The program includes three days of sessions facilitated by Frank Yiannas, Vice President of Food Safety & Health, Walmart, USA and Adjunct Professor in the Online Master of Science in Food Safety Program at MSU.The program also includes guest lectures by William “Bill” Marler, Managing Partner, Marler Clark LLP PS, and The Robert Leader Endowed Lecture with Guest Lecturer Dr. Patricia Griffin, Chief of the US Centers for Disease Control and Prevention’s (CDC) Enteric Diseases Epidemiology Branch.

Frank Yiannas  Patricia Griffin, CDC  Bill Marler

The program will be conducted at the James B. Henry Center for Executive Development at Michigan State University. Evening activities include a welcome reception at the University Club of MSU on Tuesday, May 22; dinner and a tour of the internationally celebrated Eli and Edythe Broad Art Museum on Wednesday, May 23 and a “tailgate” dinner at the Huntington Club at Spartan Stadium on Thursday, May 24.

Yiannas is the author of Food Safety Culture – Creating a Behavior-based Food Safety Management System and Food Safety = Behavior (30 Proven Techniques to Enhance Employee Compliance). He is also Vice–Chair of the Global Food Safety Initiative (GFSI) and past President of the International Association for Food Protection.

NOTE: Cancellations are subject to a $100.00 administrative fee. No refunds will be granted after May 1, 2018. Send cancellation requests in writing to Esther Haviland at estherh@msu.edu.

Clearly, tweeting is not just happening in the Oval Office.

Granted, assuming that the E. coli O157:H7 illnesses stopped in early December – CDC and Canadian health authorities have not yet updated the toll – 58 sick with two dead – and, given that romaine lettuce is a perishable product, Dr. Gottlieb may well be correct.  However, since there has been no report where the romaine was grown or processed, we do not really know where the contamination occurred and if subsequent lots of romaine (or other products) are at risk.

I’ll stick with the old CDC adage: “When in doubt, throw it out.”

From Business Insider:

A deep knowledge of thousands of food poisoning cases across the US has scared Bill Marler off of certain foods.

With more than two decades working as a food poisoning advocate and attorney, there are simply some things that Marler has cut out of his diet. Marler has won more than $600 million for clients in foodborne-illness cases — and become convinced that some foods aren’t worth the risk.

In an article by Health Insider from BottomLine and in conversations with Business Insider, Marler has identified certain foods that he avoids — and that others should be wary of as well.

Here are the foods that this expert says scare him the most:

Marler told Business Insider that the idea he would have to warn people against drinking unfiltered, untreated water didn’t cross his mind until recently.

“Almost everything conceivable that can make you sick can be found in water,” Marler says.

Unfiltered, untreated water — even from the cleanest streams — can contain animal feces, spreading Giardia, which has symptoms such as vomiting and diarrhea and results in roughly 4,600 hospitalizations a year. Hepatitis A, which resulted in 20 deaths in a California outbreak in 2017, can be spread through water if it isn’t treated. E. coli and cholera can also be transmitted via untreated water.

Uncooked flour is on the other end of the spectrum — something that most people see as harmless, but that can actually spread bacteria, Marler says.

From late 2015 to 2016, 56 people in 24 states developed an E. coli infection from eating raw or uncooked flour, Consumer Reports reported. 

Most people think that raw eggs are the biggest food poisoning threat in cookie dough, Marler says. However, flour can also be a culprit — and you don’t even have to eat it. Simply not washing your hands after getting uncooked flour on them can spread E. coli.

Marler says that he has seen more foodborne illnesses linked to shellfish in the past five years than in the two preceding decades.

The culprit: warming waters. As global waters heat up, they produce microbial growth, which ends up in the raw oysters consumers are slurping down.

Marler says that he avoids these “like the plague.” Convenience may be nice, but, as more people handling and processing the food means more chances for contamination, it isn’t worth the risk.

For example, a study from Consumer Reports found unacceptable levels of bacteria that commonly cause food poisoning in about a third of the 208 salad bags that were tested. As Business Insider’s Rebecca Harrington notes, that doesn’t mean these bacteria would cause illness; just that they had the potential to do so.

Sprout outbreaks are surprisingly common, with more than 30 bacterial outbreaks — primarily salmonella and E. coli — in the past two decades.

“There have been too many outbreaks to not pay attention to the risk of sprout contamination,” Marler says. “Those are products that I just don’t eat at all.”

Marler agrees with known-germaphobe President Trump on at least one thing: well-cooked meat is the way to go.

According to the expert, meat needs to be cooked to 160 degrees throughout to kill bacteria that could cause E. coli or salmonella.

For anyone who remembers the salmonella epidemic of the 1980s and early ’90s, this is a no-brainer. According to Marler, the chance of getting food poisoning from raw eggs is much lower today than it was 20 years ago, but he still isn’t taking any chances.

A precursor to the raw water trend is the movement encouraging people to drink “raw” milk and juices, arguing that pasteurization depletes nutritional value.

Marler says that pasteurization is not dangerous — but raw beverages can be, as skipping the safety step means an increased risk of contamination by bacteria, viruses, and parasites.

“There’s no benefit big enough to take away the risk of drinking products that can be made safe by pasteurization,” he says.

Our plan is to ask nicely for the records in this case so the FDA can see the benefit or transparency.  If the FDA refuses to respond by disclosing the information, we will ask a Court to decide if the public has a right to know.  FSIS has done this on recalls of beef, pork and poultry for over a decade and the world did not stop spinning.

 

January 3, 2018

Food and Drug Administration

Division of Freedom of Information

Office of the Executive Secretariat, OC

5630 Fishers Lane, Room 1035

Rockville, MD 20857

 

 

REQUEST FOR PUBLIC RECORDS

Outbreak of E. coli, January-March 2017

                        I.M Healthy SoyNut Butter, I.M Healthy Granola, Dixie Diner’s Club Carb Not Beanit Butter, and 20/20 Life Styles Yogurt Peanut Crunch Bars

                       

To Whom It May Concern:

I am writing to request copies of public records on file at the Food and Drug Administration (FDA) regarding the names and locations of all retailers known by the FDA to have received shipments of I.M. Healthy SoyNut Butter, I.M. Healthy Granola, Dixie Diner’s Club Brand Carb Not Beanit Butter, and 20/20 Life Styles Yogurt Peanut Crunch bars that have been recalled due to potential contamination with E. coli.

On March 3, 2017, The SoyNut Butter Company voluntarily recalled its I.M. Healthy Original Creamy SoyNut Butter with Best By dates of August 30, 2018 and August 31, 2018. On March 4, 2017, The SoyNut Butter Company expanded the recall of its I.M. Healthy Original Creamy SoyNut Butter to include product packaged in 15oz. plastic jars with Best By dates of July 05, 2018, August 30, 2018, and August 31, 2018; individual portion cups with a Best By date of August 08, 2018; and 4lb. plastic tubs with Best By dates of November 16, 2018 and July 25, 2018.

On March 7, 2017, The SoyNut Butter Company recalled all lots of I.M. Healthy SoyNut Butter and I.M. Healthy Granola. I.M. Healthy SoyNut Butter is packaged in 15 oz. plastic jars, individual portion cups, 4 lb. plastic tubs or 45 lb. pails. The products are available in Original Creamy, Chunky, Honey Creamy, Unsweetened and Chocolate. I.M Healthy Granola is packaged in individual serving packages, 12 oz. bags, 50 oz. bags, and 25 lb. bulk bag. I.M. Healthy Granola is available in Original, Apple, Blueberry, with Raisin, and Cranberry.

On March 10, 2017, The SoyNut Butter Company expanded its recall to include all best buy dates of Dixie Diner’s Club brand Carb Not Beanit Butter. The recalled product was only available for purchase via mail order or online portals.

On March 24, 2017, Pro Sports Club recalled 20/20 Life Styles Yogurt Peanut Crunch bars because they were made with soy nut butter supplied by The SoyNut Butter Company.

Despite the recall of these products, Amazon was still selling I.M. Healthy SoyNut Butter as of September 5, 2017, a Lucky’s Market in Redwood City, California was still selling I.M. Healthy SoyNut Butter as of September 26, 2017, and Shop.com was still selling I.M. Healthy SoyNut Butter as of October 12, 2017.

We are willing to pay all costs associated with providing the requested records.  If you require pre-payment, please contact me and I will arrange for it to be made. Responsive documents can be sent via email, facsimile (206-346-1898) or by U.S. Mail.  If you choose to mail documents please send them to my attention at the following address.

 Marler Clark Law Firm

1012 First Avenue, Fifth Floor

Seattle, WA 98104-1008

If you have any questions about my request or need further information, please contact me.  Thank you in advance for your prompt reply.

 

 

Very truly yours

Katrina Deardorff, MPH

Epidemiologist

I talked to Kate Taylor at Business Insider about “Raw Water” yesterday:

When food-safety expert Bill Marler saw The New York Times’ trend pieceon Silicon Valley’s recent obsession with raw water, he thought he was reading a headline from The Onion.

According to The Times, demand for unfiltered water is skyrocketing as tech-industry insiders develop a taste for water that hasn’t been treated, to prevent the spread of bacteria or other contaminants.

In San Francisco, “unfiltered, untreated, unsterilized spring water” is selling for as much as $60.99 for a 2.5 gallon jug. Startups dedicated to untreated water are popping up. People — including startup Juicero’s cofounder Doug Evans — are gathering gallons of untreated water from natural springs to bring to Burning Man.

Tourmaline Spring sells an untreated water as “sacred, living water.” 

While Evans and other fans say raw water is perfect for those who are “extreme about health,” Marler — a food-safety advocate and a lawyer — says the opposite is true.

“Almost everything conceivable that can make you sick can be found in water,” Marler told Business Insider.

Unfiltered, untreated water, even from the cleanest streams, can contain animal feces, spreading Giardia, which has symptoms such as vomiting and diarrhea and results in roughly 4,600 hospitalizations a year. Hepatitis A, which resulted in 20 deaths in a California outbreak in 2017, can be spread through water if it isn’t treated. E. coli, and cholera can also be transmitted via untreated water.

Because filtered, treated water has become the norm, Marler says, most people don’t realize how dangerous s0-called raw water can be.

“The diseases that killed our great-grandparents were completely forgotten about,” he said.

Most Americans don’t personally know anyone who died of Hepatitis A or cholera, thanks to advances in technology and more stringent safety standards. As a result, they had a hard time realizing the risks involved in consuming untreated water.

“It’s fine till some 10-year-old girl dies a horrible death from cholera in Montecito, California,” Marler said.

On January 2, Business Insider’s Melia Robinson visited a San Francisco supermarket where a small company called Live Water sells its untreated water. Rainbow Grocery was sold out of the Fountain of Truth Spring Water from Live Water, but a sign indicated a “slight price increase.”

The cost of a 2.5 gallon jug increased from $36.99 to $60.99 since The Times’ article published. While the price includes the glass container, a refill costs only $14.99, according to The Times.

According to Marler, the raw-water trend is similar to people’s obsession with raw milk or opposition to vaccines. While they lack scientific evidence, they’re convinced that they are correct, in part because they have failed to see the repercussions of life without scientific advances.

“You can’t stop consenting adults from being stupid,” Marler said. “But we should at least try.”

The Food and Drug Administration’s Food-Recall Process Did Not Always Ensure the Safety of the Nation’s Food Supply 

Prior Office of Inspector General (OIG) reviews focused on U.S. Food and Drug Administration (FDA) oversight of food recalls. Food recalls are the most effective means of protecting public health when a widely consumed food product is either defective or potentially harmful. At the time of those OIG reviews, FDA did not have statutory authority to require food manufacturers to initiate recalls of most foods.

After those reviews, enactment of the FDA Food Safety Modernization Act gave FDA new authority to order a mandatory recall and require firms to recall certain harmful foods. We conducted this review to determine whether FDA is fulfilling its responsibility in safeguarding the Nation’s food supply now that it has mandatory recall authority.

Our objective was to determine whether FDA had an efficient and effective food-recall process that ensured the safety of the Nation’s food supply. Specifically, we focused on FDA’s (1) oversight of firms’ initiation of food recalls, (2) monitoring of firm-initiated recalls, and (3) maintenance of food-recall data in the electronic recall data system.

We reviewed documentation for 30 voluntary food recalls judgmentally selected from the 1,557 food recalls reported to FDA between October 1, 2012, and May 4, 2015.

FDA did not always have an efficient and effective food-recall process that ensured the safety of the Nation’s food supply. We identified deficiencies in FDA’s oversight of recall initiation, monitoring of recalls, and the recall information captured and maintained in FDA’s electronic recall data system, the Recall Enterprise System (RES). Specifically, we found that FDA could not always ensure that firms initiated recalls promptly and that FDA did not always (1) evaluate health hazards in a timely manner, (2) issue audit check assignments at the appropriate level, (3) complete audit checks in accordance with its procedures, (4) collect timely and complete status reports from firms that have issued recalls, (5) track key recall data in the RES, and (6) maintain accurate recall data in the RES.

Recalls were not always initiated promptly because FDA does not have adequate procedures to ensure that firms take prompt and effective action in initiating voluntary food recalls. FDA’s monitoring of recalls was not always adequate because FDA staff had insufficient oversight to ensure that the assignment was at the appropriate level, and FDA obtained incomplete or inaccurate consignee information from firms initiating recalls. Additionally, FDA lacked adequate procedures to collect timely and complete status reports from these firms because the procedures did not require staff to request status reports at the time the recall was initiated. Lastly, the RES contained deficient recall information because it did not track all information necessary for FDA to effectively monitor recall activities and assess the timeliness of recalls; the RES also contained inaccurate data.

We recommended that FDA use its Strategic Coordinated Oversight of Recall Execution (SCORE) initiative to establish set timeframes, expedite decision-making and move recall cases forward, and improve electronic recall data. We also made other procedural recommendations, which are listed in the report.

FDA agreed with our conclusion that it needs to help ensure that recalls are initiated promptly in all circumstances and said that it will consider the results of our review as it “continues to operate the SCORE team.” FDA also described other actions it has taken in response to our early alert, issued June 8, 2016, and draft report including initiating a new quality system audit process and a plan to provide early notice to the public and more guidance to staff.

Download the complete report or the Report in Brief.

I had a good talk the R.J. Wilson of Healthway a few weeks ago – love the illustration.

Most of us live in relatively ignorant bliss when it comes to our food. We know that we shouldn’t eat from the salad bar of a seedy motel, for instance, and that we’re better off avoiding fast-food sushi.

Ultimately, however, we don’t really know what happens to our food before it’s presented to us.

Studies show that 76 million people are affected by food illness every year. Those illnesses can be caused by bacteria, viruses, molds, and even parasites—and in some cases, the symptoms are life-threatening.

Food poisoning attorney Bill Marler has seen just about everything. He has represented clients in some of the biggest food safety cases on record, and over time, his professional life has shaped his food preferences.

I have a different relationship with food because of my profession.

In early 2016, Marler compiled a list of six foods that he never eats (although, as we’ll explain shortly, he’s taken occasional liberties with one of those foods). The article quickly went viral, which didn’t surprise the attorney.

“I get asked a lot about what foods I stay away from,” Marler explains to HealthyWay. “It was one of those kind of things where I finally decided to just put them [together], and I came up with six.”

But while Marler thought that the piece would do well, he might not have anticipated its reach.

“My daughter called me and said, ‘Dad, you’re trending [online],’” he recalls. “It was the first time she actually thought I was interesting!”

We spoke with Marler to review the original list—and to find out whether he’s really serious about some of these.

1. The first item isn’t exactly a hard one to pass up…

What’s healthier than raw sprouts? They’re a great addition to any sandwich, right?

Not quite. In the past 20 years, over 30 reported illness outbreaks resulted from sprout consumption, including numerous cases of salmonella and E. coli.

In 2014, 19 people were hospitalized with salmonella poisoning from eating sprouts. Marler warns that there have been too many outbreaks to not pay attention to the risks.

The U.S. government’s consumer food safety website, Foodsafety.gov, includes this warning: “Children, the elderly, pregnant women, and persons with weakened immune systems should avoid eating raw sprouts of any kind (including alfalfa, clover, radish, and mung bean sprouts).”

Of course, the site also notes that cooking the sprouts kills the harmful bacteria, so if you prefer your bean sprouts cooked, you’ve got nothing to worry about.

Plus, sprouts are…well, kind of gross, so we don’t really mind avoiding them. Unfortunately, the list gets harder from here.

2. Marler admits to cheating on this one.

This one isn’t so much about the food as the way it’s prepared.

Pre-cut fruit seems like a great idea, in theory; you get delightfully sliced pieces of perfectly ripened fruit filled with vitamins, minerals, and antioxidants.

However, in his original article, Marler wrote that he avoids pre-cut fruit “like the plague.”

As Marler wrote, the extra handling and processing increases the chances that the fruit will be contaminated. According to the Australian Institute of Food Safety, pre-cut fruit is one of the most common foods associated with foodborne illnesses.

Still, Marler admits that he doesn’t exactly avoid cut fruits “like the plague.” He was using a bit of hyperbole to get his point across.

“If I’m traveling or looking for a quick lunch, sometimes it’s just too convenient,” he says.

He does recommend eating whole fruits instead; that should help people avoid listeria, a bacteria that can cause gastrointestinal and nervous system issues.

3. Ready for a healthy breakfast? Well…sorry in advance.

This one might be hard for some people to stomach; we can’t imagine asking for our eggs over-hard.

Even though much has changed in the way of the handling and processing of eggs nowadays, it wasn’t long ago that people were getting sick from raw eggs. In the early ’80s and ’90s, salmonella was an epidemic, but in 2010, the CDC reported around 2,000 cases of salmonella contamination involving eggs.

Salmonella can live both inside and outside the shells of eggs. Symptoms of salmonella poisoning can last for over a week and include cramps, diarrhea, and fever. Infectious disease experts recommend keeping eggs refrigerated until they’re ready to be prepared.

Marler admits that eggs are getting safer. “[Salmonella in eggs] is less of a problem than it was, say, 10 years ago,” he says. “But it’s still a risk that is, in my view, not worth taking.”

Not to disagree with our expert, but we’ll note that the risk is quite limited. Per Forbes, about one in 20,000 eggs is infected with salmonella. That’s a pretty small number, all things considered. Cooking your eggs (properly) limits the growth of bacteria and reduces the chance of salmonella poisoning.

Still, a representative of Foodsafety.gov tells HealthyWay that eggs still pose a pretty significant risk, particularly to immunocompromised people, and consumers need to understand that risk before partaking.

4. This food trend might seem healthy, but that’s not the case.

Pasteurization removes some of the nutrients in juice and milk and that doesn’t bode well with the super-health-conscious crowd. As a result, raw milk and juices have become more popular over the past few years, despite warnings from the FDA.

Marler argues that there’s no benefit compelling enough to minimize the risks involved with these drinks. Since pasteurization is an important safety procedure that eliminates harmful parasites, bacteria, and viruses from beverages, it would be irresponsible to risk possible infection for a couple of extra nutrients.

Of course, his opinion is informed by his case work. In 1996, Marler fought for several children against the popular beverage company Odwalla. One client developed a serious affliction called hemolytic uremic syndrome (HUS) from drinking unpasteurized apple juice. HUS is caused by E. coli and is linked to anemia and kidney failure.

Ultimately, Odwalla was held responsible and had to pay a $1.5 million fine and another $12 million to the victims.

5. We’ve got bad news for meat eaters.

Although something of a delicacy, rare steak (and other kinds of beef) carry with them a host of potential foodborne pathogens, including listeria, salmonella, and E. coli. Marler recommends steering clear of meat that is cooked rare.

He suggests that steak should only be consumed if it’s medium-well or well, which should kill the harmful bacteria.

It may not be the most delicious way to eat a steak, but Marler says the risks outweigh the rewards. The FDA cautions that red meat needs to be cooked to 145 degrees Fahrenheit (160 degrees for ground meats) in order to be safe.

Ground meat products (like hamburgers and meatloaf) need to be cooked even more thoroughly since bacteria that sits on the surface of the meat is often ground inside of it.

Still, we had to ask: Does he really order all of his steaks well done? Yes, although he recalled one meal in which a restaurant confused his order with his colleague’s.

“They switched the order, and I quickly looked at his steak and my steak and realized it,” Marler recalls. “We had to switch them back.”

6. But Marler received the most complaints for this final item.

Most people know that oysters are not the cleanest food available, but often people don’t realize why. Oysters filter feed, which means they eat (and hold on to) everything that’s in the water—and we mean everything.

When you eat raw oysters, you ingest their bacteria (somewhat obviously). Marler says that he has seen many more issues with the consumption of raw oysters over the last five years as compared to 20 years ago, and he believes that warmer water temperatures are to blame.

Why? Well, higher water temperatures mean more microbial growth, which means more cases of foodborne illness. In order for an oyster to be safe from bacteria and viruses, it must be cooked thoroughly. That reduces the risk of an illness, but doesn’t eliminate it altogether.

“We’re starting to see more cases [involving oysters],” Marler says, noting that, despite the pushback from his friends on the East Coast, he wouldn’t take the mollusks off of his list.

So, would Marler make any changes to this list?

Nope. He says that while he’s seen contamination with specific brands, he doesn’t think he’d make any additions.

“There’ve been lots of outbreaks linked to, for example, soy nut butter,” Marler says. “But [the list] includes things that, historically, in my experience, have been much more risky. They’re involve products that don’t have a ‘kill’ step—they’re not cooked.”

He also says that while he’s fairly strict about his own diet, he doesn’t ask his friends to order differently at restaurants.

“Most people know what I do, and they either don’t care or they change their order,” Marler says with a laugh. “I have a different relationship with food because of my profession.”

Perhaps I need to add in flour in cookie dough?

  1. Safely Thaw Your Turkey

Thaw turkeys in the refrigerator, in a sink of cold water that is changed every 30 minutes, or in the microwave. Never thaw your turkey by leaving it out on the counter. A frozen turkey is safe indefinitely, but a thawing turkey must defrost at a safe temperature. When the turkey is left out at room temperature for more than two hours, its temperature becomes unsafe as it moves into the danger zone between 40°F and 140°F, where bacteria can grow rapidly.

  1. Safely Handle Your Turkey

Raw poultry can contaminate anything it touches with harmful bacteria. Follow the four steps to food safety – cook, clean, chill, and separate – to prevent the spread of bacteria to your food and family.

  1. Safely Stuff Your Turkey

Cooking stuffing in a casserole dish makes it easy to make sure it is thoroughly cooked. If you put stuffing in the turkey, do so just before cooking. Use a food thermometer to make sure the stuffing’s center reaches 165°F. Bacteria can survive in stuffing that has not reached 165°F and may then cause food poisoning. Wait for 20 minutes after removing the bird from the oven before removing the stuffing from the turkey’s cavity; this allows it to cook a little more. Learn more about how to prepare stuffing safely.

  1. Safely Cook Your Turkey

Set the oven temperature to at least 325°F. Place the completely thawed turkey with the breast side up in a roasting pan that is 2 to 2-1/2 inches deep. Cooking times will vary depending on the weight of the turkey. To make sure the turkey has reached a safe internal temperature of 165°F, check by inserting a food thermometer into the center of the stuffing and the thickest portions of the breast, thigh, and wing joint. Let the turkey stand 20 minutes before removing all stuffing from the cavity and carving the meat. Learn more about safe minimum cooking temperatures and how to use a food thermometer for turkey and other foods.

  1. Take Care with Leftovers

Clostridium perfringens are bacteria that grows in cooked foods left at room temperature. It is the second most common bacterial cause of food poisoning. The major symptoms are vomiting and abdominal cramps within 6 to 24 hours after eating.

  • Clostridium perfringens outbreaks occur most often in November and December.2
  • Many of these outbreaks have been linked to foods commonly served during the holidays, such as turkey and roast beef.

Refrigerate leftovers at 40°F or colder as soon as possible and within two hours of preparation to prevent food poisoning.

Use a food thermometer to check for a safe internal temperature.

 Thanks to CDC

Homelessness in the greater Seattle/King County region seems to be rising as fast as High-Tech jobs and housing prices.  There are estimated to be 3,000 people in Seattle each night who are unsheltered and about 10,000 homeless people living on either the streets or in shelters. And, as the nights grow wetter and colder, the lives of our fellow citizens grow even more precarious.  Clearly, homelessness is a complex issue that combines various elements of poverty, substance abuse and mental health, however, now, enters yet another concern – public health – specifically, the growing risk of hepatitis A amongst the homeless, and the risk that it will spread.

It is what is happening in other regions and the risk that it could happen here is real.

In the Detroit, Michigan area there have been 486 cases of hepatitis A, including 19 fatalities, identified as related to an outbreak in Southeast Michigan, according to the Michigan Department of Health and Human Services. In October, health officials said they were investigating cases at Firewater Bar and Grill and a Little Caesars Pizza location in Detroit and a restaurant worker in Ann Arbor. Cases were also linked to Whole Foods in Detroit and Social Kitchen in Birmingham and recently at Champs Rotisserie and Spirits in Wayne County.

In San Diego, California, the county Health and Human Services Agency published new weekly totals, which add one to the number of deaths recorded since the health crisis started in November 2016. The running tally of confirmed cases also continues to increase, reaching 536 from a previous total of 516 – including 20 deaths. On September 15th, the county notified the public that a worker at World Famous restaurant in Pacific Beach had tested positive.

And, thanks to the Huffington Post, you can see the problem in the whole country:

Hepatitis A is preventable with a vaccine and/or good sanitation and/or handwashing. Hepatitis A is a communicable — or contagious — disease that often spreads from person to person. Person-to-person transmission occurs via the “fecal-oral route,” while all other exposure is generally attributable to contaminated food or water.

Hepatitis A is relatively stable and can survive for several hours on fingertips and hands. It can live up to two months on dry surfaces. The virus can be inactivated by heating to 185 degrees F (85°C) or higher for one minute, or disinfecting surfaces with a 1:100 dilution of sodium hypochlorite (household bleach) in tap water. Freezing does not kill the virus.

The vaccine is recommended by public health officials for the following people:

  • Travelers to areas with increased rates of hepatitis A;
  • Men who have sex with men;
  • Injecting and non-injecting drug users;
  • Persons with clotting factor disorders;
  • Persons with chronic liver disease;
  • Persons with occupational risk of infection;
  • Children living in regions of the U.S. with increased rates of hepatitis A; and
  • Household members and other close personal contacts.

So, what can we do to prevent the tragedies that have hit California and Michigan hard and appear to be spreading to other areas of the country?

  • Encourage and offer hepatitis A vaccines to the homeless and other at-risk members of the public;
  • Provide sanitary bathroom and handwashing facilities to the homeless; and
  • Provide assistance to our neighbors to deal with the underlying issues of poverty, substance abuse and mental health.