Marler Clark Clients, Elizabeth and Ashley Armstrong, Profiled on CNN
Elizabeth Armstrong and her 5-year-old daughter Ashley put a face on the 76,000,000 American’s who become sick by food each year at a cost of over $152,000,000,000.
Peanut Corporation of America Salmonella Client, David Krieger Profiled in USA Today
Elizabeth Weise of USA Today again shows how the Nation’s Paper does a great job of covering Food Safety issues. According to her story this morning, “Food-borne illnesses cost the United States $152 billion a year, a tab that works out to an average cost of $1,850 each time someone gets sick from food, a report by a former Food and Drug Administration economist says.” "A lot of people don't realize how expensive food-borne illnesses are," says Robert Scharff, a former FDA regulatory economist and now a professor of consumer science at Ohio State University. "It's important for the public to understand the size of this problem."
The Summer 2008 E. coli O157:H7 Outbreak linked to Nebraska Beef and Whole Foods - A story of companies out of control leaving victims in its wake.
On June 30, 2008, Nebraska Beef, Ltd., an Omaha-area beef processor, recalled approximately 531,707 pounds of ground beef products because the meat was potentially contaminated by E. coli O157:H7.
On June 24, 2008, the CDC announced an outbreak of E. coli O157:H7 illnesses among 24 residents of Michigan and Ohio. The next day, the CDC announced that the number of outbreak linked cases had grown to 32, and that ground beef sold at Kroger stores, the Cincinnati based grocery chain, was the likely outbreak vehicle. That afternoon, Kroger recalled all varieties and weights of ground beef products bearing a Kroger label sold between May 21 and June 8 at Michigan and Central and Northwestern Ohio Kroger retail establishments. By June 26, the outbreak had claimed 33 victims; and by June 30, the CDC counted 35 confirmed cases linked to ground beef sold by Kroger, with 19 people hospitalized and 1 known case of hemolytic uremic syndrome.
But Kroger did not produce the meat from which the contaminated ground beef implicated in this developing outbreak was made. Investigation by health officials in Michigan and Ohio, in collaboration with officials at the CDC and FSIS, showed that the contaminated Kroger beef had actually been produced by an Omaha, Nebraska beef processor called Nebraska Beef, Ltd. On the basis of these investigative findings, Nebraska Beef recalled approximately 531,707 pounds of beef products on June 30, 2008.
The outbreak linked to Nebraska Beef’s products would continue to grow through the end of June and into July. On July 1, the CDC announced that 38 people had now been infected in Ohio and Michigan; on July 3, the number rose to 41. That day, Nebraska Beef expanded its recall “to include all beef manufacturing trimmings and other products intended for use in raw ground beef produced between May 16 and June 26.” The massive recall now totaled an estimated 5.3 million pounds of beef. In an FSIS press release the same day, it was reported:
FSIS has concluded that the production practices employed by Nebraska Beef, Ltd. are insufficient to effectively control E. coli O157:H7 in their beef products that are intended for grinding. The products subject to recall may have been produced under insanitary conditions.
Meanwhile, further epidemiological investigation revealed that the outbreak had spread beyond the states of Michigan and Ohio. On July 15, the CDC announced that New York, Indiana, and Kentucky had reported outbreak cases as well—i.e. individuals with a stool sample that was positive for a strain of E. coli O157:H7 that was indistinguishable from the patterns detected in recalled beef products and in other already-recognized outbreak cases. The next day, the CDC reported that the State of Georgia had a case too, bringing the total to 45 victims nationally.
But Nebraska Beef’s contaminated beef products had spread even further than that into the stream of commerce, and unfortunately into the homes of consumers. On August 8, 2008, Nebraska Beef announced yet another massive recall. This time, the troubled company recalled approximately 1.2 million pounds of primal cuts, subprimal cuts and boxed beef due to potential E. coli O157:H7 contamination.
This latter recall also occurred in the wake of a large-scale investigation into a multi-state outbreak of E. coli O157:H7 illnesses with exposures to ground beef products from a variety of retail outlets. At least 31 people in 12 states and Canada had been infected. The investigation ultimately showed that, through a middleman called Coleman Natural Meats, Nebraska Beef had supplied the implicated retail outlets, including certain Whole Foods and Dorothy Lanes locations.
The total amount of beef products recalled by Nebraska Beef from June to August 2008 was 6,660,000 pounds. The contaminated beef subject to Nebraska Beef’s various recalls ultimately caused at least 80 illnesses in 16 states and Canada.
Eula Bentley-Tobias
Eula Plum Bentley-Tobias is a two-and-a-half-year-old, free spirited little girl who lives in Charlottesville, Virginia with her parents, Jonah and Lisa. At the time of her illness, Eula was just twenty-one months old, and the Tobias family was living in New York City.
Prior to her HUS illness, Eula was an extremely healthy child. In fact, after her birth, she had never even been to a hospital, she was not on any medications, and she had no known allergies or other health problems whatsoever. Moreover, she had met all of her major developmental milestones, both psychosocial and physical, including babbling at six months, speaking her first word (“dada”) at eight months, and walking at twelve months. Without a doubt, Eula was an entirely healthy toddler with no congenital impediment to leading a productive, normal life.
On July 2, 2008, Eula and her parents traveled to Charlottesville, Virginia for the Fourth of July holiday. They stayed at Jonah’s mother and father’s home. While there, Jonah’s mother purchased ground beef on two occasions from the local Whole Foods store. The first package of ground beef was actually returned to the store because, when Lisa took it from the refrigerator to prepare hamburgers, she noticed that the meat appeared grayish in color. Whole Foods willingly allowed Jonah’s mother to exchange the discolored meat for a new package of fresh ground beef the morning of July 4. That afternoon, Lisa prepared hamburgers for many members of the family, including Jonah. Eula did not consume any of the ground beef.
Eula began to suffer from a low-grade fever on July 7 or 8. No other symptoms of illness manifested until approximately one week later, when Eula began to complain that her “tummy hurt.” Onset of diarrhea occurred around the same time, quickly increasing in intensity and frequency over the next twenty-four hours. Eula saw her pediatrician, Mark Levin, MD, on July 17, who noted significant abdominal pain and guarding. Dr. Levin’s differential diagnosis included gastroenteritis and intussusception, which is a potentially fatal condition characterized by the enfolding of the large and small bowel. He recommended that Jonah and Lisa take Eula immediately to the emergency department at Beth Israel Hospital for further diagnostic tests.
Jonah and Lisa were ill prepared for what they would witness over the course of the next month, much less the medical reality that would confront their then-only child by the time she was finally discharged from the hospital on August 16. During her three-day-stay at Beth Israel, Eula’s kidneys would shut down, becoming clogged with cellular debris produced by the hemolyzing effect of the shiga toxins circulating in her bloodstream. She would also become badly anemic and suffer from a precipitous decline in platelets, signaling the onset of hemolytic uremic syndrome, a potentially fatal condition triggered by E. coli O157:H7 bacteria.
Unable to produce urine, yet requiring intravenous fluids due to the dehydration caused by her continuing, grossly bloody diarrhea, Eula’s entire body, even her eyelids, swelled to the point that her frightened parents could hardly recognize the form that their daughter had taken. And toward the end of her short stay at Beth Israel, before being transferred to New York Presbyterian Hospital’s pediatric intensive care ward, Eula’s body began to experience metabolic changes that would ultimately cause insulin-dependent diabetes. By July 20, 2008, Eula’s condition had deteriorated to the point that her team of doctors at Beth Israel agreed that she should be transferred to New York Presbyterian for potentially life-saving kidney dialysis and other care.
Eula’s body continued its rapid descent toward catastrophic, total failure at New York Presbyterian. After being directly admitted to the intensive care unit, blood tests confirmed that her kidneys had shut down completely, and that she had experienced a critical drop in red blood cells and platelets. The first of many blood transfusions occurred in the early morning hours of July 21. Over the next ten days, Eula would be repeatedly transfused with red blood cells.
On July 22, swollen and failing, Eula became much more irritable and fussy; too much so, in fact, for the change to be simply a consequence of her very ill condition. She began to speak incoherently, losing entirely the relatively advanced verbal structure that she had developed over the course of her first twenty-one months of life. In an email written to family and friends, Eula’s mother said, “She is slowly slipping away from us mentally, becoming less and less responsive.”
The changes became more pronounced that evening. Then, at midnight on July 22, Eula’s pediatric critical care specialist noticed certain behaviors, including agitation and a pronounced, left-sided gaze, that he believed to be a seizure. An EEG done later detected a seizure lasting eighteen minutes in the right hemisphere of Eula’s brain. Doctors immediately loaded her with Dilantin, an anti-seizure medication that caused Eula to become only minimally responsive. And then, four days later, she suffered a grand mal seizure lasting over an hour. During the seizure, Jonah and Lisa Tobias were rushed out of the room, and watched through a window in the door as doctors compressed Eula’s chest to ensure that her heart continued to beat. Ultimately, Eula would remain only minimally responsive into the month of August, when the anti-seizure medications could be safely withdrawn.
Meanwhile, Eula continued to suffer from total kidney failure, and metabolic changes that lead to respiratory failure, alternating low and high blood pressures, liver and pancreas disease, and, ultimately, insulin-dependent diabetes mellitus. Peritoneal dialysis began on July 25, having to take over the job of Eula’s failing kidneys and rid her body of the harmful toxins and wastes that were building up due to her inability to produce any urine. Eula remained sedated, and breathing through a mechanical ventilator, through the end of July.
Eula ultimately remained on dialysis through August 11, by which point her kidneys had been irreversibly and severely damaged. By the time of discharge from New York Presbyterian Hospital on August 16, she had regained most of her mental function, and doctors were optimistic that, despite the severity of her neurological involvement, she had not sustained any organic brain damage. Nevertheless, due to the severity of her kidney injury and her ongoing diabetes mellitus, Eula remained on a variety of medications after discharge from the hospital, including Enalapril, Nystatin, Dilantin, Erythropoietin, and Lantus.
Since discharge, Eula’s recovery has been gradual and, sadly, incomplete. Her kidneys have not regained the functional capacity that they had before she became infected by E. coli O157:H7 in July 2008; and they never will. Eula remains on multiple medications to support her damaged kidneys and prolong their life, but she will require medical monitoring for the rest of her life, and at some point will likely require kidney transplantation and further dialysis for survival.
Nebraska Beef’s Six-Plus Years of Serious Food Safety Violations
Continue Reading...Linda Rivera's Deadly Dance with E. coli O157:H7
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For readers here, and those who saw the Washington Post article, who have followed Linda and her family's struggle with E. coli O157:H7, the report that I received late yesterday from her brother-in-law is heartbreaking. It seemed only a few days ago that there was talk about her leaving the hospital (where she has been since May 2009) and starting rehabilitation. There was hope that both her ventilator tube and feeding tube were being removed. There was a dream that she might one day go home. Now this:
2-4-2010
I was on the phone with Richard this morning. Linda has developed a condition called “ascites”. Ascites is when the liver weeps out fluid from itself and the fluid builds up within the abdominal cavity. The fluid buildup can get to the point where the person appears similar to a woman who is pregnant. Linda had around 7 liters of fluid in her belly. The doctors “tapped” out the fluid and sent it for analysis.
Why Linda has this fluid buildup is not certain but, very likely, represents progression of her liver problems to cirrhosis. Other possibilities not related to the liver are possible but cirrhosis leads with the highest possibility. Due to this buildup, they decided not to surgically close the tracheotomy (the breathing opening in her throat). Fluid buildup in the belly interferes with breathing mechanics because the fluid interferes with the diaphragm, the anatomic structure that allows us to breathe in and out. Also, this fluid oftentimes leaks into the cavity surrounding the lungs, which can interfere with her ability to obtain oxygen within her lungs. Rather than risk taking out the tracheostomy device and closing the tracheotomy opening, only to have to potentially put down another breathing tube due to respiratory failure, they have elected to keep the opening for as long as this threat remains.
This is a setback, possibly reflecting onset of end stage liver disease. Please keep Linda and Richard in your thoughts and prayers. It has been a roller coaster ride for sure.
A roller coaster ride for sure.
2006 E. coli O157:H7 Outbreak Linked to Organic Pastures Raw Milk - One Victims Story
Chris Martin, then age seven, developed an E. coli O157:H7 infection in September 2006 following consumption of raw milk. He was hospitalized beginning on September 8, suffering from severe gastrointestinal symptoms, including bloody diarrhea. Shortly thereafter, he developed hemolytic uremic syndrome (HUS). In an effort to properly treat his rapidly deteriorating condition, Chris was moved to multiple medical facilities, twice by life-flight. His HUS was remarkably severe, marked by prolonged renal failure, pancreatitis, and severe cardiac involvement. He required 18 days of renal replacement therapy. On two occasions his cardiac problems became so severe that he was placed on a ventilator. At several junctures, the possibility that he might not survive was very real. Ultimately he was hospitalized through November 2, after incurring over $550,000 in medical bills. Renal experts have opined that Chris is likely to develop severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.
On September 18, 2006, the California Department of Health Services (CDHS) opened an investigation of a possible outbreak of E. coli O157:H7 infections after receiving reports of two patients who had been hospitalized with HUS. One was culture confirmed as infected with E. coli O157:H7. Interviews revealed that both patients had consumed unpasteurized cow milk sold by Organic Pastures in the week prior to the onset of illness.
In the following days, four additional cases of E. coli O157:H7 were identified. All of the additional cases had consumed raw milk or raw cow product sold by Organic Pastures. Isolates of the E. coli O157:H7 cultured from the five culture-positive patients had indistinguishable “genetic fingerprints” as determined by pulsed-field gel electrophoresis (PFGE) testing. These PFGE patterns were new to the national PulseNet database. In other words, the pattern associated with all of these children was unique, and had not been seen before in conjunction with any other outbreaks of E. coli O157:H7. In addition, the PFGE pattern differed markedly from the patterns associated with the outbreak of E. coli O157:H7 associated with Dole fresh-bagged baby spinach that had peaked a few weeks prior to these illnesses.
CDHS conducted an epidemiological and environmental investigation of the cluster of illnesses. A review of 50 consecutive E. coli O157:H7 cases reported to CDHS from October 2004 to June 2006 revealed that 46 of 47 cases asked about raw milk consumption reported consuming no raw milk. In contrast, five of the six patients in the cluster being investigated reported definite consumption of Organic Pastures raw dairy products. The sixth denied consuming the raw milk, but his family routinely consumed Organic Pastures raw milk during the suspected time frame. Two of the children developed Hemolytic Uremic Syndrome. This is the video of one of the children in the hospital:
The California Department of Food and Agriculture conducted an environmental investigation. As part of the investigation, fecal samples were collected from dairy cows at Organic Pastures. E. coli O157:H7 was isolated from five of the samples, although the PFGE patterns differed from the pattern associated with the outbreak. Testing of Organic Pastures product revealed abnormally high aerobic plate counts and fecal coliform counts. CDHS ultimately concluded: “the source of infection for these children was likely raw milk products produced by the dairy.” The CDC published this report in 2008.
2008 Raw Goat Milk E. coli O157:H7 Outbreak linked to Dairy and Retail
The Outbreak
On May 12, 2008 the Lawrence County Health Department (LCHD) was notified of a case of HUS in a child with a history of bloody diarrhea. The health care provider reported that the child had consumed unpasteurized goat’s milk obtained from a local store, the Herb Depot, in Barry County, Missouri. The milk had been purchased on April 29, 2008. It was quickly learned that an additional Barry County child that had cultured positive for E. coli O157:H7 had also consumed unpasteurized goat’s milk from the same store. As a result, the LCHD contacted the Missouri Department of Health and Senior Services (DHSS) who began a full epidemiological and environmental investigation of the illnesses. The investigation revealed that the milk consumed by both ill children had been produced at Autumn Olive Farms.
At the conclusion of its investigation, the DHSS ultimately announced that there were four cases of E. coli O157:H7 associated with the outbreak. Of these, three were laboratory confirmed, and one was identified as a probable case. Each of these individuals resided in different counties in Southwest Missouri, and were not known to have any relation to each other. Nonetheless, each shared a common exposure to milk from Autumn Olive Farms. In addition, the three culture-confirmed cases shared a common, indistinguishable genetic strain of E. coli O157:H7. The strain was identified as a unique subtype of E. coli O157:H7, never before reported in Missouri. Each of the four cases had consumed milk from Autumn Olive Farms within 3-4 days of onset of illness. The DHSS reported: “no other plausible sources of exposure common to all four cases were identified [other than the milk.]” The final outbreak report ultimately concluded: “the epidemiological findings strongly suggest the unpasteurized goat’s milk from Farm A [Autumn Olive] was the likely source of infection for each of the cases associated with this outbreak.”
The Victims
Larry Pedersen had just turned one year old when he developed an E. coli O157:H7 in May 2008. When his diarrhea turned bloody, his parents took him for medical treatment. He was admitted to the hospital on May 8. Shortly thereafter, Larry developed hemolytic uremic syndrome (HUS) and was transferred to a specialty care facility. As is typical of HUS, Larry was then suffering from acute renal failure. He was started on dialysis, which was necessary at that point for his survival. He required 15 days of dialysis before his kidneys recovered enough to function on their own. Larry was discharged on May 29, to continue recovery and treatment on an outpatient basis. The medical bills associated with his care approached $90,000. As the result of damage to his kidneys suffered during his bout with HUS, Larry is at significant risk for severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.
Nicole Riggs developed an E. coli O157:H7 infection in May 2008 from consumption of raw goat’s milk. She was nine years old at the time. Nicole suffered from symptoms typical of E. coli O157:H7 infections – bloody diarrhea, cramping, and nausea – that quickly intensified and led to her hospitalization on May 8, 2008. Once hospitalized, Nicole developed renal failure, anemia, and thrombocytopenia (low platelet count) indicating that she was developing HUS. She was transferred to a Children’s hospital and started on dialysis in order to save her life. She received dialysis for 18 days. Nicole’s renal function slowly returned to the point that she was deemed healthy enough for discharge on June 1. After discharge, she remained under the care of a nephrologist. In addition, damage suffered during her HUS has required that her gall bladder be removed. Medical costs to this point exceed $180,000. As the result of damage to her kidneys suffered during her bout with HUS, Nicole is at significant risk for severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.
Whole Foods and Town Farm Dairy Raw Milk E. coli O157:NM Outbreak - For this Young Mother any Raw Milk Benefits were not Worth the Risks.
The Outbreak
On July 16, 2008, the Connecticut Department of Public Health (CDPH) was investigating two cases of hemolytic uremic syndrome HUS as part of its routine surveillance. Interviews conducted in these investigations revealed that both children had consumed raw milk in the week before the onset of their illnesses. Both children had consumed raw milk produced by the Simsbury Town Farm Dairy. CDPH notified the Connecticut Department of Agriculture (CDA), and opened an investigation. In the following two weeks five additional confirmed and seven additional probable cases of E. coli O157:NM infection, each associated with consumption of raw milk from the Simsbury Town Farm Dairy with many linked to purchases at Whole Foods in Glastonbury, Connecticut.
As part of the investigation of the outbreak, CDA conducted an environmental inspection of the Simsbury Town Farm Dairy. CDA found a number of troubling practices at the dairy. These included: manual bottling of raw milk directly from the bulk tank; failure to cap valves; an improper seal around the shaft of the transport tank; and a biofilm protein residue found inside the transport tank. In addition, investigators found a number of “poor hygienic practices” at the dairy. Among these was the storage of a stainless steel milk tank in an exposed unsanitary bucket. In addition, investigators found a lack of hand soap, a lack of hot water and the hand-washing sink, and soiled floors. Flies were observed in the bulk milk storage tank room. The dairy workers were unable to identify the dairy’s sanitization process for glass milk bottles that were re-used. It was also noted that the glass bottles from the dairy did not feature the statutorily required consumer advisory language.
A laboratory study was also conducted. Of the six patients that cultured positive for E. coli O157:NM, 5 had a “genetic fingerprint” that was indistinguishable. The sixth varied very slightly on one test. Samples of feces from the cows at the dairy were also tested. One of the tests was positive for E. coli O157:NM of a strain matching that of the group of five patients. The CDPH concluded: “several findings from this investigation indicated that consumption of raw milk from Farm X [Simsbury] was the cause of the outbreak.”
The Victim
Kalee Prue, a 27-year-old mother of one, became infected with E. coli O157:NM in June, 2008, as the result of consumption of raw milk. Her symptoms began in early July, and intensified for several days. On two occasions, Kalee sought treatment in the emergency room. On July 12, it became apparent that she was developing HUS. She was then admitted to the hospital on July 13. Kalee’s renal failure was complete and prolonged, and she required plasmapharesis from July 13 through August 11. Severe anemia necessitated repeated transfusions with packed red blood cells as well. By the time she was released from the hospital on August 14, she had incurred nearly $250,000 in medical bills. Kalee has not recovered full renal function. She is at severe risk for long-term renal complications, including end stage renal disease (ESRD), dialysis, and transplant.
Risky Business - Why would a retailer, like Whole Foods, sell Raw Milk?
E. coli O157:H7 Outbreak Linked to Raw Milk in California in 2006
On September 18, 2006, the California Department of Health Services (CDHS) opened an investigation of a possible outbreak of E. coli O157:H7 infections after receiving reports of two patients who had been hospitalized with HUS. One was culture confirmed as infected with E. coli O157:H7. Interviews revealed that both patients had consumed unpasteurized cow milk sold by Organic Pastures in the week prior to the onset of illness.
In the following days, four additional cases of E. coli O157:H7 were identified. All of the additional cases had consumed raw milk or raw cow product sold by Organic Pastures. Isolates of the E. coli O157:H7 cultured from the five culture-positive patients had indistinguishable “genetic fingerprints” as determined by pulsed-field gel electrophoresis (PFGE) testing. These PFGE patterns were new to the national PulseNet database. In other words, the pattern associated with all of these children was unique, and had not been seen before in conjunction with any other outbreaks of E. coli O157:H7. In addition, the PFGE pattern differed markedly from the patterns associated with the outbreak of E. coli O157:H7 associated with Dole fresh-bagged baby spinach that had peaked a few weeks prior to these illnesses.
CDHS conducted an epidemiological and environmental investigation of the cluster of illnesses. A review of 50 consecutive E. coli O157:H7 cases reported to CDHS from October 2004 to June 2006 revealed that 46 of 47 cases asked about raw milk consumption reported consuming no raw milk. In contrast, five of the six patients in the cluster being investigated reported definite consumption of Organic Pastures raw dairy products. The sixth denied consuming the raw milk, but his family routinely consumed Organic Pastures raw milk during the suspected time frame. Two of the children developed Hemolytic Uremic Syndrome. This is the video of one of the children in the hospital:
The California Department of Food and Agriculture conducted an environmental investigation. As part of the investigation, fecal samples were collected from dairy cows at Organic Pastures. E. coli O157:H7 was isolated from five of the samples, although the PFGE patterns differed from the pattern associated with the outbreak. Testing of Organic Pastures product revealed abnormally high aerobic plate counts and fecal coliform counts. CDHS ultimately concluded: “the source of infection for these children was likely raw milk products produced by the dairy.”
More Video of what Cargill E. coli Hamburger did to Stephanie Smith
This video was produced by the New York Times less than two months ago:
A Dancer's Fight with E. coli O157:H7
We are filing suit on behalf of Stephanie Smith, the young dancer profiled in the New York Times, against food giant Cargill in Federal Court. Here is a video of her story:
Mr. President, Senators, Congress Members watch this video now!
It is long past time for meaningful changes in the safety of the food our children eat. Whether the food is raw, local, organic, small farm, big farm, mass-produced or slow, if it contains E. coli O157:H7, or another pathogen, it can kill. It can kill your child, grandchild or the child of a friend. It can kill just like it killed Abby. Here is her story:
It is time to step up and make Abby and her family the last to suffer this horror. Mr. President, Senators, Congress Members, do your jobs!
Abby’s illness, and her Grandfather's, were linked to a Class I Recall by FSIS in May 2009 - Illinois Firm Recalls Ground Beef Products Due To Possible E. coli O157:H7 Contamination
The Alexandre Eco Farms Dairy Raw Milk Campylobacter Outbreak
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I. THE OUTBREAK
On October 2, 2008, the California Department of Public Health (CDPH) issued a report linking an outbreak of Campylobacter illnesses to unpasteurized milk from Alexandre Eco Farms Dairy. The report was the result of an investigation commenced on July 14, 2008, when Dr. Thomas Martinelli, the County Health Officer for Del Norte County, California reported four cases of laboratory confirmed Campylobacter infections and five additional cases of diarrhea in Del Norte County residents. Eight of the original nine sick individuals were members of the Alexandre Eco Farms “cow-leasing” program. Eight of these individuals had consumed milk produced on the farm. The ninth sick individual worked with cattle on the Alexandre Eco Farms Dairy. One of the eight individuals who were sick, Mari Tardiff, had already been hospitalized with GBS, following the onset of acute gastroenteritis after consumption of the milk.
As part of the investigation, health department officials retrieved a refrigerated carton of partially consumed Alexandre Eco Farms milk from Mari Tardiff’s home. Mari had consumed a portion of the milk before her illness. The specimen tested positive for Campylobacter jejuni DNA using a test called polymerase chain reaction (PCR). Testing indicated that multiple strains of Campylobacter jejuni were present in the milk. Del Norte County officials eventually identified 16 cases of Campylobacter jejuni associated with the outbreak. Fifteen of those were persons who consumed milk from Alexandre Eco Farms Dairy. The 16th case was the farm employee. CDPH and Del Norte county officials concluded that “the available epidemiologic and laboratory data support the conclusion that this cluster of acute diarrheal illness in Del Norte County was an outbreak of C. jejuni infections caused by consumption of unpasteurized milk from [Alexandre Eco Farms Dairy.]”
The causal link between Alexandre Eco Farms Dairy and Mari’s illness was so clear, and her injuries so remarkable, that the physicians that treated her published a report on her case in the medical journal. “Investigation of the First Case of Guillain-Barre Syndrome Associated with Consumption of Unpasteurized Milk – California, 2008.” Amy K. Earon, T. Martinelli, W. Miller, C. Parker, R. Mandrell, D. Vugia. The authors explained the laboratory methods used in investigating Mari’s illness:
We reviewed the patient’s medical record and interviewed her husband to assess her symptoms and exposures. We used polymerase chain reaction (PCR) and multilocus sequence typing (MLST) to test a six-week old unpasteurized milk sample, obtained from the cow leasing-program and partially consumed by the patient, for genes encoding the bacterial membrane component lipooligosaccharide (LOS) in GBS-associated Campylobacter jenuni.
In addition to the DNA testing, the authors also tested Mari’s blood for anti-bodies to GBS. The authors then explained that the PCR and MLST testing of the milk detected Campylobacter jejuni gene. In addition, the blood test was positive for anti-bodies that indicated the presence of GBS. The authors concluded, “Combined laboratory and epidemiologic evidence established the first reported association between GBS and unpasteurized milk consumption.”
II. MARI TARDIFF’S ILLNESS
On the weekend after Mari drank raw milk, she developed flu-like symptoms, including diarrhea and vomiting. By Thursday, June 12, the food poisoning was overwhelming her body with an amazingly swift force. First her vision blurred. Then her hands went numb. Mari went to an emergency room, and there lab work was done and abdominal X-rays were taken. But doctors could not determine what was wrong. On Friday, Peter took Mari to a neurologist. An MRI was normal but the doctor and radiologist mentioned a frightening possibility – Guillain-Barré syndrome, or GBS, a potentially fatal inflammatory disorder.
Hours later Mari’s legs were on fire, searing with pain that, ironically, only hot water helped to soothe. Her legs hurt so much that she soon retreated to bed, wrapping her legs in warm towels and a heating blanket. During that night, Mari awoke and realized she could not move. Peter bear-hugged her to lift her to the toilet and then carried her back to bed. In the early hours of the morning, he called for help, which led to an ambulance ride to the small Sutter Coast Hospital, and then a medivac flight to the Intensive Care Unit at the larger, better-equipped Rogue Valley Medical Center (RVMC) in Medford, Oregon. She remained hospitalized for two and one-half months.
Mari was moved to Redding Rehabilitation Hospital and was finally able to come home on November 1, 2008. Today, Mari lives in her family room, which now is equipped with a hospital bed, portable toilet, a Hoyer lift and a stand-up frame, all purchased by the Tardiffs. Using their own resources, they also renovated a downstairs half-bath and laundry room into a handicapped-accessible bathroom and shower. The Tardiffs pay two nurses $10.50 an hour to care for Mari from 7:30 A.M. until 7:00 P.M. five days a week while Peter is at work. Home health physical and occupational therapists also come to the house five days a week.
Mari works very hard at therapy but it is a slow, painful process. Peter has found it so upsetting that he no longer can watch. Every improvement is celebrated, but he knows how much discomfort and frustration goes into each minute, regained movement. Mari may never walk again. She lost her job, she lost her dreams and plans that she held dear. The illness has been a long, arduous journey for Mari, her family and friends, and while she has made progress, there remains a long way to go.
READ MORE ON CAMPYLOBACTER AND GULLAIN BARRE SYNDROME
Continue Reading...Mr. President, Eating an Undercooked E. coli O157:H7-Tainted Hamburger Could Have Resulted in Hemolytic Uremic Syndrome
As much as any other victim of the 2006 Dole Spinach Outbreak, Suzanne Bandy’s case is about the staggering contrast between past and present. When asked for her thoughts, Suzanne wrote of her first 57 years: “very simply, my life embodied the American Dream.” Suzanne’s former life is, however, gone for good. Now, she states, “I pray to God every day that I may wake up from this horrible nightmare and return to the life that I loved.”
Sadly, Suzanne’s prayers will never be answered. The E. coli O157:H7 infection, along with the resulting hemolytic uremic syndrome (HUS), that she suffered in September 2006 devastated her kidneys. Consequently, her current renal function—measured roughly a year after her acute illness—is nearing a level where either a kidney transplant or lifelong dialysis will be necessary for survival. It is forecast that Suzanne will reach end stage renal disease in as little as five years.
Mr. President, this could have happened to you too. E. coli O157:H7, as you will see from this video, is a very nasty bug.
On A Day That Others Are Walking the Halls of Congress for Food Safety, Ruby is There in Spirit.
Ruby would have liked to have been there too. Her daughter, son-in-law and grandchildren stood up for Ruby by suing the companies whose E. coli O157:H7 product took her life long before her time. This is yet another video of another victim of the "safest food supply in the world."
Its Been 16 Years Since the Jack in the Box E. coli O157:H7 Outbreak and Brianne Kiner's Story is Still Hard to Watch
In 1993, Jack in the Box suffered a major foodborne illness outbreak involving E. coli O157:H7 bacteria. Four children died of hemolytic uremic syndrome (HUS), hundreds were hospitalized and 600 others were reported sick after eating undercooked patties contaminated with fecal material containing the bacteria at locations in California, Washington, Idaho and Nevada. Brianne Kiner was one HUS survivor. Click on below to watch short video:
After two years of litigation, we were able to recover $15,600,000 for Brianne and her family.
E. coli O157:H7, Spinach and Children Do Not Mix - Well
Severe illness - Hemolytic Uremic Syndrome (HUS) - caused by E. coli O157:H7, impacts kids the hardest. Here is another family's story of when feeding your kids something healthy goes very wrong.
Another E. coli O157:H7 Death Caused by Tainted Spinach
Click on below to watch video.
Hepatitis A in Imported Green Onions - Its Impact on One Man
In late October 2003, Beaver County ER doctors reported an alarming number of Hepatitis A cases. Investigators from the Pennsylvania Department of Health initiated an investigation immediately and discovered that many, if not all, cases had eaten at Chi Chi’s restaurant in Monaca, Pennsylvania’s Beaver Valley Mall. Along with the health department, the federal Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) conducted further studies of the outbreak. Preliminary analysis of a case-control study suggested that green onions were the probable source of the outbreak. The onions had been shipped to the restaurant in boxes and were stored and refrigerated in buckets of ice. They were eventually chopped up and served in various dishes at the restaurant, often uncooked, as in the preparation of mild salsa. “Preliminary trace-back information indicated that the green onions supplied to Chi Chi’s had been grown in Mexico.” Ultimately, over 650 people were sickened in the outbreak. The victims included at least thirteen Chi Chi’s employees and numerous residents of six other states. Four people died from their injuries, and more than 9,000 people obtained immune globulin shots as protection against the virus. This is the story of one of those cases.
Yet Another Reason E. coli O157:H7 Has No Place in Our Food
Donna Roy was part of the 2006 Dole Spinach E. coli O157:H7 Outbreak. She developed Hemolytic Uremic Syndrome (HUS), which is a severe, life-threatening complication of an E. coli O157:H7 bacterial infection. It is now recognized as the most common cause of acute kidney failure in childhood in the United States. E. coli O157:H7 is responsible for over 90% of the cases of HUS that develop in North America. In fact, some researchers now believe that E. coli O157:H7 is the only cause of HUS in children. However, it clearly impacts all of us - young and old.
Another E. coli O157:H7 Outbreak and Even More Victims
The thing about E. coli O157:H7 is that it does not discriminate - child, young adult, grandparent, man or woman, rich or poor. It sickens over 70,000 people in the US yearly. Here are the short stories of three from 2006 - Remember, they could be your kid, your daughter or your parent:
E. coli O157:H7 Impacts Your Friends, Neighbors, the Young and Old
The following five short videos, I hope tell the story of what this nasty bug, E. coli O157:H7, can do and why it needs to be prevented.
Stewart Parnell and King Nut, if you have access to the internet, please look at the video
We provided this video clip to the Congressional Subcommittee investigating this Salmonella outbreak that has sickened over 640, hospitalized 150 and killed nine. Clifford's son, Lou, offered his testimony to the Subcommittee as well. Clifford was a hero, who should not have died from eating King Nut peanut butter.
E. coli O157:H7 in Bagged Spinach - Its Impact on One Woman
Official word of the bagged spinach outbreak broke with the FDA’s announcement, on September 14, 2006, that a number of E. coli O157:H7 illnesses across the country “may be associated with the consumption of produce.”
Meanwhile, the FDA and CDC, in conjunction with local and state health agencies from across the country, worked feverishly to figure out the brand names associated with illness. Early statistical analysis suggested that many brands were implicated, but the spinach sold under the several brand names had all come from the Natural Selection Foods processing center in San Juan Batista, California. Accordingly, Natural Selection recalled all of its spinach products with “use by” dates from August 17 to October 1, 2006. The recall, of course, included Dole brand spinach. But further data and study ultimately narrowed the possible sources of the outbreak down to one brand of packaged greens: Dole.
Ultimately, the FDA confirmed 205 outbreak-related cases, with 102 hospitalizations, thirty-one cases of HUS, and five deaths, though the actual number of people affected by the outbreak was certainly much larger. This is the story of one of those cases.
C. Botulinum Toxin - Botulism - in Canned Chili - Its Impact on One Man
On July 7, 2007, the Centers for Disease Control and Prevention (“CDC”) learned that two siblings in Texas were critically ill with botulism and that their illnesses were likely acquired by eating contaminated food. Four days later on July 11, public health officials in Indiana reported to the CDC that a married couple in Indiana were suspected of having foodborne botulism. On July 17, CDC staff provided information regarding the production-dates and times to the FDA. The evidence strongly suggested that brands of Castleberry’s hot dog chili sauce were the common source of the four ill persons with botulism. By August 24, eight cases of botulism had been reported to the CDC. In addition to the Indiana couple, the mother of the children in Texas had developed symptoms of botulism, which brought the total number of Castleberry-associated cases in Texas to three. There were also three unrelated residents of Ohio who had developed botulism consuming Castleberry’s hot dog chili sauce in the week before symptom onsets. Botulinum toxin was identified in leftover chili sauce collected from the refrigerator belonging to one of the Ohio cases.
On July 18 and 19, a team of federal investigators were sent to the firm’s warehouse. Samples of Castleberry’s Austex and Castleberry’s brand Hot Dog Chili Sauce with the “best by May 7, 2009” and “best by May 8, 2009” lot codes were collected and sent to FDA laboratories for testing. FDA testing of sample 428113, consisting of 17 swollen cans, found C. Botulinum toxin in 16 of the cans. This sample included the same time-stamp and lot code from the May 8, 2007 production as the can found in the Indiana home. FDA testing of sample 420352, consisting of six swollen cans, found C. Botulinum in four cans. FDA sample 420353 included one swollen can, and its contents tested positive for C. Botulinum toxin.
Federal investigators conducted extensive tests on Castleberry equipment. The findings are presented in an FDA report issued on August 10, 2007. Noted observations include:
1. The system, equipment, and procedures used for thermal processing of foods in hermetically sealed containers were not operated and administered in a manner that ensures commercial sterility is achieved.
2. Each retort did not have an accurate temperature records device.
3. Failure to supply a suitable water valve used for water cooling to prevent leakage of water into the retort during processing.
4. The condensate bleeder was not checked with sufficient frequency to ensure removal of condensate or equipped with an automatic alarm system for the continuous monitoring of condensate bleeder functioning.
5. Required information was not entered on designated forms at the time the observation was made by the retort or processing system operator or designated person.
6. Failure to maintain fixtures in repair sufficient to prevent food from becoming adulterated.
7. Failure to properly adjust the temperature-recording device. The temperature recorded on the temperature-recording device chart was higher than the mercury-in-glass thermometer during processing.
The report ultimately placed blame on Castleberry management saying there was no commitment from employees in making the products and there was not adequate management oversight. As one Castleberry employee noted: “Two years ago the [implicated reports] were maintained very well, but they are maintained poorly now.” The FDA plainly agreed, citing Castleberry’s for the “failure to maintain fixtures in repair sufficient to prevent food from becoming adulterated.” This is the story of one of those cases.
Salmonella in Peanut Butter - Its Impact on One Woman
On February 14, 2007 the FDA announced a nationwide outbreak of Salmonella in ConAgra peanut butter produced at the Sylvester, Georgia plant. The CDC eventually reported that 714 people suffered culture-confirmed Salmonella Tennessee infection with a genetic pattern matching one of the three strains associated with the ConAgra outbreak. Seventy-three percent of cases are female, and twenty percent of all cases required hospitalization as a result of their illnesses. Onset dates ranged from August 1, 2006 to July 19, 2007, and forty-eight states reported at least one confirmed case. This is the story of one of those cases.
