October 2014

 Second time recently CDC has linked tainted food product to illnesses by genomic sequencing – see earlier report of Salmonella nut butter outbreak and recall.

According to the CDC, whole-genome sequences of the Listeria monocytogenes strains isolated from recalled quesito casero cheese produced by Oasis Brands, Inc. were found to be highly related to sequences of Listeria strains isolated from one person who became ill in September 2013 and two persons who became ill in June and August 2014.

These three ill persons were reported from three states: New York (1), Tennessee (1), and Texas (1).

All ill persons were hospitalized. One death was reported in Tennessee. One illness was related to a pregnancy and was diagnosed in a newborn.

All ill persons were reported to be of Hispanic ethnicity and reported consuming Hispanic-style soft cheese. The two persons who were able to answer questions about specific varieties of Hispanic-style soft cheeses reported consuming quesito casero, though neither could remember the brand.

Several recalls of cheese and dairy products produced by Oasis Brands, Inc. due to possible Listeria monocytogenes contamination have been announced by FDA.

On August 4, 2014, Oasis Brands, Inc. voluntarily recalled quesito casero (fresh curd) due to possible Listeria monocytogenes contamination after the pathogen was isolated from quesito casero produced by this firm.

On October 6, 2014, Oasis Brands, Inc. recalled cuajada en hoja (fresh curd) after U.S. Food and Drug Administration (FDA) isolated Listeria monocytogenes from environmental samples collected from the production facility.

On October 16, 2014, Oasis Brands, Inc. recalled various cheese and dairy products sold under the Lacteos Santa Martha brand.

 

After a far too sunny and warm summer on Bainbridge Island (no, I am not complaining), I am still finding treasures in our garden.

Maine Health official today are in the process of filing a court order to detain a health care worker for 21 days who MAY have been exposed to the Ebola virus in Africa – but does NOT have Ebola.

However, those same officials refuse to name the restaurant in Cumberland County, Maine where a food service worker with an acute Hepatitis A infection worked while infectious from September 29 to October 11, 2014.

According to news reports, the employee’s illness and food and beverage preparation practices might have placed patrons at risk for a Hepatitis A infection.  However, the agency was notified of the illness beyond the 14-day window of opportunity for post-exposure prophylaxis vaccines to be most effective.

Maine health officials encouraged health care providers to remain vigilant for Hepatitis A infection in persons with symptoms – fever, jaundice, nausea, clay-colored stool, dark urine, malaise, abdominal discomfort, or anorexia.  The Hepatitis A virus is transmitted via the fecal-oral route, commonly through consumption of contaminated food or water.  Persons will begin to exhibit symptoms 15-50 days after exposure to the virus. A person is considered infectious approximately two weeks prior to symptom onset until one week after onset of symptoms.

Yes, Billion – Per Year[1]

I suppose you can call this the economic reason why I still have a job.

The Economic Research Service of the United States Department of Agriculture recently provided Cost Estimates of Foodborne Illnesses for the major foodborne illnesses in the United States as of 2013.  This data includes:

  • Detailed identification of specific disease outcomes for foodborne infections caused by 15 major pathogens in the United States
  • Associated outpatient and inpatient medical care expenditures
  • Associated lost wages/productivity losses
  • Cost of premature deaths

Disease outcomes include both acute illness and chronic disease that sometimes follow these acute illnesses. The 15 pathogens studied account for over 95 percent of the illnesses and deaths from foodborne illnesses acquired in the United States.

The Economic Research Service estimates build on the foodborne disease estimates from the Centers for Disease Control and Prevention; peer-reviewed synthesis of data on medical costs, and economic, medical and epidemiological literature; and publicly available data on wages.

I decided to focus on 7 of the pathogens – Campylobacter, E. coli O157:H7, non-E. coli O157:H7 – shiga-toxin producing E. coli, Listeria, Norovirus, Salmonella and Shigella.

Campylobacter [2]– Total yearly cost – $1,928,787,166:

The CDC estimates yearly cases of illness at 845,024.  Of those, 45,631 saw a physician and 8,463 were hospitalized.  Of those hospitalized, 76 died.  Long-term complication – primarily Guillan Barre Syndrome (GBS) – accounted for 1,916 people and of those 86 died.

  • Medical costs of those just visiting a physician – $20,318,753.  Hospitalization costs – $121,332,675 and post-hospitalization costs – $1,140,269.  Medical costs for those with GBS – $320,416,057.  Premature death costs for those hospitalized – $657,959,135 and for those with GBS – $748,428,516.
  • Wage loss and productivity loss for those that were ill but did not visit a physician – $44,709,190; for those who visited a physician and recovered – $8,043,747; for those hospitalized – $4,305,437; and, for post-hospitalization recovery – $2,133,387.
  • Cost of premature deaths – $748,428,516.

E. coli O157:H7 [3]– Total yearly cost – $271,418,690:

The CDC estimates yearly cases of illness at 63,153.  Of those, 11,737 sought a physician’s assistance.  1,806 were hospitalized and 10 died, but did not develop hemolytic uremic syndrome (HUS).  302 did develop HUS and recovered with 12 dying acutely and 10 dying a premature death at a later point.

  • For those that did not seek medical care, medical expenses were modest at $135,960.  For those that sought medical care, but were not hospitalized, medical expenses were $4,929,205.  Hospitalized, non-HUS – $16,485,464.  Hospitalized, HUS – $2,854,946.  Hospitalized HUS and end stage renal disease (ESRD) with later premature death – $8,917,815.  Medical expenses for those hospitalized who died without HUS – $72,955; for those who died with HUS – $667,360.
  • Wage loss/productivity loss for those who did not seek medical attention – $1,431,031; for those who sought medical attention – $2,477,897; hospitalized, non-HUS – $1,110,585; hospitalized, HUS – $22,515; Hospitalized HUS and ESRD with later premature death – $588,895; hospitalized, non-HUS, death – $7,678; hospitalized, HUS, death – $4,431.
  • The cost of the premature deaths were as follows:  Hospitalized HUS and ESRD with later premature death – $558,008,517; hospitalized, non-HUS, death – $69,258,856; hospitalized, HUS, death – $103,888,284.

non-E. coli O157:H7 [4]– Total yearly cost – $27,364,561:

The CDC estimates yearly cases of illness at 112,752[5].  91,526 did not seek medical attention; 20,955 did.  271 people were hospitalized.  231 did not develop HUS; 39 developed HUS and recovered; and, there was 1 death.

  • Medical expenses for those who did not seek medical care – $252,525.  It was $8,800,355 for those who sought medical care, but were not hospitalized.  For those hospitalized, non-HUS – $2,108,605; hospitalized, HUS – $2,169,066; Hospitalized HUS and ESRD with later premature death – $947,410.
  • Wage and productivity loss for those who did not seek medical attention – $2,657, 911; for those who sough medical attention, but were not hospitalized – $4,423,987; for those hospitalized, non-HUS – $142,053; hospitalized, HUS – $2,908; hospitalized HUS and ESRD with later premature death – $58,889.
  • The cost of the 1 premature death – $5,800,852.

Listeria [6]– Total yearly cost – $2,834,444,202:

The CDC estimates yearly cases of illness at 1,591.  Only 136 were sickened and did not visit a physician and all others – 1,173 were hospitalized.  Mothers hospitalized – 189; others hospitalized with moderate illness – 33.  Severe illnesses were 697 with 247 deaths.

  • The medical cost for hospitalized mothers – $6,434,883; including infants – $31,208,947.  Other adult medical costs for moderate illness – $1,078,656; for severe illness for those who recovered – $68,513,832; medical costs for those that died – $16,181,967.
  • Productivity and wage loss was modest across all categories at $2,016,273
  • The cost of premature deaths – $2,138,172,640.

Norovirus [7]– Total yearly cost – $2,255,827,318:

The CDC estimates yearly cases of illness at 5,461,731.  4,906,357 did not require a visit to a physician.  540,711 saw a physician.  14,663 were hospitalized and 149 people died.

  • Medical expenses for those who visited a physician only – $240,768,547.  For those hospitalized – $355,175,098.
  • Wage and productivity loss totaled $367,964,198.
  • The cost of premature deaths – $1,289,946,198.

Salmonella [8]– Total yearly cost – $3,666,600,031:

The CDC estimates yearly cases of illness at 1,027,561.  934,241 did not seek medical attention.  73,984 were seen by a physician – with 19,336 being hospitalized.  There were 378 deaths.

  • Medical costs for those seeing a physician – $32,943,851.  Hospital costs were $277,217,134 with post-hospitalization cases of $2,577,468.
  • Productivity and wage loss – $52,810,195 for those who did not seek medical care.  For those who only saw a physician – $13,911,195; hospitalized and post hospital recovery – $14,659,244.
  • Premature death costs – $3,272,480,959.

Shigella [9]– Total yearly cost – $137,965,962:

The CDC estimates yearly cases of illness at 131,254.  Most did not seek medical treatment – 120,348.  1,456 were hospitalized and there were 10 deaths.

  • Total medical expenses – $42,130,731.
  • Total wage and productivity loss – $9,261,661
  • Premature death costs – $86,573,570.

I guess I still have work to do.


[1] Of course this does not account for business losses that includes lost sales, recall cost, advertising costs, litigation costs, etc.

[2] See, www.about-campylobacter.com According to the CDC, Campylobacteriosis is an infectious disease caused by bacteria of the genus Campylobacter. Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within two to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts about one week. Some infected persons do not have any symptoms. In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a serious life-threatening infection.

[3] See, www.about-ecoli.com According to the CDC, Escherichia coli (abbreviated as E. coli) are a large and diverse group of bacteria. Although most strains of E. coli are harmless, others can make you sick. Some kinds of E. coli can cause diarrhea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses. Still other kinds of E. coli are used as markers for water contamination—so you might hear about E. coli being found in drinking water, which are not themselves harmful, but indicate the water is contaminated. It does get a bit confusing—even to microbiologists.

[4] In 2012 E. coli O26, O11, O103, O121, O45 and O145 were declared adulterants by the USDA/FSIS – http://www.foodpoisonjournal.com/food-policy-regulation/fsis-to-declare-the-big-six-non-o157-stecs-adulterants/#.VFK5G9ZvZqI

[5] ERS Spreadsheet indicated 63,153, but that is incorrect.

[6] See, www.about-listeria.com  According to the CDC, Listeriosis, a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes, is an important public health problem in the United States. The disease primarily affects older adults, pregnant women, newborns, and adults with weakened immune systems.

[7] See, www.about-norwalk.com According to the CDC, Norovirus is a very contagious virus. You can get norovirus from an infected person, contaminated food or water, or by touching contaminated surfaces. The virus causes your stomach or intestines or both to get inflamed (acute gastroenteritis). This leads you to have stomach pain, nausea, and diarrhea and to throw up.

[8] See, www.about-salmonella.com According to the CDC, Salmonellosis is an infection with bacteria called Salmonella. Salmonella germs have been known to cause illness for over 100 years. They were discovered by an American scientist named Salmon, for whom they are named.  Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment. However, in some persons, the diarrhea may be so severe that the patient needs to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness

[9] See, www.about-shigella.com According to the CDC, Shigellosis is an infectious disease caused by a group of bacteria called Shigella. Most who are infected with Shigella develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacteria. Shigellosis usually resolves in 5 to 7 days. Some people who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.

Shenandoah Growers Inc. of Harrisonburg, VA, announced Wednesday that one lot of its conventional fresh-cut cilantro was being recalled due to the potential of Salmonella contamination.

The company said the single lot, consisting of 465 plastic clamshell containers in all, was shipped to two customers in Maryland and Alabama (one retail distribution center and one wholesaler) on Oct. 8 and 9, 2014.

Only two of the company’s products are affected by this recall, and each bears the lot code “15 273283″ stamped on the front of the package. The two products are Shenandoah Growers brand conventional fresh-cut cilantro in 0.75-ounce plastic clamshells and Giant brand conventional fresh-cut cilantro in 2.5-ounce plastic clamshells.

Due to perishability, the recalled products are very likely no longer available in the marketplace, the company stated. No illnesses have been reported to date, and no other products sold by Shenandoah Growers are affected.

Anyone who purchased either of these products bearing the lot number indicated above and still has it in their possession is advised to dispose of it.

The grower initiated this recall after receiving test results on Oct. 28 that one of four routine samples taken on Oct. 8 by the Virginia Department of Agriculture and Consumer Services revealed the presence of Salmonella. Concurrent testing of samples from the same lot conducted by an independent laboratory as part of the company’s internal testing program contained no findings of contamination.

Today the USDA’s Food Safety and Inspection Service posted a 13-page distribution list of retail stories in CO, ID, IL, MA, ME, MI, MN, MT, ND, NH, NV, RI, VT, UT, WI and WY which may have received this recalled product.)

Chicago-based Aspen Foods Division of Koch Meats is recalling 28,980 pounds of chicken products shipped to Minnesota that may be contaminated with Salmonella Enteritidis. The U.S. Department of Agriculture requested that Aspen Foods conduct this recall after the product was found to have caused an outbreak in Minnesota that has sickened at least six people.

CBS News San Francisco reports that More than 50 attendees attending an NAACP gala in Redwood City Saturday evening were sickened by a case of possible food poisoning.

At least twelve people were taken to local hospitals and treated for dehydration, according to the San Jose Mercury News.  Several others transported themselves to hospitals.

Cynthia Adams, 2nd vice president of the Oakland NAACP, told KPIX 5 there may be as 100 people who became ill. The official said that she had to transport half a dozen kids to the hospital, and at least one of them is still hospitalized late Tuesday night.

Adams said among those hospitalized include former Oakland Mayor Elihu Harris.

More than 300 people attended the event, including former San Francisco Mayor Willie Brown, which was held at the grand ballroom of the Sofitel San Francisco Bay Hotel in Redwood City.

Guests became sick after a meal of salmon and salad, and reportedly were throwing up in the hotel lobby while firefighters and paramedics treated others.

Public health officials were investigating the source of the illness.

 

Following last week’s recall of fresh Serrano chile peppers by Bailey Farms Inc., Giant Food Stores LLC and Martin’s Food Markets announced that they removed from sale Serrano, Anaheim, Red Cherry Hot and Finger Hot peppers sold in a variety case due to potential Salmonella contamination.

The following product is included in this recall: Serrano, Anaheim, Red Cherry Hot and Finger Hot Peppers, PLU 4691, purchased on or after Oct. 9, 2014. The stores have not received any reports of illnesses to date.

Martin’s Food Markets and Giant Food Stores operate in Maryland, West Virginia, Pennsylvania and Virginia. Both retail chains are owned by Netherlands-based Ahold.

New York State Agriculture Commissioner Richard A. Ball today warned consumers in Sullivan County and the surrounding area not to consume “unpasteurized” raw farm milk from the Richard Dirie Farm, due to possible Listeria contamination. The Dirie Farm is located at 1345 Shandelee Road, Livingston Manor, New York. To date, no illnesses are known by the Department to be associated with this product.

A sample of the milk, collected by an inspector from the Division of Milk Control and Dairy Services on October 21, 2014, was subsequently tested by the Department’s Food Laboratory and discovered to be contaminated with Listeria monocytogenes. On October 23, 2014, the producer was notified of a preliminary positive test result and he volunteered to suspend raw milk sales until the sample results were confirmed. Further laboratory testing, completed on October 28, 2014, confirmed the presence of Listeria monocytogenes in the raw milk sample. The producer is now prohibited from selling raw milk until subsequent sampling indicates that the product is free of harmful bacteria.

Listeria monocytogenes is an organism which can cause serious and sometimes fatal infections in young children, cancer patients, elderly people and others with weakened immune systems. Although otherwise healthy persons may suffer only short-term, flu-like symptoms such as high fever, severe headaches, stiffness, nausea, abdominal pain and diarrhea, Listeria can cause miscarriages and stillbirths among pregnant women.

It is important to note that raw milk does not provide the protection of pasteurization, which eliminates all pathogenic bacteria, including Listeria.

Chetak New York L.L.C. of Edison, NJ is recalling its 5560 packages of 7oz., 3840 packages of 14oz., & 1920 packages of 28oz. “DEEP RAW CASHEW PIECES” because they have the potential to be contaminated with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

The recalled “Deep Raw Cashew Pieces” were distributed nationwide in retail stores from March 12, 2014 to October 21,2014. The product comes in a 7 oz., 14oz., & 28oz. clear plastic package marked with UPC number on the rear of the package.

  • UPC number for 7oz. is 011433133104
  • UPC number for 14oz. is 011433133111
  • UPC number for 28oz. is 011433133128

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

The potential for contamination was noted after routine testing conducted by the FDA.