prevalence and severity of infection in the elderly. If the pathogen is E. coli O157:H7, decreased peristalsis allows the bacteria to multiply and produce more of the toxin that is absorbed in the gastrointestinal tract and leads to the aforementioned complications of an E. coli O157:H7 infection.

A Higher Prevalence of Underlying Medical Conditions—
Co-Morbidity Factors

Underlying medical conditions or disease (co-morbid factors) also contribute to the morbidity and mortality of infection in the elderly. Among hospitalized patients, those older than 65 develop pneumonia twice as often as younger patients due to poor nutrition, neuromuscular disease (poor cough reflex and aspiration), pharyngeal colonization, depressed level of alertness, endotracheal intubation, intensive care unit admission, nasogastric tube use, and antacid use. Pneumonia is the leading infectious cause of death in the elderly.

Atherosclerosis, another common co-morbid disease, compromises circulation and blood flow to the peripheral tissues and the skin, particularly in elderly individuals who are hospitalized and bedridden with an infectious illness. Unfortunately, it is the skin and the previously discussed mucous membranes that serve as the body’s first line of defense against invasion by infectious microorganisms. Loss of the integrity of the skin may result in the development of pressure ulcers, which are warm, moist mediums for infectious microorganisms to rapidly multiply and are associated with a number of infectious complications.

When an infectious microorganism, regardless of source, gains access to the bloodstream, the patient may develop systemic sepsis, also know as bacteremia. Bacteremia is most common in people who are already affected by, or are being treated for, some other medical problem (co-morbid disease); conversely, people in good health with strong immune systems rarely develop bacteremia. The main sources of bacteremia in elderly patients are the urinary tract, gastrointestinal tract, respiratory tract, and the skin. Other potential sources include surgical wounds, invasive tubes and catheters, intravenous lines—virtually any site where an invasive medical procedure has occurred. Bacterial organisms most likely to cause bacteremia include members of the Staphylococcus, Streptococcus, and Escherichia coli genera. Because bacteremia is far more prevalent in those with co-morbid conditions, which group is substantially populated by the elderly, the presence of co-morbid conditions is clearly a determinant of the mortality associated with infectious disease.

A Weakened Immune System—the Inability to Fight Off Infection

With advancing age come progressive weakness, decline, and dysfunction of the immune system. Many of the body’s natural physiologic responses to infection are therefore blunted in the elderly; and the intensity of many clinical signs and symptoms in an elderly patient with an infectious process are muted when compared to those in a younger person. This age-related decline contributes significantly to the increased risk of severe illness and mortality in elderly persons with infectious disease.

The effect of a weakened immune response on the health of an elderly person often manifests most apparently during periods of intense stress (e.g., surgery, sepsis, multiple organ failure, malnutrition, dehydration).

New Jersey Department of Health reported that it currently has two residents that are ill in connection to a major outbreak caused by the consumption of raw milk from a Pennsylvania farm, Family Cow Dairy.

Currently 78 people in four states have become ill with campylobacteriosis, a gastrointestinal illness, from the consumption of the raw milk contaminated with bacteria. Pennsylvania Department of Health officials said Thursday that the total number of cases continued to increase. The department has identified 68 cases in Pennsylvania, five in Maryland, two in New Jersey and three in West Virginia.

The bottled raw milk products were distributed throughout Pennsylvania, including Montgomery, Bucks, Philadelphia, and Delaware counties, which all border the Delaware River. The raw milk from this farm was purchased in Pennsylvania. The sale or distribution of raw milk is banned in New Jersey.

While the majority of illness has occurred in Pennsylvania, residents in New Jersey, Maryland and West Virginia have also been affected. A 27-year-old male from Burlington County and a 3-year-old male from Gloucester County both got ill after consuming raw milk from the Family Cow Dairy in Pennsylvania.

The illness typically lasts one week. Some infected people do not have any symptoms. In those with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a life-threatening infection. Long-term complications may include contracting Guillain Barre Syndrome, which may result in paralysis and usually requires intensive care.

The source of this outbreak, Family Cow Dairy, has since been permitted by the Pennsylvania Department of Agriculture to resume bottling. It is important to note that this outbreak occurred despite the fact that Family Cow Dairy is licensed, inspected, and operating in compliance with Pennsylvania laws.

Here is a good overview on the statistics on raw milk risks - "CDC: Raw Milk Much More Likely to Cause Illness"

Also, see Real Raw Milk Facts Outbreak Tables and Reports.

And, for those who think campylobacter is just a "tummy ache," please watch this video:

Taco Bell - “Mexican-style fast-food restaurant chain” - Salmonella Outbreak

A 22-year-old Oklahoma woman who says she contracted salmonella after eating at Taco Bell has sued the fast-food company. Leah Smith claims she became sick while attending a University of Oklahoma football game last fall, two days after eating at a Taco Bell in Norman. She says she was sick for two weeks.

The Centers for Disease Control said last month that 16 people in Oklahoma are among 68 people who were infected with salmonella after eating at a “Mexican-style fast-food restaurant chain.”

Jimmy John’s - E. coli Outbreak

An Altoona woman has become the second Iowan to sue Jimmy John's sandwich chain over an outbreak of foodborne illness linked to sprouts. Mollie Horton, 23, filed the lawsuit Thursday in Polk County District Court. She said she fell ill Dec. 26, days after eating a sandwich from a Jimmy John's party platter at a family gathering. Horton's lawsuit said she removed the sprouts from the sandwich but nonetheless caught E. coli poisoning that caused her to be hospitalized for three days and sick for weeks. Testing showed her illness was the result of the strain linked to the outbreak, which sickened 12 people in five states. Federal authorities said last week that five of the 12 patients were from Iowa.

A Jimmy John's spokeswoman declined to comment. But Horton's attorney, Bill Marler, says the Illinois-based chain has finally pulled sprouts from its menu.

A Polk County woman sickened for weeks after eating tainted sprouts has filed a lawsuit accusing sandwich chain Jimmy John’s of serving unsafe food. On Tuesday, Heather Tuttle of Clive filed a separate lawsuit in Des Moines seeking damages for pain and suffering. Tuttle was diagnosed with E. coli poisoning after eating a turkey sandwich from a West Des Moines Jimmy John’s in West Des Moines last month. Her lawsuit describes weeks of excruciating cramps and diarrhea that required medical treatment.

The Outbreak

4.         On February 15, 2012, the Centers for Disease Control announced an ongoing investigation into illnesses linked to the consumption of raw clover sprouts consumed at Jimmy John's Restaurants in several states.

5.         Among 11 ill persons with information available, 10 (91%) reported eating at a Jimmy John's sandwich restaurant in the 7 days preceding illness. Ill persons reported eating at 9 different locations of Jimmy John's restaurants in 4 states in the week before becoming ill. One Jimmy John's restaurant location was identified where more than one ill person reported eating in the week before becoming ill. Among the 10 ill persons who reported eating at a Jimmy John's restaurant location, 8 (80%) reported eating a sandwich containing sprouts, and 9 (90%) reported eating a sandwich containing lettuce. Currently, no other common grocery stores or restaurants are associated with illnesses.

6.         Preliminary traceback information has identified a common lot of clover seeds used to grow clover sprouts served at Jimmy John's restaurant locations where ill persons ate. Officials from the Food and Drug Administration, and various states, conducted a traceback that identified two separate sprouting facilities; both used the same lot of seed to grow clover sprouts served at these Jimmy John's restaurant locations. On February 10, 2012, the seed supplier initiated notification of sprouting facilities that received this lot of clover seed to stop using it. Investigations are ongoing to identify other locations that may have sold clover sprouts grown from this seed lot.

Prior Jimmy John’s Outbreaks Linked to Sprouts

            7.         In 2010, Sprouters Northwest of Kent, Washington, issued a product recall after the company's clover sprouts were implicated in an outbreak of Salmonella Newport in Oregon and Washington. At least some of the cases had consumed clover sprouts while at a Jimmy John's restaurants.  A total of at least 7 people were sickened in the outbreak.

            8.         In 2010, 140 people, mostly residents of Illinois, were sickened by of Salmonella, serotype I4,[5],12:i:-, in an outbreak linked to alfalfa sprouts served on Jimmy Johns sandwiches.  On December 21, 2010, Jimmy John Liautaud, the owner of the franchised restaurant chain, requested that all franchisees remove sprouts from the menu as a "precautionary" measure. On December 23, the Centers for Disease Control revealed that outbreak cases had been detected in other states and that the outbreak was linked with eating alfalfa sprouts while at a nationwide sandwich chain, a/k/a “Jimmy Johns”. On December 26, preliminary results of the investigation indicated a link to eating Tiny Greens’ Alfalfa Sprouts at Jimmy John’s restaurant outlets.

            9.         In 2009, at least 256 people were infected by Salmonella Saintpaul after consuming contaminated alfalfa sprouts.  Many of the 256 cases, but not all, were sickened after eating the contaminated sprouts on Jimmy Johns sandwiches.  The initial traceback of the sprouts indicated that although the sprouts had been distributed by various companies, the sprouts from the first cases originated from the same sprouting facility in Omaha, Nebraska. Forty-two of the illnesses beginning on March 15 were attributed to sprout growing facilities in other states; these facilities had obtained seed from the same seed producer, Caudill Seed Company of Kentucky. The implicated seeds had been sold in many states. On April 26, the FDA and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts. In May, FDA alerted sprout growers and retailers that a seed supplier, Caudill Seed Company of Kentucky, was withdrawing all alfalfa seeds with a specific three-digit prefix.

            10.       In 2008, at least 28 people were sickened in and around Boulder Colorado with E. coli O157:NM after consuming sandwiches containing contaminated alfalfa sprouts at several Jimmy Johns locations.  The investigation by Boulder County health officials revealed that consumption of alfalfa sprouts at the Jimmy John's Restaurants in Boulder County and Adams County were risk factors for illness. In addition, the environmental investigation identified Boulder Jimmy John's food handlers who were infected with E. coli and who had worked while ill. The health department investigation found a number of critical food handling violations, including inadequate handwashing. The fourteen isolates from confirmed cases were a genetic match to one another.

Download Iowa Jimmy John's Complaint

We the undersigned are writing to offer another perspective on Michael Taylor, the deputy commissioner for foods at the Food and Drug Administration, and the subject of a petition that SignOn.org, which is sponsored by MoveOn.org, is circulating on the Internet. The petition attacks Taylor based on his former employment at the controversial agricultural biotechnology company Monsanto. The undersigned have diverse views regarding genetically engineered foods, but we are unanimous in our belief that Taylor is a valued deputy commissioner, and we regret that a factually untrue Internet smear campaign has attracted so much support.

Several of us have been representing consumer interests on food safety and nutrition issues for most of our careers. All of us have known Michael Taylor for many years, including when he occupied previous high‐level positions in the federal government, taught at George Washington University School of Public Health, and even when he worked at Monsanto.

We acknowledge that Monsanto symbolizes a lot of things that many people (including some of us) don’t like about modern, industrial agriculture. But Mr. Taylor’s résumé is not reducible to his work at that company. It is far more relevant that in the Clinton Administration he headed the Food Safety and Inspection Service at the U.S. Department of Agriculture, where he stood up to the meat industry and fought for strict controls that help keep E. coli and other pathogens out of meat and poultry. Since joining the Obama Administration, Taylor has been working extraordinarily hard to transform the FDA from a reactive agency that chases down foodborne‐illness outbreaks after people fall ill, to a proactive public‐health‐based agency focused on preventing foods from becoming contaminated in the first place. We are confident that his leadership, formerly at USDA and now at FDA, has and will continue to reduce the number of Americans sickened, hospitalized, and killed by foodborne pathogens.

Also, the attack on Taylor includes statements about genetically engineered foods that are simply without any basis in fact. The petition states that since the introduction of GE foods, the “diagnosis of multiple chronic illnesses in the U.S. has skyrocketed,” and that the industry’s products “may also be contributors to colon, breast, lymphatic, and prostate cancers.” Reasonable people can disagree about Monsanto’s corporate policies (often bad), or the quality of government oversight of GE foods (inadequate), or the appropriateness of genetically engineering food crops in the first place. But all of us agree that there is no foundation for the outlandish statements made in the petition.

Undermining MoveOn’s credibility is that the petition’s author, Frederick Ravid, self‐ identifies as the “the 21st generation descendent from father‐to‐son of the famous 12th century Kaballistic [sic] Master Rabbi Abraham ben David, of Posquierres, known as the RaVaD.” Ravid’s web site claims that President Barack Obama is the reincarnation of a Civil War‐era Senator, Lyman Trumbull. It also indicates his belief that various events, such as the earthquake in Haiti or the founding of the League of Nations, are linked to solar eclipses. We mean no disrespect for Mr. Ravid’s religious beliefs, but we do question his respect for science.

We are disturbed that SignOn.org/MoveOn.org and other organizations have spread Mr. Ravid’s uninformed statements so far and wide, seemingly without any apparent concern about their veracity or of its author’s bona fides. Frankly, the petition represents the baldest sort of character assassination and plays right into the hands of those who are bent on convincing the public that all government officials are corrupt.

Michael Taylor has been an important part of an impressive food safety team that has accomplished an enormous amount in a short time. While the Administration has not accomplished everything we food safety advocates would like to see done, Mike Taylor, along with President Obama, USDA Secretary Tom Vilsack, Under Secretary for Food Safety Elisabeth Hagen, and FDA Commissioner Margaret Hamburg, have made great progress on food safety in a rather short period of time. They deserve the chance to keep on doing it, despite the conspiracy mongering to which Mr. Taylor is now being subjected.

We urge MoveOn to inactivate the petition, send an email to everyone who has signed the petition correcting its factual misstatements and offering instructions for people to unsign, and apologize to Mr. Taylor.

Sincerely,

Michael F. Jacobson, Ph.D., Executive Director Center for Science in the Public Interest

Shaun Kennedy, Director, National Center for Food Protection and Defense Director, Partnerships and Programs, College of Veterinary Medicine Assistant Professor, Veterinary Population Medicine University of Minnesota

William D. Marler, Esq. Marler Clark, The Food Safety Law Firm

J. Glenn Morris, M.D., Director, Emerging Pathogens Institute University of Florida

Michael Rodemeyer, Lecturer, Department of Science, Technology and Society University of Virginia, Former Executive Director, Pew Initiative on Food and Biotechnology

Donald W. Schaffner, Ph.D., Extension Specialist in Food Science and Professor Director of the Center for Advanced Food Technology Rutgers University

Deirdre Schlunegger Chief Executive Officer STOP Foodborne Illness

Carol L. Tucker‐Foreman, Distinguished Fellow, The Food Policy Institute Consumer Federation of America, Former Assistant Secretary of Agriculture

Hopefully, Parts 1 through 5 showed that there was plenty of blame to go around to farmers, shippers, brokers, auditors, retailers and the government, and that with just some simple precautions and focus, this outbreak would never have occurred.

On December 8, 2011, the CDC determined that deadliest foodborne illness outbreak was officially over and issued its final report. As of that date a total of 146 persons infected with any of the four (actually five) outbreak-associated strains of Listeria monocytogenes were reported to CDC from 28 states. The number of infected persons identified in each state was as follows: Alabama (1), Arkansas (1), California (4), Colorado (40), Idaho (2), Illinois (4), Indiana (3), Iowa (1), Kansas (11), Louisiana (2), Maryland (1), Missouri (7), Montana (1), Nebraska (6), Nevada (1), New Mexico (15), New York (2), North Dakota (2), Oklahoma (12), Oregon (1), Pennsylvania (1), South Dakota (1), Texas (18), Utah (1), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (4). Thirty deaths were reported: Colorado (8), Indiana (1), Kansas (3), Louisiana (2), Maryland (1), Missouri (3), Nebraska (1), New Mexico (5), New York (2), Oklahoma (1), Texas (2), and Wyoming (1). In addition, one woman pregnant at the time of illness had a miscarriage.

Since then two of my Listeria clients, Paul Schwarz (MO) and Sharon Jones (CO) have died. In addition, I learned recently Listeria victim, Dale Braddock (NE), also died. In addition dozens of others (my clients and not) are still suffering the impacts of eating Listeria-tainted cantaloupe. Most lives are forever changed for those who survived and the families of the 34 deaths (counting the miscarriage). Several of my clients’ acute phase medical expenses are over $5,000,000 total. Some will have similar expenses in the future. Despite the CDC’s determination of finality, it is far from over.

So, what has industry – farmers, shippers, brokers, auditors and retailers and the government done since the beginning of the outbreak or the announced end? The answer is nothing much, if at all. Did any visit a family, attend a funeral, invite them to a Congressional hearing, to visit the FDA, CDC or the White House? Of course not – those people, alive or dead, and their families, are just uncomfortable statistics.

Food safety will only become important when consumers are not statistics.

Here are all Six Parts of The Deadly 2011 Cantaloupe Listeria Outbreak - My View - Download PDF.

One Jimmy John's sprout outbreak was listed by the CDC in 2009 as "restaurant chain (Chain A)."

Multistate Jimmy John's Restaurants Raw Clover Sprouts 2011

12 Sickened - On February 15, 2012, the Centers for Disease Control announced an ongoing investigation into illnesses linked to the consumption of raw clover sprouts consumed at Jimmy John's Restaurants in several states. Among 11 ill persons with information available, 10 (91%) reported eating at a Jimmy John's sandwich restaurant in the 7 days preceding illness. Ill persons reported eating at 9 different locations of Jimmy John's restaurants in 4 states in the week before becoming ill. One Jimmy John's restaurant location was identified where more than one ill person reported eating in the week before becoming ill. Among the 10 ill persons who reported eating at a Jimmy John's restaurant location, 8 (80%) reported eating a sandwich containing sprouts, and 9 (90%) reported eating a sandwich containing lettuce. Currently, no other common grocery stores or restaurants are associated with illnesses. Preliminary traceback information has identified a common lot of clover seeds used to grow clover sprouts served at Jimmy John's restaurant locations where ill persons ate. FDA and states conducted a traceback that identified two separate sprouting facilities; both used the same lot of seed to grow clover sprouts served at these Jimmy John's restaurant locations. On February 10, 2012, the seed supplier initiated notification of sprouting facilities that received this lot of clover seed to stop using it. Investigations are ongoing to identify other locations that may have sold clover sprouts grown from this seed lot. http://www.cdc.gov/ecoli/2012/O26-02-12/index.html

Sprouters Northwest/Jimmy John's Restaurants Clover Sprouts 2010

7 Sickened - Sprouters Northwest of Kent, Washington, issued a product recall after the company's clover sprouts had been implicated in an outbreak of Salmonella Newport in Oregon and Washington. At least some of the cases had consumed clover sprouts while at a Jimmy John's restaurants. Jimmy John's Restaurants are a restaurant chain that sells sandwiches. Concurrent with this outbreak, a separate Salmonella outbreak (Salmonella, serotype I 4,5,12,i- ; see Multistate Outbreak, Tiny Greens Organic Farm, Jimmy John's Restaurants), involving alfalfa sprouts served at Jimmy John's restaurants was under investigation. The recall of Northwest Sprouters products included: clover; clover & onion; spicy sprouts; and deli sprouts. The Sprouters Northwest products had been sold to grocery stores and wholesale operations in Washington, Oregon, Idaho, Alaska, British Columbia, Saskatchewan, and Alberta. The FDA inspection found serious sanitary violations. http://www.foodsafetynews.com/2011/01/jimmy-johns-will-switch-to-clover-sprouts/, http://www.oregonlive.com/business/index.ssf/2011/01/jimmy_johns_switches_to_clover.html, http://www.thepacker.com/opinion/fresh-produce-opinion/jimmy_johns_sprout_switch_remains_puzzling_122028204.html

Multistate Outbreak, Tiny Greens Organic Farm, Jimmy John's Restaurants Alfalfa Sprouts 2010

140 Sickened - On December 17, the Illinois Department of Health announced that an investigation was underway into an outbreak of Salmonella, serotype I4,[5],12:i:-. Many of the Illinois cases had eaten alfalfa sprouts at various Jimmy John’s restaurants in the Illinois counties of: Adams, Champaign, Cook, DuPage, Kankakee, Macon, McHenry, McLean, Peoria, and Will counties. The sprouts were suspected to be the cause of the illnesses. On December 21, Jimmy John Liautaud, the owner of the franchised restaurant chain, requested that all franchisees remove sprouts from the menu as a "precautionary" measure. On December 23, the Centers for Disease Control revealed that outbreak cases had been detected in other states and that the outbreak was linked with eating alfalfa sprouts while at a nationwide sandwich chain. On December 26, preliminary results of the investigation indicated a link to eating Tiny Greens’ Alfalfa Sprouts at Jimmy John’s restaurant outlets. The FDA subsequently advised consumers and restaurants to avoid Tiny Greens Brand Alfalfa Sprouts and Spicy Sprouts produced by Tiny Greens Organic Farm of Urbana, Illinois. The Spicy Sprouts contained alfalfa, radish and clover sprouts. On January 14, 2011, it was revealed that the FDA had isolated Salmonella serotype I4,[5],12:i:- from a water runoff sample collected from Tiny Greens Organic Farm; the Salmonella isolated was indistinguishable from the outbreak strain. The several FDA inspections of the sprout growing facility revealed factors that likely led to contamination of the sprouts. http://www.cdc.gov/salmonella/i4512i-/122810/index.html

CW Sprouts, Inc., SunSprout Sprouts, "restaurant chain (Chain A)," a.k.a. Jimmy Johns 2009

256 Sickened - In February, Nebraska Department of Health and Human Services officials identified six isolates of Salmonella Saintpaul. Although this is a common strain of Salmonella, during 2008, only three cases had been detected in Nebraska and only four subtypes of this outbreak strain had been identified in 2008 in the entire USA. As additional reports were made, a case control study was conducted; alfalfa sprout consumption was found to be significantly related to illness. The initial tracebacks of the sprouts indicated that although the sprouts had been distributed by various companies, the sprouts from the first cases originated from the same sprouting facility in Omaha, Nebraska. Forty-two of the illnesses beginning on March 15 were attributed to sprout growing facilities in other states; these facilities had obtained seed from the same seed producer, Caudill Seed Company of Kentucky. The implicated seeds had been sold in many states. On April 26, the FDA and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts. In May, FDA alerted sprout growers and retailers that a seed supplier, Caudill Seed Company of Kentucky, was withdrawing all alfalfa seeds with a specific three-digit prefix.  Many of the illnesses occurred at "restaurant chain (Chain A)." http://www.cdc.gov/salmonella/saintpaul/alfalfa/, http://www.whas11.com/news/iteam/Salmonella-Outbreak-Linked-to-Louisville-Seed-Company-83577137.html, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5818a4.htm, See PDF linking outbreak to Jimmy John's a.k.a. "restaurant chain (Chain A)"

Jimmy John's Restaurant Alfalfa Sprouts and Iceberg Lettuce 2008

28 Sickened - Several University of Colorado students from one sorority became ill with symptoms of bloody diarrhea and cramping. Additional illnesses were reported. E. coli O157:NM(H-) was determined to be the cause. Consumption of alfalfa sprouts at the Jimmy John's Restaurants in Boulder County and Adams County were risk factors for illness. In addition, the environmental investigation identified Boulder Jimmy John's food handlers who were infected with E. coli and who had worked while ill. The health department investigation found a number of critical food handling violations, including inadequate handwashing. The fourteen isolates from confirmed cases were a genetic match to one another. http://www.thedenverchannel.com/news/17669936/detail.html

Again, CDC, why restaurant A?  Perhaps if the CDC would be more forthcoming as to who sells tainted sprouts, restaurants would put added pressure on suppliers to fix the problem before customers get poisoned?

The number of people sickened by raw milk linked to a Franklin County farm has climbed to 77, possibly making it the largest outbreak in Pennsylvania history.

Pennsylvania Department of Health officials said Thursday that the total number of cases continued to increase. The department has identified 67 cases in Pennsylvania, five in Maryland, two in New Jersey and three in West Virginia.

The outbreak of campylobacteriosis is the largest linked to raw milk in Pennsylvania in five years. The two prior record outbreaks since 2006 were both in 2008 - 72 cases during an outbreak originating in Lancaster County and 68 from Montgomery County raw milk. More than 250 people in Pennsylvania have become ill after drinking raw milk during the past five years, according to the state health department. Campylobacter bacteria caused six of the seven outbreaks during that time.

Individuals suffered digestive issues associated with a Campylobacter jejuni bacterial infection. The bacteria has been linked to unpasteurized milk sold by the Family Cow farm in Chambersburg.

“This outbreak has now become the largest outbreak associated with raw milk in Pennsylvania in at least the past two decades,” said health department spokeswoman Holli Senior.

For more information on the risks of raw milk, see Real Raw Milk Facts.

We should consider saving the U.S. Department of Agriculture's  Microbiological Data Program.

Social media will one day win a Pulitzer for giving people information long before the mainstream media (including, Food Safety News) even wakes up.  Thanks to the folks (Pope David) at Complete Patient for doing such a public service.  Here are some hot comments on what appears to be happening at Claravale Farm in California – the other commercial raw milk company in California:

Campylobacter Recall at Claravale?

A client of mine told me that her friend drinks Claravale and she has tested positive for campylobacter. She is now on antibiotics. Thus far Claravale has made a voluntary recall. I also heard that a half a dozen kids have been sick with bloody diarrhea and all of them were drinking Claravale. So far, the cultures have shown just campylobacter. All the kids are doing well. Some were not even treated with any medications.

It is my understanding that Claravale of California was started in 1927 and has never had a problem with their raw milk.

My prayers go out to Ron and his wife who own Claravale and all the people that have gotten sick.

February 16, 2012 | Cali Farmer

__________

Cali farmer,

As far as I know, Claravale has never had any issues with their milk. If what you posted is true, what changed? Why now?

I didn't find anything when I googles claravale nor did I see anything on their web site. I find it strange that it is not in the media.

February 16, 2012 | Sylvia Gibson

__________

Sylvia, CaliFarmer, when the dust settles I think you will find that whatever infections people may have did not come from Claravale.

I don't find it at all strange that there is nothing in the media. They have not been ordered to cease shipping by any government entity. I understand that they stopped shipping voluntarily to run additional tests after receiving a call from a few customers who said they had an illness.

We received a notice from our buying club that Claravale had voluntarily stopped shipping. We hope to have our milk back soon after they have a chance to check things out and ensure that nothing unusual has happened at their dairy.

In the past few weeks, there have been a number of cases of Campylobacter in California among a population that does not drink Claravale (or any other rawmilk). There have also been a rather large number of patients presenting to local hospitals in the extended SF Bay Area counties with "gastrointestinal flu".

We wish a speedy recovery to those who are ill.

My family and friends stand firmly in support of Claravale.

Our seniors, our children and everyone in between have been drinking Claravale daily for years. No illnesses here. My family has been buying their milk since the 1920's.

Never had any illnesses from Claravale.

February 16, 2012 | Suzanna

__________

OPDC delivery drivers are reporting to me that CA store dairy case managers are saying the official word is.... "Claravale has a plant problem". There has been no Claravale products in the stores for several days. Their website has no information. They are not answering their phone. CDFA has been silent. Their has been no media coverage at all.

I got a call from Cookson Beecher at Food Safety News today ( Bill Marlers online news letter ). They are tracking this story and told me that according to their sources, Campylobacter is involved somehow.....but not sure how. There appears to be an information void and rumors are rampant. I do know that OPDC raw milk orders are way up.

I wish every one at Claravale a rapid recovery from this first ever in 85 years....pathogen challenge. We pray for the rapid return to health for anyone that has become ill. I do know that the flu is going around like crazy right now and campylobacter and the flu are very close in symptoms.

California needs Claravale....we need Claravale, the consumers need Claravale.

I wish Ron and Collette strength and peace as they do what they need to do to get back into the market.

February 16, 2012 | Mark McAfee

We shall see what Friday brings.

A.  The outbreak’s “rogue elements”: the actions and inaction of others in the supply chain, and third parties, in bringing heavily contaminated fruit to market.

Jensen Farms’ inexcusable failures were its own, and certainly nobody will convince a jury that Jensen is blameless.  The question of causation, however, and whose actions and inactions caused or contributed to 146 illnesses, one miscarriage, and 32 deaths nationally is much broader.

Frontera was certainly no stranger to the Jensen Farms facility, and will not escape the duties of care that it too owed to consumers of its products to ensure that Jensen Farms’ cantaloupes were being safely produced.  A Frontera representative, Amy Gates, visited the facility just a short time before the fateful 2011 audit by James Dilorio,[1] which is addressed below, clearly to ensure that the farm and facility was in a proper condition for examination by its auditor of choice, Primus Labs, through Bio Food Safety.

According to the Jensen brothers, during her July 2011 visit, Amy Gates provided them with advice about preparing for the audit, but did not note any problems. Ms. Gates could have seen the conditions of Jensen’s facility (from its improper equipment, to the materials from which some of the equipment was made, to the propensity for the facility to be a breeding ground for bacteria, to the improper wash system, and the FDA’s list goes on) was ripe for anybody who favored safety over production to step in and prevent the most lethal outbreak in US history.

To read from Frontera’s website about its efforts to achieve better food safety would cause the ordinary consumer to believe that safety was, at the time of the outbreak, and remains a top priority.  Not only are its products dubiously billed as being “Primus Certified,” Frontera is stated to be GFSI compliant,[2] SQF certified,[3] and “Produce Marketing Association Gold Circle, Advancing Food Safety Certified.”

Undoubtedly, without even delving into the question of what these compliances and certifications actually mean, these safety systems recognize the importance of ensuring, at the very least, that all entities in the chain of distribution, from farm to fork, are following good agricultural and manufacturing practices, and have a dexterous understanding of basic food safety practices.

According to Will Steele:

Regarding our food safety requirements, we require that all suppliers commit to following federal government food safety guidelines appropriate to their individual operations.  These may include:  FDA’s Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables, Good Agricultural Practices and Good Manufacturing Practices.  Suppliers’ packing facilities and growing fields are required to undergo and pass third-party audits.  Finally, since 2009, we have been working with all our growers to move to third-party audits that comply with the Global Food Safety Initiative (GFSI).  Our implementation timetable is for all of the produce we market to be 100% GFSI compliant by the middle of next year, and we are on track to meet that goal.

See Steele November 28, 2011 Interview with The Packer.[4]

But the findings of every objective observer of Jensen Farms facilities and practices stands in stark contrast to everything that Frontera represented was right about its product line.  The truth of the matter is that Jensen Farms was grossly negligent, it did not follow basic industry standards, it did not follow FDA guidance, and it lacked even a basic understanding of how to safely grow and process cantaloupes at high volume to meet the distribution needs that Frontera set up for it.  Responsibility flows to more than one’s own business interests from business relationships, and Frontera did not act reasonably to ensure that Jensen’s clear failures, which were readily apparent even before the outbreak happened, were corrected.  Frontera was in a ready position to do so, at Amy Gates’ visit prior to the outbreak and at any other time, but did not act, instead relying on a very basic, and ultimately negligently conducted audit, designed primarily to ensure that product continued to flow so that Frontera could fulfill the many distributive obligations that it had secured.  After all, in what business position would Frontera have been if James Dilorio had failed Jensen Farms on July 26

In the wake of this monumental outbreak, the prevailing system for third-party audits has come under intense scrutiny.  Time and again, this firm has represented injured people, or the families of those who have died, in outbreaks where a negligent processor was given glowing reviews, only for investigating agencies later to find during unbiased, competent investigations done without the veneer of conflicting interests, that the facility in which the food was produced was not suitable for the production of CAFO-destined animal feed, much less food for human consumption.  And clearly, Jensen Farms’ packing facility was no exception.

Again, Mr. Steele:

In the wake of this experience, we are examining, among other things, the role of audits.  Third-party audits are an important and useful tool, but they are obviously not fail-safe.  Audits provide baseline information on conditions at the time they are conducted.  So we are looking at possible changes that might further enhance food safety.  One area of focus is whether additional steps are needed to validate the audit findings regarding food safety protocols that are in place.  Validation could be in the form of a follow-up audit, or perhaps other measures that will help provide additional assurance of food safety compliance.

Id.

[1]           Will Steele had been to Jensen Farms facility six times in a 6-year period.

[2]           “GFSI” stands for Global Food Safety Initiative.

[3]           “SQF” stands for Safe Quality Food.

[4]           http://www.thepacker.com/fruit-vegetable-news/Frontera-CEO-discusses-companys-role-in-listeria-outbreak-134589383.html

So, really, who would even want to inspect Tripe, Feet and Uteri?

FSIS announced today that JAA Meat Products Corporation, a Maywood, Calif. establishment, is recalling an undetermined amount of meat and poultry products because they may have been produced without the benefit of federal inspection. 

30-pound and 22-pound cases of the following products produced between January 11, 2011, and February 8, 2012:

• “AA Scalded Beef Omasum Tripe”
• “AA Honeycomb Beef Tripe”
• “AA Scalded Beef Tripe Menudo De Vovino”
• “AA Beef Omasum Tripe”
• “AA Beef Tripe”

10-pound bags of the following products produced between April 7, 2011, and February 8, 2012:

• Chicken feet
• Duck feet
• Pork uteri

The FDA’s Investigation at Jensen Farms

On September 10, 2011, with Colorado state officials, the FDA conducted an inspection at Jensen Farms and collected multiple samples, both product and environmental, for laboratory testing.  Of the 39 environmental swabs collected from within the Jensen Farms packing facility, 13 were confirmed positive for Listeria monocytogenes with PFGE pattern combinations that were indistinguishable from three of the five outbreak strains.  Of the 13 positive environmental swabs, 12 were collected at the processing line and one was collected from the packing area.  Cantaloupe collected from the firm’s cold storage during the inspection also tested positive for Listeria—in fact, five of the ten samples collected were positive for Listeria—with PFGE pattern combinations that were indistinguishable from two of the five outbreak strains.

After finding evidence of extensive contamination at Jensen Farms, the FDA, again with the assistance of Colorado state officials, conducted an environmental assessment at the facility in an effort to identify the practices and conditions that lead to such widespread contamination.  The results of the assessment, which occurred on September 23 and 24, 2011, were disclosed in a report dated October 19, 2011.  Among other things, the report notes:

a.   Facility Design:  Certain aspects of the packing facility, including the location of a refrigeration unit drain line, allowed for water to pool on the packing facility floor in areas adjacent to packing facility equipment.  Wet environments are known to be potential reservoirs for Listeria monocytogenes and the pooling of water in close proximity to packing equipment, including conveyors, may have extended and spread the pathogen to food contact surfaces.  Samples collected from areas where pooled water had gathered tested positive for an outbreak strain of Listeria monocytogenes.  Therefore, this aspect of facility design is a factor that may have contributed to the introduction, growth, or spread of Listeria monocytogenes.  This pathogen is likely to establish niches and harborages in refrigeration units and other areas where water pools or accumulates.

Further, the packing facility floor where water pooled was directly under the packing facility equipment from which FDA collected environmental samples that tested positive for Listeria monocytogenes with PFGE pattern combinations that were indistinguishable from outbreak strains.  The packing facility floor was constructed in a manner that was not easily cleanable.  Specifically, the trench drain was not accessible for adequate cleaning.  This may have served as a harborage site for Listeria monocytogenes and, therefore, is a factor that may have contributed to the introduction, growth, or spread of the pathogen.

b.   Equipment Design:  FDA evaluated the design of the equipment used in the packing facility to identify factors that may have contributed to the growth or spread of Listeria monocytogenes.  In July 2011, the firm purchased and installed equipment for its packing facility that had been previously used at a firm producing a different raw agricultural commodity.

The design of the packing facility equipment, including equipment used to wash and dry the cantaloupe, did not lend itself to be easily or routinely cleaned and sanitized.  Several areas on both the washing and drying equipment appeared to be un-cleanable, and dirt and product buildup was visible on some areas of the equipment, even after it had been disassembled, cleaned, and sanitized.  Corrosion was also visible on some parts of the equipment.  Further, because the equipment is not easily cleanable and was previously used for handling another raw agricultural commodity with different washing and drying requirements, Listeria monocytogenes could have been introduced as a result of past use of the equipment.

The design of the packing facility equipment, especially that it was not easily amenable to cleaning and sanitizing and that it contained visible product buildup, is a factor that likely contributed to the introduction, growth, or spread of Listeria monocytogenes.  Cantaloupe that is washed, dried, and packed on unsanitary food contact surfaces could be contaminated with Listeria monocytogenes or could collect nutrients for Listeria monocytogenes growth on the cantaloupe rind.

c.   Postharvest Practices:  In addition, free moisture or increased water activity of the cantaloupe rind from postharvest washing procedures may have facilitated Listeria monocytogenes survival and growth.  After harvest, the cantaloupes were placed in cold storage.  The cantaloupes were not pre-cooled to remove field heat before cold storage.  Warm fruit with field heat potentially created conditions that would allow the formation of condensation, which is an environment ideal for Listeria monocytogenes growth.

The combined factors of the availability of nutrients on the cantaloupe rind, increased rind water activity, and lack of pre-cooling before cold storage may have provided ideal conditions for Listeria monocytogenes to grow and out-compete background microflora during cold storage.  Samples of cantaloupe collected from refrigerated cold storage tested positive for Listeria monocytogenes with PFGE pattern combinations that were indistinguishable from two of the four outbreak strains.

See FDA Environmental Assessment Report, Attachment No. 1.

After conducting this environmental assessment, the FDA issued a warning letter to Jensen Farms, indicating that “we may take further action to seize your product(s) and/or enjoin your firm from operating.  Additionally, the receipt of this warning letter and any action taken to correct the violations cited in it do not preclude a subsequent criminal prosecution by the United States Department of Justice.”  See FDA Warning Letter to Jensen Farms, Attachment No. 2.  To date, despite 32 deaths, one miscarriage, and 146 confirmed illnesses nationally, no criminal indictments have issued in this outbreak—yet.

But the FDA did not close its file on this outbreak after issuing its very clear warning.  Officials from the agency also participated in the much-publicized briefings with the House Committee on Energy and Commerce in October and December 2011.  At those meetings, FDA officials cited multiple failures at Jensen Farms, which, according to the Committee Report, “reflected a general lack of awareness of food safety principles.”  Those failures, several of which draw from the FDA’s Environmental Assessment Report, included:

• Condensation from cooling systems draining directly onto the floor;
• Poor drainage resulting in water pooling around the food processing equipment;
• Inappropriate food processing equipment which was difficult to clean (i.e., Listeria found on the felt roller brushes);
• No antimicrobial solution, such as chlorine, in the water used to wash the cantaloupes; and
• No equipment to remove field heat from the cantaloupes before they were placed into cold storage.

In particular, the FDA heavily criticized the decision not to chlorinate the water used to wash cantaloupes, despite the fact that the wash was not re-circulated, as well as the use of improper processing equipment in the packing house.  As is discussed below, both of these factors not only contributed to the cause of the outbreak, but were the subject of discussion and recommendation by Primus Labs and its agent Bio Food Safety during the latter’s 2011 audit at Jensen Farms.

In short, the conditions, personnel, and facility in general at Jensen Farms in summer 2011 did not just fall well-short of good manufacturing practices and industry standard, they violated FDA guidance on the safe production of cantaloupes.  Some even violated basic, not to mention legal, standards of human decency.[1]  In fact, this is specifically the opinion held by FDA officials who spoke with the Committee in October and December:  “FDA officials stated that the outbreak could have likely been prevented if Jensen Farms had maintained its facilities in accordance with existing FDA guidance.”’

See Energy and Commerce Committee Report, Attachment No. 3.

[1]           As was widely reported in the press, the US Department of Labor assessed a civil penalty on Jensen Farms for “failing to provide migrant worker housing that meets the safety and health requirements of the Migrant and Seasonal Agricultural Worker Protection Act.”  The “Gateway Motel” in Holly, Colorado, owned by the Jensen brothers, had been “renting” rooms to Jensen Farms workers that were overcrowded, lacked functional windows, lacked any laundry facilities, lacked smoke detectors, and had numerous other unsanitary conditions.  The Department of Justice rejected the Jensen brothers argument that they were “innkeepers” and thus exempt from the reach of the Act.  Chad Frasier, the Wage and Hour Division’s district director in Denver stated that the Jensen brothers’ actions in housing their workers in such deplorable conditions was both “inhumane” and “illegal.”

Chris Ingalls’s final part to his story “Mold at WA food plant reveals flaws in food safety net” underscores the need to consider a single food safety agency or at a minimum to get the USDA and FDA working together. So says, “Bill Marler, a Seattle attorney and renowned food safety advocate (blush).”

This is the first of a six part series on my view of the deadly cantaloupe Listeria outbreak of 2011.

First, a Bit of History

Although the 2011 outbreak was the first known Listeria outbreak associated with cantaloupe, cantaloupe outbreaks are by no means a new phenomenon.  Since 1985, in fact, there have been no less than 15 recognized outbreaks in the U.S. involving cantaloupes, grown domestically and internationally:

The CDC’s Case Count

A total of 146 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes were reported to CDC from 28 states.  The number of infected persons identified in each state was as follows:  Alabama (1), Arkansas (1), California (4), Colorado (40), Idaho (2), Illinois (4), Indiana (3), Iowa (1), Kansas (11), Louisiana (2), Maryland (1), Missouri (7), Montana (1), Nebraska (6), Nevada (1), New Mexico (15), New York (2), North Dakota (2), Oklahoma (12), Oregon (1), Pennsylvania (1), South Dakota (1), Texas (18), Utah (1), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (4).

Among persons for whom information was available, reported illness onset ranged from July 31, 2011 through October 27, 2011.  Ages ranged from <1 to 96 years, with a median age of 77 years.  Most cases were over 60 years old.  Fifty-eight percent of cases were female.  Among the 144 ill persons with available information on whether they were hospitalized, 142 (99%) were hospitalized.

Thirty deaths[1] were reported:  Colorado (8), Indiana (1), Kansas (3), Louisiana (2), Maryland (1), Missouri (3), Nebraska (1), New Mexico (5), New York (2), Oklahoma (1), Texas (2), and Wyoming (1).  Among persons who died, ages ranged from 48 to 96 years, with a median age of 82.5 years.  In addition, one woman pregnant at the time of illness had a miscarriage.  Seven of the illnesses were related to a pregnancy; three were diagnosed in newborns and four were diagnosed in pregnant women.

[1]           We believe that number should now be 32 with the additional deaths of Sharon Jones and Paul Schwarz.

Pennsylvania Department of Health reported an additional five Campylobacter cases have been confirmed linked to raw milk produced by the Your Family Cow dairy.  The total now stands at 65 the Pennsylvania Department of Health reported Monday.

The latest breakdown of illnesses by state are:

Pennsylvania (56),

Maryland (4),

West Virginia (3), and

New Jersey (2).

Raw milk in two unopened bottles from the dairy tested positive for the outbreak strain of Campylobacter, according to Maryland health officials.

Yesterday it was a Boise, Idaho Cheesecake Factory restaurant that had an employee test positive for Hepatitis A while he or she worked, presenting a risk of infection to restaurant customers.  The Boise employee apparently was not involved in food preparation however, so the risk of infection to customers is thought to be low.  Though, if that employee had had a Hepatitis A vaccine, there would have been no bad news for the Cheesecake Factory or its customers.  Now customers must wait to see if symptoms show.

News reports today out Gonzales Restaurant in Dallas County, Texas in another Hepatitis A problem.  Apparently, an employee tested positive for Hepatitis A.  The Dallas County Health Department is now trying to contact people who ate there between January 25-28.  Again, this would not be news if that employee had had a Hepatitis A vaccine.  Now, again, customers must wait to see if symptoms show.

A new CDC report shows in 2010 just over 10 percent of people between the ages of 19 and 49 years old got a Hepatitis A shot.  The CDC says more needs to be done to encourage adults to get their vaccinations, including increasing access to immunizations and educating people on their importance.  Hepatitis A can be serious:

Richard Miller Hepatitis A Food Poisoning Illness and Lawsuit from Marlerclark on Vimeo.

According to the Pennsylvania Department of Health, the total number of Campylobacter cases linked to raw milk produced Edwin Shank’s Family Cow Dairy has hit 60 total cases. The per State breakdown is:

51 in Pennsylvania

4 in Maryland

2 in New Jersey

3 in West Virginia

Its been a busy week.

Stephanie Armour of Bloomberg – “Expanded E. Coli Testing on Hold Until June 4, USDA Officials Announce:”

The industry has fought the regulation, saying there’s no proof the expanded testing will prevent illnesses or outbreaks and that it may cost as much as $300 million a year.

“Hopefully this will stop the excuses by industry,” said Bill Marler, a Seattle food safety lawyer who obtained about $30 million in legal settlements against Jack in the Box Inc. (JACK) following a 1994 outbreak linked to E. coli. “I’m not at all surprised they’re giving the industry a little more time.”

Barry Estabrook of the Atlantic – “Restaurant A: How Bill Marler Tied Taco Bell to Salmonella Outbreaks:”

It should have read “How Food Safety News Tied Taco Bell to the Salmonella Outbreaks:” 

Reporters from Food Safety News, the online newspaper funded by Marler's firm, contacted all six of the possible companies. They either refused to reply or insisted that they were not Restaurant Chain A. The reporters kept digging and eventually came across a document from Oklahoma's Department of Health. (Oklahoma was one of the affected states.) Marked "for internal use only" the document was called "Summary of Supplemental Questionnaire Responses Specific to Taco Bell Exposure of Oklahoma Outbreak Associated Cases Multistate Salmonella Enterititis Outbreak Investigation" (PDF). It's a long, convoluted title, but the important words were "Taco Bell."

Marler is nothing if not tenacious -- just ask the food processers who have paid more than $600 million to his clients in the past two decades.

A restaurant poisons its customers. A government agency colludes to keep its identity under wraps. And it takes a scrappy trial attorney to uncover the truth for Americans. Talk about a sickening situation.

And, then there was Jon Humbert at KVAL talking about meat glue - “There's the beef! Now what's in it?”

Food safety lawyer Bill Marler battles companies that cut corners to get food onto customers' plates.

"I thought it was a joke," Marler said of the meat glue.

He said there's a serious gross-out factor when he sees online videos of the tasteless, odorless powder turning stew meat into steak.

"I'm a real firm believer that consumers have a right to know what they are putting in their bodies," he said.

The Food and Drug Administration says meat glue is regarded as safe as long as fused food is cooked to at least 165 degrees.

The problem is that while a steak ordered well done will reach that temperature, anything ordered medium well and below could have bacteria growing at the glue points.

E. coli, Taco Bell and Meat Glue all in one week.  Is that like a hat trick?

Would the 1993 Jack in the Box E. coli outbreak ever have happened?

Over the last few weeks I have been I taking industry (well, Taco Bell) and government (well, CDC, FDA and eight states) to task for the failure to give up the name of mystery "Mexican-style fast food restaurant chain, Restaurant Chain A" as Taco Bell. However, not “naming names” is not a new, or frankly useful, phenomenon. In medical journal articles and in CDC publications over the years, the use of mystery “Restaurant A” is far more common that you would suppose.

A Bit(e) of History:  In 1993, I was a young, ambulance chasing attorney (much thinner and with darker hair) who had his first big case in how the CDC described in 1993 as the “Multistate Outbreak of Escherichia coli O157:H7 Infections from Hamburgers -- Western United States, 1992-1993” linked to “Restaurant A” (a.k.a. Jack in the Box). Although in medical publications the name of the restaurant to this day still remains a mystery, and the CDC in presentations still keep Jack in the witness protection program, public health officials and media in Washington State let Jack out of the box in 1993.

At the beginning of the Jack in the Box case, in researching E. coli O157:H7 and hemolytic uremic syndrome (HUS) – frankly, even learning how to say them – I headed to the University of Washington Medical School Library where I stumbled upon this article:

Hemorrhagic colitis associated with a rare Escherichia coli serotype. N Engl J Med. 1983 Mar 24; 308 (12): 681-5. Riley LW, Remis RS, Helgerson SD, McGee HB, Wells JG, Davis BR, Hebert RJ, Olcott ES, Johnson LM, Hargrett NT, Blake PA, Cohen ML.

We investigated two outbreaks of an unusual gastrointestinal illness that affected at least 47 people in Oregon and Michigan in February through March and May through June 1982. The illness was characterized by severe crampy abdominal pain, initially watery diarrhea followed by grossly bloody diarrhea, and little or no fever. It was associated with eating at restaurants belonging to the same fast-food restaurant chain in Oregon (P less than 0.005) and Michigan (P = 0.0005). This report describes a clinically distinctive gastrointestinal illness associated with E. coli O157:H7, apparently transmitted by undercooked meat.

At first I thought “the same fast-food restaurant chain” must be Jack in the Box. I mean who else would poison kids in multiple states a decade apart? However, with a bit more digging, I learned that the 1982 undercooked burgers were Ronald’s not Jack’s.

So, what about transparency?  Medical journals and CDC publications become documents of record - they become history.  What if 1983 Jack in the Box knew that its chief competitor poisoned a bunch of kids?  Would Jack in the Box increased temperatures and cook times for its Jumbo Jack and avoided 1993?

Would they have denied my modest place in history?

If you hide the names, only those who know, know.  Yes, after 20 years of doing this, I can usually crack the code, but really, how useful is it to keep information like this secret from everyone else?

Food Safety News dogged reporters did what the government and Taco Bell did not do, be open with the public about the Salmonella Outbreak Linked Taco Bell restaurants in ten states.  FSN first reported that Oklahoma and Michigan broke ranks with the FDA, CDC and other states when those two states let FSN know the name of the mystery mexican-stye restaurant chain A.  It is good that FSN is getting the recognition it deserves.

Other media citing Food Safety News:

LA Times, Reuters, Daily Mail, The Consumerist, CBS News, Huffington Post, Fox News, MSNBC, Etc.

Laboratory testing by the Department of Health has identified Clostridium perfringens as the cause of the outbreak associated with the Pierre-Mitchell high school boys’ basketball game held in Pierre January 31. The investigation, which included voluntary questionnaires, implicated the tacos as the source food of the outbreak – of those completing questionnaires, 75% who ate the tacos reported becoming ill. The predominant symptoms were diarrhea and cramps lasting less than 24 hours, although the symptoms in some ill persons lasted longer. Three-quarters of the cases became ill between midnight and 6:00 AM following the game.

Clostridium perfringens is a bacterium that is sometimes found on raw meat and poultry products. It is also found in many environmental sources and in the intestines of animals and humans. Clostridium perfringens poisoning can occur when large quantities of food are prepared and kept at unsafe temperatures. Anyone can get food poisoning from Clostridium perfringens, but the very young and elderly are at highest risk. Dehydration may occur in severe cases. The illness is not passed from one person to another.

This type of food poisoning can be prevented by proper cooking and proper refrigeration. Meat dishes should be served hot, immediately after cooking. Leftover foods should be refrigerated at 40°F or lower. Large pots of food, such as soups or stews, or large cuts of meats, such as roasts or whole poultry, should be divided into small quantities for refrigeration. Leftovers should be reheated to at least 165°F before serving.

There is a truism today (and perhaps it always has been that way) that if a document exists, even if you stamp "FOR INTERNAL DISTRIBUTION ONLY" on it, it will become public eventually.  So, despite the silence from the CDC, FDA and eight states, here is the Taco Bell or "Mexican-style fast food restaurant chain, Restaurant Chain A" Salmonella Enteritidis outbreak Power Point:

The other day I said to MSNBC:

"I think it just proves the point that it is always better to be transparent," said Bill Marler, a Seattle food safety lawyer who used his blog to lobby vigorously for the release of the name. "Taco Bell could have looked like a hero by coming out and saying that it was a supplier problem and they are going to work hard to make sure it never happens again."

According to the CDC’s final report, a total of 146 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes were reported to CDC from 28 states. The number of infected persons identified in each state was as follows: Alabama (1), Arkansas (1), California (4), Colorado (40), Idaho (2), Illinois (4), Indiana (3), Iowa (1), Kansas (11), Louisiana (2), Maryland (1), Missouri (7), Montana (1), Nebraska (6), Nevada (1), New Mexico (15), New York (2), North Dakota (2), Oklahoma (12), Oregon (1), Pennsylvania (1), South Dakota (1), Texas (18), Utah (1), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (4).

Among persons for whom information was available, reported illness onset ranged from July 31, 2011 through October 27, 2011. Ages ranged from <1 to 96 years, with a median age of 77 years. Most ill persons were over 60 years old. Fifty-eight percent of ill persons were female. Among the 144 ill persons with available information on whether they were hospitalized, 142 (99%) were hospitalized.

Thirty deaths were reported: Colorado (8), Indiana (1), Kansas (3), Louisiana (2), Maryland (1), Missouri (3), Nebraska (1), New Mexico (5), New York (2), Oklahoma (1), Texas (2), and Wyoming (1). Among persons who died, ages ranged from 48 to 96 years, with a median age of 82.5 years. In addition, one woman pregnant at the time of illness had a miscarriage.

Two more have died since the CDC’s report became final. It is likely that the CDC will never count them, but they should.

Lest we forget, this outbreak was much more than statistics.

And, for that matter other amphibians and reptiles.

CDC just released a new report entitled “Outbreak of Salmonellosis Associated with Pet Turtle Exposures — United States, 2011”. This report describes an outbreak of 132 human Salmonella infections between August 2010 and September 2011 associated with exposure to small turtles (those with shell lengths < 4 inches). Many of these infections occurred in young children, whose illness can be severe and cause hospitalization. Despite a three decade ban on the sale of small turtles, these infections continue to occur. CDC reported similar outbreaks in 2007 and 2008.  Increasing enforcement of existing regulations, increasing penalties for illegal sales and emphasizing regulations can assist in decreasing infections acquired from these reptiles. Turtles are not appropriate pets in households with young children or other high risk individuals (pregnant women, older persons and the immune-compromised).

Please follow this link to educational materials on human Salmonella infections associated with small turtles and other reptiles.  Also, a web-friendly flyer is located at the following website so other organizations can link to it online: http://www.cdc.gov/healthypets/resources/posters.htm

The CDC is asking for your help to further distribute this educational flyer to help convey the important prevention messages to any individuals, groups, or organizations involved with turtles and other pet reptiles. We recommend that these flyers be displayed where young children may come into contact with small turtles, like pet stores, flea markets, day care centers, and schools. 

Michael Foods, Inc. is recalling specific lot dates of hard-cooked eggs in brine sold in 10- and 25-pound pails for institutional use that were produced at its Wakefield, Nebraska facility because the product has the potential to be contaminated with Listeria monocytogenes. Listeria monocytogenes is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.  Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

The recalled eggs were purchased by food distributors and manufacturers located in 34 states (AL, AR, AZ, CA, CO, FL, GA, IA, IL, IN, KS, KY, LA, MI, MN, MO, MS, MT, NC, ND, NE, NJ, NV, OH, OK, OR, PA, SC, TN, TX, UT, WA, WI, WV). The recall is limited to hard-cooked eggs in brine in 10- and 25-pound pails prodced at its Wakefield, Nebraska facility, which are labeled under six brand names (Columbia Valley Farms, GFS, Glenview Farms, Papetti’s, Silverbrook, Wholesome Farms) and bearing lot codes of 1 LOT 1350W through 1 LOT 2025W and expiration dates ranging from 1/30/2012 to 3/10/2012

Only lot codes immediately preceded by a “1” AND ending in a “W” are affected, please see the following example:

Here is an example of the lot codes on the packaging: USE BY 11 FEB 12    1  LOT 1362 W – Product Labels

USE BY 11 FEB 12 = Use by Date
1 = line impacted by recall
LOT 1362 = Lot Number
W = Wakefield 

None of the eggs were sold directly by Michael Foods to retailers or consumers.  However, food distributors and manufacturers who purchased the eggs could have used them in products that were sold to retail outlets or used in foodservice settings.  Michael Foods is working with customers who purchased eggs from these lots to ensure that all product is removed from the market.  Consumers who believe they might have purchased product affected by the recall, or those who are unsure, should contact the original place of purchase.        

There have been no confirmed reports of illness in connection with this product.

The recall was initiated after lab testing revealed that some of the eggs within the recalled lot dates may have been contaminated with Listeria monocytogenes.  A recall of three lot dates was announced on Thursday, January 26.  As a precautionary measure, the recall was expanded today to include additional lot dates.  Michael Foods reached the decision to expand this recall after a thorough investigation which indicated a specific repair project that took place in the packaging room as the likely source of the

Ethanol has long been promoted (especially by farm state Senators) as a solution to greenhouse gas emissions. In 2005, Congress passed the Renewable Fuel Standard, which mandated that 7.5 billion gallons of renewable fuel be blended into gasoline by 2012. Two years later it increased this amount to 36 billion gallons by 2022. Ethanol – the most common alternative fuel – is now blended into 70% of the nation’s gas.

So what’s the benefit? The U.S. Department of Energy says that ethanol production and use will reduce greenhouse gas emissions by up to 52%, compared to gasoline production and use.

But the list of ethanol cons - or “corns,” if you will - is lengthy. It includes:

-       Ethanol is harming the meat, egg and dairy industries by taking up huge amounts of the country’s corn supply (now 40%) thereby driving up the cost of the grain used to feed livestock, and in turn upping the cost of commodities that come from animals.  The end of 2011 saw the end of the government’s $5 billion in annual subsidies to the ethanol industry, but its alternative fuel requirement remains the same, meaning that if corn needs to be rationed, ethanol producers may be exempt from this rationing, putting more of a burden on meat producers, who will have to reduce the amount of animals they raise and slaughter, which will in turn make meat more expensive for consumers.

-       Ethanol uses up more energy than it produces. A study out of the University of California Berkley and Cornell University found that producing a liter of ethanol requires 29% more fossil fuel energy than the ethanol energy it produces. And ethanol may not even be more efficient than gasoline. It takes an estimated 2.2 billion gallons in oil equivalents to produce 1.7 billion gallons of ethanol, according to a 2001 article from Cornell University.

-       Ethanol production takes up large amounts of land, irrigation water and other resources. It takes 2.69 kg of corn grain to produce 1 liter of ethanol. In 2005, to produce the 10.6 billion gallons of ethanol used in the United States, approximately 1,335,000 acres of land were needed.

-       Gas with ethanol is harder on a car’s engine than pure gasoline, and cars that use ethanol mixes are less fuel-efficient.

-       For the first time in 40 years, last year the U. S. was no longer the world’s biggest corn exporter, as more and more corn goes to domestic ethanol production.

-       There are children starving in Africa – actually. In a world where the food supply is becoming an increasing problem (35% of deaths of children under 5 are due to malnutrition), corn is one of the cereal grains that make up 80 percent of what the world eats, and is therefore essential to combatting global hunger. Reducing corn exports reduces the amount of the grain available to other countries.

Now, a new study by U.S. Department of Agriculture, Agricultural Research Service, U.S. Meat Animal Research Center has pointed out yet another drawback of an ethanol byproduct, wet distillers grains with solubles (WDGS), could also be harmful to public health.

According to the study, with the catchy title “Impact of Reducing the Level of Wet Distillers Grains Fed to Cattle Prior to Harvest on Prevalence and Levels of Escherichia coli O157:H7 in Feces and on Hides,” found that cattle fed finishing diets with WDGS, as opposed to a predominantly corn diet, have been shown to harbor increased Escherichia coli O157:H7 populations in the feces and on the hides.

The problems with ethanol appear many and the benefits few, and more importantly, it appears to be downright dangerous.

Oklahoma State Department of Health
Acute Disease Service 

Summary of Supplemental Questionnaire Responses Specific to
Taco Bell Exposure of Oklahoma Outbreak-associated Cases
Multistate Salmonella Enteritidis Outbreak Investigation
November 2011 – January 2012 

Summary Demographic information

• 16 cases in 5 Oklahoma counties - Cleveland (10), Bryan (2), Lincoln (2), Pottawatomie (1), and Greer (1)

• Onset date range: 10/21/2011 – 11/18/2011 - 1 onset date unknown but believes around Thanksgiving

• Hospitalizations: 4

• Gender distribution: 10 (63%) females and 6 (37%) males

• Age range: 5 to 78 years (median 23 years)

Taco Bell exposure summary of Oklahoma cases from supplemental case-control questionnaire responses

• Total Oklahoma cases: 16

• Total interviewed: 12/16 (4 refused or were lost-to-follow-up)

• Consumed food from Taco Bell: 8/11

Like I said to MSNBC:

But food safety advocates had been putting pressure on state and federal agencies to reveal the name of firms involved in outbreaks in this case -- and those in the future.

"I think it just proves the point that it is always better to be transparent," said Bill Marler, a Seattle food safety lawyer who used his blog to lobby vigorously for the release of the name. "Taco Bell could have looked like a hero by coming out and saying that it was a supplier problem and they are going to work hard to make sure it never happens again."

And, Taco Bell's response:

In response Taco Bell said in a statement that investigators found that some of the people who became ill ate at Taco Bell, while others did not. "They believe that the problem likely occurred at the supplier level before it was delivered to any restaurant or food outlet. We take food quality and safety very seriously," Taco Bell said.