May 2013

An E. coli O157:H7 outbreak linked to BBQ Shack in Toccoa Georgia sickened as many as 18 people, health officials announced Friday.

Several of the victims were hospitalized as a result of their infections, and five developed hemolytic uremic syndrome (HUS), a complication of E. coli infection that leads to kidney failure.

The outbreak appears to be over, and to have lasted only a short time, according to health officials. Patients fell ill between May 4 and May 8, 2013. No cases with onset dates after May 8 have been reported.

Among the potential vehicles of the bacteria identified by investigators is iced tea served at the restaurant.

According to the Colorado Department of Public Health & Environment, Townsend Farms Organic Antioxidant Blend frozen berries purchased from Costco appear to be the source of a five state Hepatitis A outbreak.  Approximately 30 cases of hepatitis A have been reported from Colorado, New Mexico, Nevada, Arizona and California. The first people became ill on April 29 and the most recent on May 21.

The product is an organic blend of cherries, blueberries, pomegranate seeds, raspberries and strawberries. Costco has removed this product from its shelves, but has not yet issued a formal recall. The U.S. Food and Drug Administration (FDA) is investigating the product, including testing berries for the Hepatitis A virus, which may take several weeks.

The Hepatitis A vaccine can prevent infection if given within 14 days of exposure. Some people should receive immune globulin instead of the Hepatitis A vaccine.  If you ate these berries within the past 14 days please discuss with your doctor whether you should receive the hepatitis A vaccine or immune globulin. If you have received hepatitis A vaccine in the past, you do not need to be revaccinated.

Early signs of Hepatitis A appear two to six weeks after exposure. Symptoms commonly include mild fever, loss of appetite, nausea, vomiting, diarrhea, fatigue, pain in the upper right side of the abdomen, dark urine and jaundice (yellow eyes or skin). It is very important if you have these symptoms that you do not go to work, especially if you work in food service, health care or child care.

The disease varies in severity, with mild cases lasting two weeks or less and more severe cases lasting four to six weeks or longer. Hepatitis A infection can be severe and can result in hospitalization.

Some individuals, especially children, may not develop jaundice and may have an illness so mild it can go unnoticed. However, even mildly ill people can be highly infectious. People with symptoms suggestive of hepatitis should consult a physician immediately, even if symptoms are mild.

Hepatitis A virus is spread as a result of fecal contamination (fecal-oral route) and may be spread from person to person through close contact or through food handling. Contaminated food or beverages commonly spread the virus. People are at increased risk of acquiring hepatitis A when they have been in close contact with an infected person.

Hepatitis A can cause severe disease.

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

Tip of the pen to Lynne Terry.

A total of 35 persons infected with the outbreak strain of Shiga toxin-producing Escherichia coli O121 (STEC O121) were reported from 19 states.

82% of ill persons were 21 years of age or younger.

31% of ill persons were hospitalized. Two ill persons developed hemolytic uremic syndrome (HUS), a type of kidney failure, and no deaths were reported.

Collaborative investigative efforts of local, state, and federal public health and regulatory agencies indicated Farm Rich brand frozen food products were the source of this outbreak.

On April 4, 2013, Rich Products Corporation expanded its recall to include all Farm Rich, Market Day, and Schwan’s brand frozen food productsExternal Web Site Icon produced at its Waycross, Georgia plant between July 1, 2011 and March 29, 2013 due to possible contamination with E. coli O121.

The recalled products had “Best By” dates ranging from January 1, 2013 to September 29, 2014.

We have filed two lawsuits on behalf of sickened customers.

The Cumberland County Department of Public Health continues to investigate the source of a Salmonella infection outbreak announced May 14 at the Holiday Inn Bordeaux, 1707 Owen Drive.

To date, 99 cases of individuals with signs and symptoms consistent with Salmonella infection have been reported.  Six people have been hospitalized.

“The last date for onset of sickness is May 15, an indication that control measures put in place to prevent further spread of the illness appear to be working,” said Health Director Buck Wilson. As part of the ongoing investigation, the Health Department and the North Carolina Division of Public Health continue to ask any individuals who have experienced symptoms such as nausea, vomiting and diarrhea within three days of eating or consuming beverages at the Holiday Inn Bordeaux since May 1 to call the county Health Department at 910-433-3638.

The Holiday Inn Bordeaux serves food at two restaurants, the All American Sports Bar and Grill and the Café Bordeaux, and from a banquet kitchen.

The Health Department has set up a “Salmonella Hotline” at 910-433-3824.

Cape Fear Valley Health System has a Care Link health education line staffed by registered nurses. Call at 615-LINK (5465) with questions about Salmonella infection.

The Pennsylvania Departments of Agriculture and Health today advised consumers to discard raw milk produced by The Family Cow in Chambersburg, Franklin County, because of potential bacterial contamination.

Agriculture and Health Department laboratory tests and several recent illnesses indicate the raw milk may contain Campylobacter bacteria.

The Department of Health has confirmed five cases of confirmed Campylobacter infection in people who consumed milk from the farm at 3854 Olde Scotland Road.

Based on the reported illnesses, the Department of Agriculture collected samples of raw milk during an investigation of The Family Cow, on May 17. Positive tests for Campylobacter were confirmed Tuesday.

The packaged raw milk is sold under The Family Cow label in plastic gallon, half-gallon, quart and pint containers. It is labeled as “raw milk.” Raw milk is milk that has not been pasteurized.

The Family Cow, owned and operated by Edwin Shank, sells directly to consumers in an on-farm retail store and at drop off locations and retail stores around Pittsburgh, Philadelphia and the Lehigh Valley, as well as south-central Pennsylvania.

Agriculture officials ordered the owners of the farm to stop the sale of all raw milk until further notice.

Last week the Brazos County Health Department appropriately announced that the source of the E. coli O157:H7 outbreak that sickened 10, putting two young brothers in a Houston hospital with acute kidney failure (HUS), was traced to ground beef from a College Station restaurant. According to those health officials, the Coco Loco restaurant across the street from Texas A&M served the ground beef tacos that caused the illnesses.

By the time of the announcement, one of the two children at Texas Children’s Hospital in Houston has been released. His 18-month-old brother had been upgraded to good condition. The adults fortunately had mild illnesses.

Brazos County Health Authority Dr. Eric Wilke said the restaurant is now making changes to improve safety by adding gloves and logs for food temperature. However, he was not sure if the cause was undercooked ground beef or cross contamination. “The two most likely things are either someone touched raw meat and then their hands didn’t get clean and they touched other things and that’s how it transmitted bacteria or some meat was undercooked,” he said.

Don Plitt, director of environmental services for the Brazos Health Department, outlined a number of standards that have been put in place at Coco Loco to avoid another accidental contamination, which include:

  • Requiring kitchen staff to wear gloves and maintain a temperature log for cooked meat.
  • Health inspectors will increase their annual visits from two to three times per year to four to five.
  • Having kitchen staff go through training for proper thawing and handling of meat, which has already been done.

All the above was completely professional, and what I have grown to expect, and respect, from professionals across the country once the source of an outbreak is announced.

But, what could have been a teaching moment for all turned a bit more than odd last Tuesday as local reporters and a Houston TV news crew gathered for an update on the E. coli investigation. Just before Dr. Wilke announced the source of the bacteria had been traced to the Coco Loco restaurant off George Bush Drive in College Station, he did something I have never seen a public health official ever do in 20 years of following foodborne illness outbreaks – he took a bite – just before he began to speak – of the food product – a taco – that sickened 10 of his fellow citizens.

Apparently, the idea was to stress that the outbreak was considered an isolated incident and that the restaurant was now considered a safe place to eat.

However, others did not quite see it the same way. According to local College Station media, by Wednesday, the press conference had been picked up by food industry bloggers as well as statewide and national media, and had spurred a slew of comments from area residents and elsewhere, who felt Wilke’s behavior at the press conference was inappropriate and insulting to the families affected by the E. coli.

Really?

By Thursday, Dr. Wilke seemed to have regained his senses. As he said to the local paper: “I would just like to say that I’m sorry if anything I said, or did, yesterday gave the impression to some people that I did not appreciate the gravity of what was going on,” he said. “It was simply an attempt to quell some of the public’s concerns about food safety.” Wilke also said he apologized personally to Greg Melton, the children’s father, and said that Melton was very gracious about it.

Honestly, the Meltons are better than me. If I were Wilke’s boss, I would have fired him on the spot. Public health is the public’s health it is not assuring the sales of tacos from a place that either undercooked meat or cross-contaminated its kitchen.

You can see the video HERE.

A man fought for our country in World War II and earned a Purple Heart, and then he died 57 years later after eating a Listeria-tainted cantaloupe grown here in the United States – the country he fought for.

Food Safety and the CEO – Keys to Bottom Line Success

Foodborne illness has, of course, been around as long as there has been food. But the identification and diagnosis of these diseases is an emerging science that is changing all sectors of the food business, and those chief executive officers (CEOs) and senior level directors and managers who do not keep up are bound to be at a significant disadvantage when making critical decisions about their businesses.

It is one thing to read or view media reports on the latest foodborne illness outbreaks and brand-damaging product recalls; it is quite another to really understand the widespread, adverse impact these incidents have on your consumer base, on your employees, on the efficiencies of your operations, and ultimately, on your bottom line. In other words, today’s food company CEO needs to know a lot more than producers in the fresh-cut produce industry initiated massive recalls last week, or that a regional restaurant chain closed down, or that a spate of pet fatalities due to the inclusion of a banned substance on an international scale means his or her company should look more closely at imported ingredients for awhile.

What you, the CEO, should know about food safety comes down to a few key concepts. First, all companies along the food supply chain need to go beyond managing the business: To be successful, food companies are now in the business of managing risk. This means garnering a good understanding of why food safety is important to your business, what risks there are to the business, how you can mitigate or eliminate those risks, and how in doing so the food safety program will provide a return on your investment.

Why Food Safety Needs Your Immediate Attention

E. coli O157:H7, which occupies much of my professional time as an attorney, was only first recognized as a human pathogen in 1982 during an outbreak of illness caused by hamburgers from a fast food restaurant in Oregon.(1)  But, the problem drew little public attention for another decade when, finally, 600 people across the West, most of them children or senior citizens, became ill after eating undercooked Jack in the Box hamburgers.(2)  Four children died, and many others suffered terrible kidney damage, which may eventually lead to the need for transplants.

I became involved when a friend of woman for whom I’d done some pro bono work years earlier contacted me.  The friend’s daughter, Brianne Kiner, had eaten one of those burgers, and was in the hospital with hemolytic uremic syndrome (HUS). Brianne proved to be only the first of many young children I’ve seen sprawled in hospital beds, horribly bloated and discolored, hooked up to kidney dialysis and life support machines, surrounded by doctors frustrated by a disease for which there is no known cure. Many of these kids died. Brianne barely survived, and she will suffer after-effects from her E. coli poisoning for the rest of her life. I hope that suffering is eased somewhat by the $15.6 million settlement eventually paid by the company. Jack in the Box, co-defendants and insurers paid out over $125 million in compensation to victims. The costs to the businesses involved were at least twice that.

At the time, E. coli O157:H7 was viewed as a pathogen carried only in ground beef—and especially beef crammed into industrial feedlots. There were outbreaks involving hamburger from virtually every fast food chain in America, ground beef from supermarkets, big box stores and public school lunches. People were getting sick around the country, and it was all blamed on meat. Since then, I’ve made a career of representing people poisoned by E. coli, Salmonella and a half-dozen other pathogens potentially carried in virtually every food, processed or unprocessed, fresh or packaged, industrial or homegrown. Here are just a few examples:

Shortly after the Jack in the Box case, we represented most of the seriously  affected  victims of an outbreak of E. coli traced to Odwalla apple juice.(3)   Odwalla is a San Francisco-based processor that marketed “fresh” juice with no preservatives. At least 70 people fell ill, and a 16-month- old Colorado girl died, from drinking unpasteurized juice that is believed to  have  become contaminated  by  apples that fell off trees and into cow manure before being harvested. The case had a nationwide impact, demonstrating that food- borne illness can be contracted from fresh produce as well as meats. After an ugly legal fight, the company eventually paid a multi-million-dollar settlement to the victims and their families—and Odwalla began pasteurizing its juices using a flash pasteurization treatment.

Vegetables came next. In 2002, more than 50 high school cheerleaders and dancers contracted E. coli from prepackaged lettuce served at a dance camp in Washington.4   We represented several victims, including a Spokane teenager who had to endure dialysis treatments because her kidneys were severely damaged by the E. coli. The U.S. Food and Drug Administration (FDA) was sufficiently alarmed to issue a rare warning that consumers should throw out prepackaged bags of Romaine lettuce. The following year, at least 660 people were sickened, and four died, from hepatitis A contracted from Mexican green onions served at a Chi-Chi’s chain Mexican restaurant near Pittsburgh, Pennsylvania. The FDA attributed the outbreak to poor sanitation, leading to the largest single- source epidemic of hepatitis A in U.S. history.(5 ) We represented many of the approximately 300 victims who sought compensation from Chi-Chi’s and four companies that supplied the green onions. One gentleman who required a liver transplant collected nearly $6.5 million. Total compensation to victims was nearly $50 million and Chi-Chi’s never exited bankruptcy.

In 2006, a nationwide E. coli epidemic was attributed to prepackaged, fresh-cut spinach packed for Dole Foods by Natural Selection Foods LLC, a California company that specializes in processing specialty lettuces, primarily spinach and spring mix. The Centers for Disease Control and Prevention (CDC) and FDA confirmed 204 illnesses in 26 states—including a frightening 31 with HUS—104 hospitalizations, and three deaths associated with this outbreak. Victims of the E. coli outbreak were identified in 26 states. E. coli was isolated on cattle ranches adjacent to the spinach fields.(6)  We represented 93 of the victims.

It goes on and on. We have handled cases of foodborne illness traced to packaged almonds, homemade apple cider, alfalfa sprouts, fruit salad, packaged breakfast cereal, sushi, orange juice, tomatoes, cantaloupe, gelatin desserts, and most recently, peanut butter. The microorganisms involved in these outbreaks range from Listeria monocytogenes, to E. coli O157:H7, to numerous strains of Salmonella, and include microbial toxins and viruses such as Clostridium botulinum, Cryptosporidium, Vibrio, hepatitis A, and Norwalk virus, to name a few. We have represented thousands of clients, sued most of the nation’s large restaurant chains and won a total of $600 million in judgments and settlements.

Managing Risk is Part of Managing the Business

So what’s happening out there? Is there an epidemic of E.  coli and Salmonella and other foodborne illness? Or is it just a bunch of guys like me, chasing ambulances and making life miserable for hardworking CEOs? We know, after all, that people have been getting sick from eating tainted meat, fruits, vegetables and dairy products since the beginning of human history; and it may well be true that, thanks to advances such as pasteurization and flash freezing, that food is actually safer than it was 50 years ago. So why is this happening now?

First, it may be true that industrial food production fosters an environment friendlier to these bugs. Enormous feedlots, centralized processing plants, long-distance shipping, and even air conditioning systems may create new opportunities for pathogens to spread. And in any case, big business makes the system less tolerant of error. If a small town processing plant has an outbreak, a few people might be infected—perhaps too few to detect. But today, with extended and increasingly efficient supply chains, a mistake in a peanut butter plant in Georgia or meat packing plant in Colorado can quickly sicken thousands of people around the country or even on a global scale.

Second, recent technological advances, especially DNA analysis, provide new tools for detecting, tracking and identifying pathogens such as E. coli O157:H7. It’s only very recently that we can establish a direct and virtually certain link between one or more sick people and a specific food source. My job would be far more difficult without DNA analysis. The bottom line is that with technology comes the great likelihood that a company that produces tainted food will get caught.

And, perhaps contemporary society is less tolerant of risk, as well. People these days expect to be healthy. When they get sick, they want to know why. And if they know why, they want to hold somebody accountable. You can argue with that phenomenon, but it is a fact of life.

So, what can you do about it? How can you manage your own business and produce a healthy and profitable product without making people sick? Given these new realities, how can we manage risk in a free society? There are three broad options.

First, we can do what most Western societies have do for most of their history, and what much of the world still does today,which is to rely on the open market. In part, it is up to the individual consumer. We can choose to trust our farmers and food processors, and the marketplace will take care of everything else. If they make an error and some of our kids get sick, that is too bad. The marketplace imposes sanctions; if people are afraid of getting sick, they’ll stop buying the product. Case closed.

We know the problem with that. Consider the case of those nice people in California who produced unpasteurized apple juice, poisoning hundreds of kids. Most farmers and processors will be conscientious. But a few bad apples will get lazy, or cocky, and make a fatal mistake. Consumers will become wary not of just one bad apple, but of the entire apple industry. Everybody in the affected food category pays the consequences of one outfit’s error.

The second option is Big Brother: regulate. We enact laws, impose penalties and hire the inspectors necessary to enforce them. But my guess is that this solution doesn’t appeal to anybody in any business. To make it work, we would need trained inspectors on every farm, in every processing plant, in every restaurant, at every hot dog stand. It’s expensive, and potentially too intrusive. And there’s another problem: Regulatory systems may work for a while but success tends to be followed by breakdowns. Inspectors get lazy, or corrupt, and stop doing their jobs. Or the political system intervenes; government budgets come under strain and politicians look at the system and conclude that nobody is getting sick, so clearly we don’t need so many inspectors. They cut budgets, the regulatory system gets stretched too thin, some E. coli bacteria slip through the cracks, and suddenly we have another tragic outbreak.

The third option is the legal system. If people get sick, we allow them, even encourage them, to go to court and sue for compensation. Food producers go about their business, and if they do everything right, they’re fine. But if somebody gets sick then somebody like me will probably be waiting at his or her doorstep. And I will do my best to make it a very costly mistake. But civil law, of course, has its own costs. Even if you run a flawless business and never poison anybody, you need to carry enough insurance to spread the risks and costs across your industry.

In the U.S., we’ve seen the evolution of a political system that is a mix of each of these elements. We have a market system that theoretically rewards farmers and producers who don’t take risks—or, at least, whose mistakes are not detected and traced back to the source. We have a regulatory system of food safety laws and enforcement, though that system is, by almost any account, woefully inadequate in funding, staffing and efficiency to enforce the laws presently in force, let alone any new and tougher body of law. And we have civil laws that allow people to seek compensation for their injuries.

Whatever strategies we employ to prevent foodborne illness, the analysis should not be purely political or legal. We could criminalize food poisoning (see what China does), employ thousands of inspectors and impose stiffer penalties for people who produce tainted food. But ultimately, this is also a fundamental question of morality. As individuals and as businesses, do we subscribe to the Law of the Jungle? Or to the Golden Rule? If food producers, and their CEOs, put themselves in   the position of food consumers, perhaps it would be easier for them to understand why consumers need to be able to trust their food supply. If CEOs could see what I’ve seen—two- and three-year-old children hooked up to kidney dialysis machines and life support, or in their tiny coffins—it might change some attitudes about the importance of food safety.

If that were to happen, the food industry would profit, consumers would be safer, and lawyers like me would have to   look for another way to make a living.

The CEO’s Checklist

I often speak to food manufacturers, foodservice and retailers about why CEOs and senior management (even outside of the traditional food safety or quality assurance department functions) must be dedicated to food safety, as I’ve related above. But I also have a few recommendations for translating the “why” into a practical “how.” The fact is, paying attention to headlines isn’t nearly as important as paying attention to your food safety management professionals on staff and those with whom you contract for their food safety systems expertise. CEOs are in the business of managing the business to make a profit—whether you are a multinational food manufacturer or a one-shop restaurant owner—and are not necessarily versed in the lingua franca of science-based solutions that microbiologists, chemists or food engineers propose. But investments in food safety systems, technologies, testing and tools are just that—economic investments of either money, staff or time that must be justified at the bottom line or to the company’s shareholders. This is why my first recommendation to CEOs is to ensure that the company is placing qualified people in charge of food safety—and the second is to listen to them.

1.  Put qualified people in charge of food safety.  Invest in hiring scientists and experienced quality assurance professionals to manage the food safety programs. These individuals can often be trained in management techniques that will help them articulate to CEOs and senior level management the basis for requests to implement or improve food safety programs that involve technical concepts.

Providing and supporting general and overall training programs to food safety leaders in your organization is also important. You want to keep your qualified staff qualified. Continuous training and education of food safety department heads, managers and staff practical way that CEOs can ensure they are getting the most up-to-date information and recommendations from which to make critical—and proactive—food safety decisions.

This may mean investing in fee-based training or professional certification or accreditation seminars in planning and implementing Hazard Analysis and Critical Control Points (HACCP) programs, specialized testing laboratory workshops for technicians and supervisors, or even train-the-trainer type courses in auditing methods or safe food handling.  For smaller companies, off-the-shelf and customized software programs and video and audio training can be a cost-effective way to achieve professional development of your food safety staff.

Also, encourage food safety professionals in your organization to get involved with recognized industry and scientific organizations, and to attend these organizations’ trade conferences, participate in committees and network with other food safety colleagues and leaders in the field—and fund it. Food safety is not a competitive issue and supporting your staff in these types of collegial, educational endeavors will help them deepen their knowledge of emerging trends, issues and solutions, which in turn improves corporate knowledge and decision-making effectiveness.

2.  Listen to the qualified food safety professionals you’ve hired.  Understanding what your in-house experts or outside contract professionals are recommending is key to investing in the right food safety systems and technologies—and to helping you justify associated costs to relevant stakeholders on the business side. Pay attention to what the experts advise are the existing or potential risks to your operation. Not all microbes, viruses or chemical contaminants are equal when it comes to the likelihood of adulterating particular foods or beverages.  But, if you are manufacturing ready-to-eat luncheon meat or deli salads, it is important to know that these have been ranked as products with a very high risk for Listeria monocytogenes contamination if appropriate preventive strategies and systems are not in place. The operation may have other bugs to worry about but identifying the “baddest” bug helps senior managers understand why recommended technologies, equipment or systems investments should be implemented faster than others. Similarly, restaurant and other foodservice establishments  where food is handled know that risks associated with poor personnel hygiene practices, among others, can result in the spread of hepatitis A, noroviruses and other illnesses. Knowing this makes it easier to make the investment decision to   improve employee training or provide more handwashing stations. Your food safety professionals should be able to identify and rank the risk factors associated with your particular processing or food handling/distribution operations and provide information on the management strategies or technological solutions that will mitigate or eliminate those risks.

It is great to have good advice that you, as a critical decision maker, can trust but you must be able to translate that into action. When the head of food safety recommends a capital investment in new equipment that is of sanitary design, be prepared to see past the new line item it represents. Rather, focus on listening to the why’s, what’s and how’s of the presented material to better understand how your company can get a return on investment for the proposed expenditure.

3.  Use contracts with your vendors to protect your customers and indemnify your company of liability if something goes wrong.  Putting pressure on your suppliers to make sure they take into account food safety is a good thing. Your product is only as safe as its component parts. Requiring suppliers to be bound by your specifications makes the risks lower that and error will occur.  And, if a supplier’s product is contaminated, shouldn’t it pay for its error and not you?

4.  Understand  why  information  management  (IT)  is important  to  your  company,  especially  as  it  relates  to  the food  safety  mission.  In today’s high-tech  climate  and  global economy, it is more important than ever to develop and implement IT systems that increase the food company’s effectiveness in making collected food safety data meaningful. Without this “usability” factor, critical data on traceability, sanitation and food safety audit findings, testing results, and HACCP, allergen control or other food safety management and control systems are essentially impotent. Streamlined, inter-departmental management and reporting of food safety data helps senior management see the big picture and navigate a course that takes into account all areas that involve the food safety imperative.

5.  Stay current with regulatory and code compliance for every jurisdiction in which your company operates.  Certainly, food company CEOs and senior level managers who are educated about the applicable food safety laws and regulations that govern the production, distribution or handling of foods and beverages are better prepared to respond to a crisis or recall event. But perhaps more importantly, those who are more knowledgeable about these laws and rules are able to make food safety improvement decisions that foster proactive compliance.

From the Top

Ultimately, dedication to food safety must go beyond the company’s HACCP program—in terms of compliance, implementation, testing and auditing. This commitment starts at the top of the organization with the CEO, president and senior management team. Managing the business in a way that pays more than lip service to food safety will produce high-quality, profitable products that don’t make people sick, and is essential to the continued health of your bottom line and the health of your consumers.

References

1.       CDC. Epidemiologic Notes and Reports Isolation of E. coli O157:H7 from Sporadic Cases of Hemorrhagic Colitis—United States. MMWR Nov. 5, 1982. 31(43); 580,585. www.cdc.gov/mmwr/preview/mmwrhtml/00001184.htm.

2.       CDC. Update: Multistate Outbreak of E. coli O157:H7 Infections from Hamburgers—Western United States, 1992-1993. MMWR April 16, 1993. 42(14);258-263. www.cdc.gov/mmwr/preview/mmwrhtml/00020219.htm.

3.       CDC. Outbreak of E. coli O157:H7 Infections Associated with Drinking Unpasteurized Commercial Apple Juice—British Columbia, California, Colorado, and Washington, October 1996. MMWR Nov. 8, 1996. 45(44), 975. www.cdc.gov/mmwr/preview/mmwrhtml/00044358.htm.

4.       California Department of Health Services. E. coli O157:H7 Illnesses in Washington— July, 2002. Final Report. Oct. 29, 2002. www.dhs.ca.gov/ps/fdb/local/PDF/02_07reportweb.pdf.

5.       CDC. Hepatitis A Outbreak Associated with Green Onions at a Restaurant—Monaca, Pennsylvania, 2003. MMWR Nov. 21, 2003. 52 Dispatch;1-3. www.cdc.gov/mmwr/preview/mmwrhtml/mm52d1121a1.htm.

6.       California Department of Health Services. CDHS Investigation of an E. coli O157 H7 Outbreak Associated with Consumption of Dole Brand Prepackaged Baby Spinach Manufactured by Natural Selection Foods: Sept. 13, 2006 – March 21, 2007. Redacted. www.dhs.ca.gov/ps/fdb/local/PDF/2006%20Spinach%20Report%20Final%20redacted.pdf.

Reprinted from Food Safety Magazine – October/November 2007

With nearly 150 Firefly Salmonella victims as clients, it did not take long for one of the locals to send a picture of the new, hopefully Salmonella free, location.

Questions that I plan on asking is how long had the new location been in the works?  And, did the focus on the new facility take attention off the old one that became the epicenter of nearly 300 patrons with Salmonella?  Here is the story of just one:  “Salmonella creates complications, hard choices for pregnant Las Vegan.”

Food Safety News reports that at least 86 people fell ill after eating at one of two restaurants within the Holiday Inn Bordeaux in Fayetteville, N.C., as of Friday, according to Cumberland County Department of Public Health Director Buck Wilson. That number is up from 70 cases counted on Monday.

Seven of the patients have tested positive for Salmonella in laboratory cultures, Wilson told Food Safety News.

The hotel has two restaurants inside, the All American Sports Bar and Grill and the Café Bordeaux, both of which appear to be connected to the outbreak.

State and county health investigators are still working with the Holiday Inn to investigate the source of the outbreak. The county health department anticipates releasing a report on their findings shortly.