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

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. 

Daniele Recalls another 23,754 pounds of Salami

Daniele International Inc., an establishment with operations in Pascoag and Mapleville, R.I., is now recalling approximately 1,263,754 pounds of ready-to-eat (RTE) varieties of Italian sausage products, including salami/salame, in commerce and potentially available to customers in retail locations because they may be contaminated with Salmonella, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

FSIS became aware of the problem during the course of an ongoing investigation of a multi-state outbreak of Salmonella serotype Montevideo illnesses. The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), FSIS, state health and agriculture departments, and Daniele International are cooperating in this investigation. The CDC has posted information about the multi-state outbreak on its website (http://www.cdc.gov/salmonella/ montevideo/index.html) but the investigation is ongoing, and has not yet definitively identified a food vehicle(s).

During the course of that investigation, a sample of product found in commerce was tested on behalf of a participating state department of health and found to contain Salmonella, which FSIS has a zero tolerance for in RTE products. The product tested was similar to products bought by customers who later became sick in the Montevideo investigation, but currently there is not a direct link. The Salmonella strain in the tested product does not appear to be the Montevideo strain of interest and further testing of the sample is ongoing at a state health partner laboratory. FSIS is continuing to work with the CDC, affected state public health partners, and the company on the investigation and will update the public on the progress of this investigation as information becomes available.

In addition, the company presented information to FSIS and took the additional action to voluntarily recall all products in commerce associated with black pepper, which the company believes is a possible source of contamination.

The products subject to recall include:

* 3-ounce packages of "DANIELE NATURALE SALAME COATED WITH COARSE BLACK PEPPER."

* Approximately 6-pound packages of "DANIELE SALAME GRANDE COATED WITH PORK FAT & PEPPER."*

The Food and Drug Administration, along with the Centers for Disease Control and Prevention and the U.S. Department of Agriculture’s Food Safety and Inspection Service, continues to work closely with the Rhode Island Department of Health and other states in the investigation of an outbreak of Salmonella Montevideo infections associated with certain Italian-style sausage products including salami/salame.

The CDC reports that 207 people have been infected with a matching strain of Salmonella Montevideo in at least 42 states and the District of Columbia. Recently, the CDC and public health officials in multiple states conducted an epidemiologic study by comparing foods eaten by 41 ill and 41 well persons. Preliminary analysis of this study suggested salami/salame as a possible source of illness: http://www.cdc.gov/salmonella/montevideo/index.html.

On Jan. 23, 2010, Daniele International Inc. recalled ready-to-eat varieties of Italian style meats and expanded its recall a week later to include additional ready-to-eat meats. The recalled products, including salami and Hot Sopressata Calabrese, are regulated by the USDA: http://www.fsis.usda.gov/News_&_Events/Recall_006_2010_Expanded/index.asp.

Recent samples of black pepper collected by the Rhode Island Department of Health at Daniele International Inc. tested positive for Salmonella. One sample from an open container matched the outbreak strain. The remaining supply of pepper testing positive for Salmonella has been voluntarily placed on hold by both of Daniele’s suppliers.

The FDA is actively investigating the supply chain of the black pepper used in the manufacturing of the recalled meat products to see if it poses a risk to consumers. The agency has collected and is currently analyzing both domestic and imported black pepper samples. To date, all the samples collected and analyzed by the FDA have tested negative for Salmonella; however, sample collection and analysis continues.

Mincing Oversees Spice Company and Wholesome Spices Black Pepper Linked to Salami Salmonella Montevideo Outbreak

The Rhode Island Department of Health announced this afternoon that recent test results strongly suggest black pepper is the source of the Salmonella outbreak associated with Daniele Inc. Daniele purchased black pepper from two different distributors (Mincing Oversees Spice Company and Wholesome Spices) who buy imported black pepper. Samples of pepper from both distributors have tested positive for Salmonella

The CDC reports that a total of 207 individuals infected with a matching strain of Salmonella Montevideo have been reported from 42 states and District of Columbia since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (5), CA (30), CO (4), CT (4), DC (1), DE (2), FL (3), GA (3), IA (1), ID (2), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (4), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (8), NM (2), NY (16), OH (9), OK (1), OR (9), PA (5), RI (2), SC (1), SD (3), TN (5), TX (7), UT (9), VA (1), WA (15), WV (1), and WY (2).

Among the persons with reported dates available, illnesses began between July 4, 2009 and January 19, 2010. Infected individuals range in age from < 1 year old to 93 years old and the median age is 37 years. Fifty-three percent of patients are male. Among the 155 patients with available information, 41 (26%) were hospitalized. No deaths have been reported.

Marler Clark Clients to Share in $12 Million Settlement against Peanut Corporation of America

According to the Atlanta Journal Constitution and AP, over 100 victims of last year's nationwide salmonella outbreak will split $12 million as part of a bankruptcy settlement with the insurer of the company linked to the illnesses.

The attorney for the bankruptcy trustee, Atlanta attorney Alan Maxwell said Monday the money comes from an insurance policy that Lynchburg, Va.-based Peanut Corp. of America had with Hartford Financial Services Group Inc. The settlement could be doled out to more than 100 victims or their survivors who filed a claim.

Lawsuits against Kellogg Co. and King Nut Co. are still pending.

The outbreak was traced to the company's plants in Georgia and Texas. It sickened about 700 people and was linked to at least nine deaths. Peanut Corp. has since filed for bankruptcy and authorities have allegedly launched a criminal investigation.

Impacts of the 2008-09 Foodborne Illness Outbreak Linked to Salmonella in Peanuts

Kelsey Wittenberger and Erik Dohlman of USDA's Economic Research Service just published an interesting report on the 2008-2009 Salmonella Peanut Butter Outbreak - Outlook Report No. (OCS-10a-01) 18 pp, February 2010.  I was a bit surprised at their conclusion:

The 2009 foodborne illness outbreak linked to Salmonella in peanut products resulted in one of the largest food safety recalls ever in the United States. The source of the outbreak handled a small share of the U.S. peanut supply, but the scope of the recalls was magnified because the peanut products were used as ingredients in more than 3,900 products. Consumer purchases of peanut-containing products initially slowed during the recalls, but retail purchases soon returned to normal and peanut processing held steady. The recalls do not appear to have had a lasting impact on peanut demand and production.

Daniele Recalls 17,235 more pounds of Salami due to Salmonella Risk

The recall is being expanded as a result of a confirmed finding of Salmonella in an unopened salami product reported by the Illinois Department of Public Health.

According to FSIS release, Daniele International Inc., an establishment with operations in Pascoag and Mapleville, R.I., is expanding its January 23 recall to include approximately 17,235 pounds of ready-to-eat (RTE) varieties of Italian sausage products, including salami/salame, that may be contaminated with Salmonella. 1,240,000 pounds had already been recalled.

The recall is being expanded as a result of a confirmed finding of Salmonella in an unopened salami product reported by the Illinois Department of Public Health. The product was sampled during the course of an ongoing investigation of a multi-state outbreak of Salmonella serotype Montevideo illnesses. The product tested was not included in the previous recall (FSIS Recall 006-2010) issued January 23, but is similar to products bought by customers who later became sick in the Montevideo investigation. Product subject to the expanded recall may have been cross-contaminated with black pepper before it was packed. The company believes that black pepper is a possible source of Salmonella contamination.

Further testing is ongoing at a state health partner laboratory, and may determine if the product contained the Salmonella Montevideo strain associated with the multi-state outbreak. The Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), FSIS, state health and agriculture departments, and Daniele International are cooperating in this investigation. The CDC has posted information about the multi-state outbreak on its website (http://www.cdc.gov/salmonella) but the investigation is ongoing, and has not yet definitively identified a food vehicle(s).

FSIS is continuing to work with the CDC, FDA, affected state public health partners, and the company on the investigation and will update the public on the progress of this investigation as information becomes available.

The products subject to recall include:

• Packages of “DANIELE HOT SOPRESSATA CALABRESE,” produced on 11/7/09, 12/16/09 and 12/18/09.
• Packages of “DANIELE SOPRESSATA CALABRESE,” produced on 12/16/09 and 12/18/09.
• Packages of “BOAR’S HEAD BRAND HOT SOPRESSATA CALABRESE,” produced on 11/28/09, 12/9/09 and 12/14/09.

Each package bears a label with establishment number “EST. 54” inside the USDA mark of inspection and weighs approximately 3 to 3.5 pounds. These products were distributed to retail establishments nationwide. When available, the retail distribution list(s) will be posted on FSIS’ website at http://www.fsis.usda.gov/FSIS_Recalls/ Open_Federal_Cases/index.asp.

Update - According to a press release from Daniele, the black pepper was sourced from Vietnam.

Stewart Parnell's business, Peanut Corporation of America, sickened 700 and killed 9. Where is the accountability?

Sunday’s Atlanta Journal Constitution (AJC) said it all: “Blakely peanut illness: Little has changed since scare.”  Not only has Food Safety taken a back seat to nearly everything else in Washington DC, but the political theater that is always Washington has accomplished nothing in bringing justice to those 700, nor the families of the 9 who died.

Who can forget the PCA emails?

"Turn them loose," Parnell had told his plant manager in an internal e-mail disclosed at the House hearing. The e-mail referred to products that once were deemed contaminated but were cleared in a second test last year.

Parnell ordered products identified with salmonella to be shipped and quoting his complaints that tests discovering the contaminated food were "costing us huge $$$$$."

Parnell insisted that the outbreak did not start at his plant, calling that a misunderstanding by the media and public health officials. "No salmonella has been found anywhere else in our products, or in our plants, or in any unopened containers of our product."

Parnell complained to a worker after they notified him that salmonella had been found in more products. "I go thru this about once a week," he wrote in a June 2008 e-mail. "I will hold my breath .......... again."

As, the AJC noted:

As for possible criminal charges, a Georgia Bureau of Investigation spokesman said the agency dropped its investigation last year and left it to federal authorities. Federal agencies ranging from the U.S. Food and Drug Administration to the FBI to the U.S. Attorney in Macon declined to comment.

Families of victims waver between frustration and outrage. The primary target of their anger: Stewart Parnell, the Peanut Corp. chief executive. When he appeared before Congress last February he declined to answer questions about e-mails and other information that investigators say indicated he knowingly ordered contaminated peanut products sent to buyers.

Bill Marler, a Seattle attorney handling lawsuits for about 45 victims, said, “In 17 years of litigating every major food-borne illness outbreak in the U.S., I have not seen a clearer situation that demanded criminal prosecution.”

Parnell declined to speak with the AJC for this story. One of his lawyers, W. William Gust, said investigators have not contacted Parnell in about six months.

No wonder that people become disgusted with government.  True, Washington has had a few things on its plate, Health Care, Afghanistan, the Economy, etc.  However, food safety legislation passed overwhelmingly last July out of the House and made it out of the Senate HELP committee in the Fall.  Since then - nothing.

A criminal investigation and prosecution against Peanut Corporation of America (PCA), although talked about loudly by all in early 2009, has gone nowhere since. 

700 people and the families of 9 deserve and answer.

Salmonella Montevideo Outbreak linked to Black Pepper Salami appears to be over - Body count 202 in 42 States

The CDC reports that a total of 202 individuals infected with a matching strain of Salmonella Montevideo have been reported from 42 states and District of Columbia since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AK (1), AL (2), AZ (5), CA (30), CO (4), CT (4), DC (1), DE (2), FL (3), GA (3), IA (1), ID (2), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (3), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (7), NM (2), NY (16), OH (9), OK (1), OR (9), PA (5), RI (2), SC (1), SD (3), TN (4), TX (7), UT (7), VA (1), WA (15), WV (1), and WY (2). Because this is a commonly occurring strain, public health investigators may determine that some of the illnesses are not part of this outbreak.

Among the persons with reported dates available, illnesses began between July 4, 2009 and January 11, 2010. Infected individuals range in age from < 1 year old to 93 years old and the median age is 37 years. Fifty-three percent of patients are male. Among the 148 patients with available information, 38 (26%) were hospitalized. No deaths have been reported.

Salmonella Salami Suspect Named - Wholesome Spice - Mystery Over?

Although officials from USDA, FSIS and FDA remain silent, as has Daniele Salami, both CIDRAP and Food Safety News reported Rhode Island Health Officials have named Wholesome Spice as the likely source of the Salmonella-tainted black pepper that has sickened 189 in 40 states. However, the country of origin of the black pepper is still unnamed.

Robert Roos, CIDRAP News Editor wrote in “Tests strengthen pepper link in Salmonella outbreak” and Dan Flynn, Food Safety News Editor wrote “Black Pepper Positive for Salmonella” that Annemarie Beardsworth, a spokeswoman for the Rhode Island Department of Health, reported findings from the department's tests of ground pepper from Daniele. "We got positive results for Salmonella, and the strain did match the national outbreak," she said. "The one caveat is the sample was from an opened container of ground pepper. That means it's the probable source of the outbreak. We do have samples from closed containers that are in the process of being tested."

The fact that the sample came from a previously opened container means the pepper could have been contaminated at Daniele rather than at the facility where it was produced, she noted. "We're pretty sure that it didn't get contaminated at Daniele, but we need a positive sample from a closed container to be absolutely 100% sure," she added. Beardsworth said the ground pepper came from a New York firm called Wholesome Spice, a distributor that sells ground pepper only to Daniele.

So, now, where did the black pepper originate from?

Black Pepper tests positive for Salmonella, however Daniele still tells the public nothing - so much for Transparency

Tip o” the blog to www.efoodalert.com for posting the update FAQ's from Daniele:

Daniele, Inc. Frequently Asked Questions (FAQs)

Q: Why is this product being recalled?

A: Samples of the black pepper used to coat some of our products have tested positive for salmonella. A sample of the recalled product has been linked to an outbreak of salmonellosis.

My emphasis.

Q: Are plant operations suspended?

A: We have suspended new production of all Pepper-Coated Salame products included in the recall. In addition, we have stopped using pepper from our inventory and switched to using only pasteurized pepper.

According to FSIS, Daniele International Inc., an establishment with operations in Pascoag and Mapleville, R.I., is recalling approximately 1,240,000 pounds of ready-to-eat (RTE) varieties of Italian sausage products, including salami/salame, in commerce and potentially available to customers in retail locations because they may be contaminated with Salmonella.

The CDC reports a total of 189 individuals infected with a matching strain of Salmonella Montevideo have been reported from 40 states since July 1, 2009. The number of ill persons identified in each state with this strain is as follows: AL (2), AZ (5), CA (30), CO (3), CT (4), DE (2), FL (2), GA (3), IA (1), ID (2), IL (11), IN (3), KS (3), LA (1), MA (12), MD (1), ME (1), MI (1), MN (4), MO (1), NC (9), ND (1), NE (1), NH (1), NJ (7), NY (15), OH (9), OK (1), OR (8), PA (3), RI (2), SC (1), SD (3), TN (4), TX (7), UT (7), VA (1), WA (14), WV (1), and WY (2).

So, Daniele, why not tell the public where you got the pepper?  Where is the FSIS and FDA on this?

253 days after Abby's death, Valley Meats posts a press release about its new "Multiple Testing and Safety Procedures in the Processing of Beef Products."

I do not sleep much. So, in the middle of the night when Valley Meats press release hit the wire about their “Multiple Testing and Safety Procedures in the Processing of Beef Products,” I was awake and could not help but think what will Abby’s grieving parents will think about Valley Meats new-found love for food safety.

You might recall that on May 21, 2009, four days after Abby’s death, the FSIS announced that Valley Meats LLC, a Coal Valley, Ill., establishment was recalling approximately 95,898 pounds of ground beef products that may be contaminated with E. coli O157:H7. The “problem” as FSIS said was discovered through an epidemiological investigation of illnesses. On May 13, 2009, FSIS was informed by the Ohio Department of Health of a cluster of E. coli O157:H7 infections. Illnesses have been reported in Ohio, Pennsylvania, and Illinois.  Abby died of Hemolytic Uremic Syndrome.

Here is a bit of Abby's story:

 

Here is a portion of Valley Meat’s press release:

… While lawmakers prepare to introduce legislation to mandate greater E. coli inspections of ground beef and national media fuels the debate on the need for greater testing and safety procedures, one regional Illinois-based processor, Valley Meats, has taken a major pre-emptive move and has instituted a series of state-of-the-art testing and treatment technologies to eradicate harmful pathogens into their product stream.

… Valley Meats, which owns and operates a successful 30,000-square-foot food processing facility in Coal Valley, Illinois, has recently employed the highly-effective Test-and Hold system for finished ground beef verification sampling and the SANOVA® disinfectant system to continuously spray the surfaces of raw materials used to produce ground beef products.

… As one of a small percentage of beef processors in the U.S. to routinely employ test-and-hold inventory management protocols, Valley Meats' finished ground beef sampling system is one of the industry's most effective, delineating responsibilities for personnel, documentation, equipment and materials. The program clearly defines guidelines for raw material handling, sampling of finished product, testing of two hour production lots and USDA/FSIS sampling.

… Corrective actions based on improper sample collection, presumptive positive test results and safety zones are established to ensure that no implicated product enters commerce.

... If a pathogen is detected, the entire lot is either sold to a "cooker", a firm that cooks or sells prepared meat (E. Coli bacteria is destroyed when properly cooked at minimum temperatures of at least 160ºF) or the lot is destroyed.

For Abby’s parents, the question is why now? Why not ten months ago?

Nestle Cookie Dough E. coli Victim, Linda Rivera, Continues to Make Slow, Steady Improvement

I love getting these email updates as of late from Linda's brother-in-law:

Sent: Sat, January 23, 2010 9:46:41 AM
Subject: Linda Rivera Continued Improvement

1-23-2010 @ 9:45am PST

Linda continues to improve, slowly, but surely. Richard went over some daily labs with me and they are all normal, except for some anemia. Of major note is that she has, up to around 2 1/2 weeks ago, required a tracheostomy (an opening in the front of the throat) and regular attachments to a breathing machine to keep her alive. She does not now require the assisted breathing and the tracheostomy opening is going to be surgically closed next week!! This is a major milestone for her. Additionally, a major source of hospital acquired infection is being sealed shut when they close the tracheostomy. One big threat to her life is shut out!!

Linda is recovering in all other areas. Kidneys, liver, lungs, and bed sore healing are progressing normally. Labs for these organs (kidneys, liver, lung) are good. It’s almost like a Lazarus healing from just hours from death several months ago to shedding the ventilator and healing of her organs. There is good reason to believe she may be discharged over the next months or so. Setbacks are not uncommon. Unfortunately good outcome is not a lock.

Linda, as many readers know, has been hospitalized since May 1 - now, almost nine months.  She has lost her job and she and her husband are now on the COBRA portion of her former employer's insurance (she was a teacher).  Linda's husband, Richard, and the entire Rivera clan, have been constant companions through her every struggle.

One amazing woman, one amazing husband, one amazing family.

BPI vs Iowa State University - the plot thickens, or is that added ammonia?

I wanted to make sure that I got my letter in support of Iowa State and its obligations under its Public Documents Laws out today.  I am glad to see that the University is in the corner of transparency.  As a former Regent at a state university, I too understand the need for an open public discourse.  I would urge my subscribers to support Iowa State by either dropping Ms. DeAngelo a note or requesting the BPI records as well - some already have.

Nestle had planned to go with Cooked Flour after E. coli Outbreak

Last week within minutes of Nestle’s press release announcing E. coli O157:H7 positives in samples of finished cookie dough (that did not leave its plant), I posted “Nestle to use heat-treated flour – moves to become industry leader in product safety.” Today, Marion Nestle (no relationship) shot my an email with the article from Food Production Daily, “Nestle USA heat-treated flour switch planned for months.”

The company told FoodProductionDaily.com that proposals to change its flour had been underway since late summer 2009 – around the same time as it re-started production at its Virginia plant following a nationwide recall of its raw cookie dough. …

The firm (Nestle) said it had not confirmed that its current flour was responsible for the E. coli H7:O157-tainted sample results either last week or last year but that it had made the switch on precautionary safety grounds.

In a post last week, I complemented Nestle for announcing that it “will [now] begin using heat-treated flour in the manufacture of its Nestle Toll House refrigerated cookie dough,” shows its desire to lead the industry by making one of its key ingredients (flour) safer for human consumption. It still does, however, raise some interesting issues that Nestle will need to respond to:

1. What did Nestle (and the entire flour industry) know about the risk that uncooked flour can be contaminated with a pathogen?

2. What testing protocols did Nestle use on cookie dough ingredients after June 2009 and what were the test results?

3. When did Nestle make the decision to consider heat-treated flour? (I guess they answered this one to Food Production).

4. With respect to the two samples of Nestle Toll House refrigerated cookie dough that tested positive for E. coli O157:H7, were those sample (including PFGE analysis) provided to the FDA and CDC?

I wonder if Nestle will stop saying this too:

As an important reminder, Nestle strongly advises that cookie dough should not be eaten raw, and to bake our products before consuming.

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.

Contaminated Flour - Something else to worry about?

Yesterday’s announcement from Nestle that it had “informed the FDA [on January 11, 2010] that two samples of Nestle Toll House refrigerated cookie dough … had tested positive for E. coli O157:H7…,” came as both a shock, that sick months after a severe E. coli O157:H7 outbreak, product was testing positive again, and a wake up call that clearly more needs to be done to make the product safe. The good news is that according to Nestle, “[c]onsistent with [its] quality assurance protocol, the finished product involved never left [its] factory or entered the supply chain, and none was shipped to customers.

Clearly, Nestle by also announcing that it “will [now] begin using heat-treated flour in the manufacture of its Nestle Toll House refrigerated cookie dough,” shows its desire to lead the industry by making one of its key ingredients (flour) safer for human consumption. It does, however, raise some interesting issues that Nestle will need to respond to.

1.  What did Nestle (and the entire flour industry) know about the risk that uncooked flour can be contaminated with a pathogen? Interesting, that discussion has been going on over at the FoodSafe Listserve both yesterday and today. Some cited examples of prior studies can be found below.

2.  What testing protocols did Nestle use on cookie dough ingredients after June 2009 and what were the test results? Being an industry leader requires transparency.

3.  When did Nestle make the decision to consider heat-treated flour?  Why?  Did it take time to reformulate recipe?

4.  With respect to the two samples of Nestle Toll House refrigerated cookie dough that tested positive for E. coli O157:H7, were those sample (including PFGE analysis) provided to the FDA and CDC? Again, being an industry leader requires transparency.

How do you say “leadership” and “transparency” in Swiss?

Continue Reading...

Nestle to use heat-treated flour - moves to become industry leader in product safety

Sometimes when bad things happen, companies do step up.

A few minutes ago, Nestle USA's Baking Division announced "it will begin using heat-treated flour in the manufacture of its Nestle Toll House refrigerated cookie dough."  This was in response to recent positive E. coli O157:H7 test results that were disclosed to the FDA two days ago.  According to the Nestle press release, "quality assurance protocols [implemented after the E. coli O157:H7 outbreak of 2009] include[d] testing ingredients before they enter our facility, rigorous environmental sampling throughout the facility, and testing of finished product before it is shipped to customers."  None of the positive product was shipped.

In June 2009, Nestle USA voluntarily recalled refrigerated cookie dough after the Food and Drug Administration (FDA) and Centers for Disease Control after at least 80 people were sickened, some severely, nationwide.

I do spend a bit(e) of time taking companies to task for doing stupid and evil things.  When a company steps up after a tragedy, I need to give them praise too.  Does anyone know how to say "good job" in Swiss?

Also, who supplied Nestle the flour?

Off to see Michael Pollan at WSU, but E. coli Outbreaks not far from mind

Sitting at the Seattle Airport waiting for my flight to Pullman (no, that is not the plane), gave me a little time to work on the 2009 JBS meat recall and E. coli outbreak.

In early April 2009, health officials from several states began investigating reports of E. coli O157:H7 illnesses associated with the consumption of ground beef products manufactured by the JBS Swift company. On June 24, 2009, JBS Swift announced a voluntary recall of approximately 41,280 pounds of beef products due to potential contamination with E. coli O157:H7. Most of the products associated with the June 24 recall bore the establishment number "Est. 969" and had identifying package dates of "042109" or "042209."

By June 28, the recall was expanded to include 380,000 pounds of beef primal products. The products implicated in the expanded recall were produced on April 21, 2009, and were distributed nationally and internationally. These items bore the establishment number "EST. 969," an identifying package date of "042109," and a time stamp ranging from "0618" to "1130." According to the Centers for Disease Control and Prevention (CDC), some of the products were likely cut again or made into ground beef at retail and then re-packaged. Thus, ground beef packages purchased by consumers may not have exhibited identifying information.

After the recall announcements, the multi-state investigation into the reported E. coli O157:H7 illnesses continued. Samples from unopened packages of ground beef recovered from the house of one of the patients were tested by the Michigan Public Health Laboratory. The tests yielded an E. coli O157:H7 isolate that was an identical PFGE match to the outbreak strain.

By early July 2009, the Centers for Disease Control and Prevention (CDC) had been notified of twenty three persons from nine states that were infected with the same PFGE-confirmed strain of E. coli O157:H7 implicated in the JBS Swift recall. The number of ill persons identified in each state was as follows: California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6).

Among the seventeen ill persons for whom hospitalization status is known, twelve (70%) were hospitalized. Two of the hospitalized patients developed HUS. Fourteen of the patients (64%) were male and 59% were less than nineteen years old, with ages ranging from 2 to 74 years. JBS Swift and FSIS released a list of stores that had received recalled product on July 2, 2009. Potentially E. coli-contaminated JBS Swift meat products were distributed to the following retail outlets:

* BJ's Wholesale Clubs
* Bloom and Food Lion Stores
* Costco
* Food 4 Less
* Fry's Food and Drug Stores
* Hannaford Bros. Co.
* Kroger
* Price Chopper
* Roundy's Supermarkets
* Smith's Food and Drug Stores
* Stop & Shop
* WinCo Foods

I represent three of the Hemolytic Uremic Syndrome cases, one who ate hamburger and two that ate steak - all kids.

One Year after over 700 sickened and nine deaths caused by PCA Salmonella Peanuts, why has Stewart Parnell not been Prosecuted?

Good question.  I asked some of my clients their thoughts.

“As someone who testified in front of the House subcommittee last February, I saw the emails that Parnell had sent out,” said Lou Tousignant, whose father, Clifford Tousignant, died from eating the tainted product. “I saw that he knowingly shipped contaminated product to high-risk areas (nursing homes and schools). If there can be a precedent of criminal charges for those that knowingly commit an act that can cause harm to society, maybe someone like Parnell would think twice before shipping contaminated products that sickened hundreds and killed 9 people, including my father.”

We think his actions were akin to a personal invasion of our home to assault Karen,” said Larry Andrew, whose wife was severely sickened by Salmonella in PCA peanut butter. “He killed people! If a similar methodology were to be undertaken by a cell of terrorists, the country would be outraged and the federal government would immediately arrest and prosecute the perpetrators.”

Earlene Carter, whose mother, Minnie Borden, succumbed to her Salmonella infection, added that Mr. Parnell “…should face the consumers under criminal law - not civil - to answer for the crimes he committed. After depriving families of their loved ones (who are gone to soon), he should not be shielded. This should never happen again.”

Here is the video from the Congressional Hearing when Stewart took the Fifth:

Two Reasons to get up early in the Morning

One is the view from my kitchen window:

The other is for the email I received from the family of E. coli victim, Linda Rivera:

1-6-2009 @ 9:35pm

Linda’s condition is amazingly improved. Though still seriously disabled, she actually has a reasonable prospect of a decent rehabilitation and restoration of most normal day-to-day functions. Today, my heart melted as she greeted me and Sharon with an ear-to-ear smile, outstretched arms, a gentle embracing hug, and mouthing words of being glad to see us. She gave us a hardy “two thumbs up” and a big smile when asked how she was doing.

Linda is breathing on her own for most of the time via a special T-piece tube that delivers humidified oxygen to her tracheostomy opening. A so called “talking tracheostomy” tube was placed in her tracheostomy and allowed her to talk. Linda is quite animated now. When I was last with her in August, she was unable to move most of her left side and unable to mouth words. Back then her eyes were fixed in a stare straight ahead. To see her completely participate in visiting us and her other visitors is truly a miraculous sight. Mortality for what she has been thru exceeds anywhere from 60-85%.

Linda has stable organ systems, still gets nauseated and doesn’t always hold food down. Also of good note is that she is able to actually take small oral feedings, swallow them, and able to direct the food down her esophagus and away from going down her lungs. This is a medical testimony to recovery of brain stem cranial nerve function and resolution of brain substance damaged by the stroke a few months earlier.

There is definite reason for cautious optimism regarding her prognosis. It has gone from nearly grave some months ago to guarded but more favorable today. Infection is probably her biggest threat and adversary.

Medicine and nursing are great, so we are very blessed to have had such persevering health practitioners. Ultimately, the One who revealed and provided all the resources known to man for effective medical care of Linda deserves all praise and worship.

It looks like it will be a good day.

CDC Weighs in on National Steak and Poultry E. coli Recall from CA, CO, FL, HI, IA, IN, KS, MI, MN, NV, OH, OK, SD, TN, UT, and WA

I should have waited until 6:00 AM to post what I did below at 2:00 AM.  In any event, the CDC confirmed that it is collaborating with public health officials in several states and the United States Department of Agriculture’s Food Safety and Inspection Service (FSIS) to investigate a multistate outbreak of human infections due to Escherichia coli O157:H7 (E. coli 0157:H7).  Illnesses amount to 21 persons infected with the outbreak strain of E. coli O157:H7 from 16 states. The number of ill persons who were identified resides in each state as follows: CA (1), CO (1), FL (1), HI (1), IA (1), IN (1), KS (1), MI (1), MN (3), NV (1), OH (2), OK (1), SD (2), TN (1), UT (2), and WA (1).  Now for the cool map:

The CDC also confirmed that the known illness onset dates range from October 3, 2009 through December 14, 2009. Most patients became ill between mid-October and late November. Patients range in age from 14 to 87 years and the median age of patients is 34 years, which means half are younger than 34 years. Forty-three percent of patients are females. There have been 9 reported hospitalizations, 1 case of hemolytic uremic syndrome (HUS), and no deaths.  Now for the cool chart:

Here is an interesting description of the actual investigation performed by local and state health officials with the CDC:

In early December 2009, CDC's PulseNet staff identified a multistate cluster of 14 E. coli O157:H7 isolates with a particular DNA fingerprint or pulsed-field gel electrophoresis (PFGE) pattern reported from 13 states. CDC's OutbreakNet team began working with state and local partners to gather epidemiologic information about persons in the cluster to determine if any of the ill individuals had been exposed to the same food source(s). Health officials in several states who were investigating reports of E. coli O157:H7 illnesses in this cluster found that most ill persons had consumed beef, many in restaurants. CDC is continuing to collaborate with state and local health departments in an attempt to gather additional epidemiologic information and share this information with FSIS. At this time, at least some of the illnesses appear to be associated with products subject to a recent FSIS recall.

Clearly, more work to do.

Olive Garden, Applebees, Moe's Southwest Grill, Carino's Italian and 54th Street Grill & Bar linked to E. coli Meat Recall

According to Alan Liddle of Nation’s Restaurant News “at least five restaurant chains are now included in a list of those affected by the late December recall of 124 tons of beef including,” Olive Garden, Applebees, Moe’s Southwest Grill, Carino’s Italian and 54th Street Grill & Bar.

"The Owasso, Oklahoma-based National Steak and Poultry said in a statement to Nation's Restaurant News that it had contacted all of its customers by December 24."

As I blogged earlier, the U.S. Centers for Disease Control and Prevention have reported 21 confirmed cases of E. coli illness in 16 states, including nine that required hospitalization with one that developed Hemolytic Uremic Syndrome (HUS).

According to the CDC, the onset dates of the E. coli O157:H7 illness cases reported so far have ranged from Oct. 3 to Dec. 14. The states impacted are California, Colorado, Florida, Hawaii, Iowa, Indiana, Kansas, Michigan, Minnesota Nevada, Ohio, Oklahoma, South Dakota, Tennessee, Utah and Washington.

CDC tells which states have the 21 ill due to E. coli O157:H7 tainted National Steak and Poultry beef products

As of Monday, January 4, 2010, 21 persons infected with the outbreak strain of E. coli O157:H7 had been reported from 16 states. The number of ill persons who were identified resides in each state as follows: California (1), Colorado (1), Florida (1), Hawaii (1), Iowa (1), Indiana (1), Kansas (1), Michigan (1), Minnesota (3), Nevada (1), Ohio (2), Oklahoma (1), South Dakota (2), Tennessee (1), Utah (2), and Washington (1). Known illness onset dates range from October 3, 2009 through December 14, 2009. Most patients became ill between mid-October and late November. Patients range in age from 14 to 87 years and the median age of patients is 34 years, which means half are younger than 34 years. Forty-three percent of patients are females. There have been 9 reported hospitalizations, 1 case of hemolytic uremic syndrome (HUS), and no deaths.

According to the FSIS, National Steak and Poultry, an Owasso, Okla., establishment, is recalling approximately 248,000 pounds of beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

"Tip-o-pen" to efoodalert.

The products subject to recall include:

Continue Reading...

"We're not waiting to be the victim of the next food outbreak"

So say, Peter Hurley.

Lynn Terry of the Portland Oregonian profiled my clients, Peter and his young son who was a victim of the Peanut Corporation of America Salmonella Outbreak in 2009 – “Year-end profile: Portland officer advocates food safety on son's behalf.”

It is a great read and a great picture.  It is an honor to represent them.

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?

Hello, My Name is _________ and I Stopped Selling Raw Milk in 2006

I just got the below email tonight.  I deleted identifying information to protect the dairyman's identification.

I've been following your blog ever since our unfortunate involvement in the raw milk business in 2006. I've found it to be an excellent information source. We've talked in the past, as you might recall. We no longer are involved in producing raw milk products, nor will we ever be.

What people need to realize with E-coli is that it doesn't take very many cells, to make a person deathly ill. And it's in manure, that's a fact, it's not a matter of if someone will get sick from raw milk it's just a matter as to when. And it appears that the person has 3 possible outcomes, 1) their immune system gets them through it, very painful. 2) They survive but have lifetime health issues, HUS etc. or 3) Death. This is why I will never produce raw milk products for commercial sale ever again.

We now produce a very nice pasteurized _____ Guernsey yogurt that you might like to try, it's available at the _____ Market on _____, also _____ Market.

As an ending comment, have you noticed how lax the media has been on the latest E-coli outbreak? According to press release, 3 people have been sickened from e-coli in raw milk from the Dungeness farm in Sequim, WA and not a peep, from the health department or mainstream media television etc. We had one confirmed incident, with another possible that didn't require hospitalization and we had helicopters over our house for 3 days. With the seriousness of what E-coli is, I would think the health professionals and media would want to educate and warn the public as much as possible when an incident occurs.

Thank you, _____

USA vs Organic Pastures and Mark McAfee - More Raw Milk Litigation

In perhaps what seems a bit like trying to pound a square peg into a round hole (or would that be a round peg into a square hole if Mark were the peg) with a sledge hammer, the US Government in a Civil Action against Organic Pastures and Mark McAfee has asked for a permanent injunction stopping all interstate sales of raw milk for human consumption - whether labeled for human or pet consumption (knowing it will be sold for human consumption).  What is also interesting is that the Government raises a third reason for the injunction - that raw milk is a drug - and, that the claims made by Organic Pastures and Mark about raw milk's health benefits are not supported by actual fact.  Click on the below to download the document.  It is fun reading.

Raw Milk E. coli and Campylobacter Illnesses - A Big Cold Glass of Reality

I know my friends over at Weston Price Association and the Complete Patient think I spend all my time beating up on raw milk (hmm, did they notice what I did to Cargill last week?).  What really gets to me about the "raw milkies," is their religious passion for their personal freedom trumping the fact that people get very sick from drinking raw milk on more than a few occasions.  It also drives me a bit crazy how they see everything as a evil conspiracy - that all the outbreak investigations are wrong - or that there must have been something wrong with the victim.  It is a time for a big cold glass of reality.  Here is a shortened version of what happened in the raw milk outbreaks that I have been involved with:

Grace Harbor Farms

M.S. acquired an E. coli O157:H7 infection from consumption of raw milk in September, 2006. He developed a fever, nausea, and severe diarrhea. When the diarrhea turned bloody, M.S. was taken to his physician. Out of concern that he was at risk for the development of hemolytic uremic syndrome (HUS), M.S. was transported to the local children’s hospital. M.S. was admitted to the hospital on September 22. There, MS was treated for his ongoing infection and monitored for signs of HUS. The severity of his symptoms required that MS be hospitalized through October 2. Thankfully, MS did not develop HUS. Medical bills for the hospitalization exceeded $30,000.

Organic Pastures

Chris Martin, then age nine, 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 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.

Lauren Herzog developed an E. coli O157:H7 infection in September, 2006, as the result of consumption of raw milk. She was 11 years old at the time. Lauren was hospitalized beginning on September 11. Shortly thereafter, Lauren began to developed hemolytic uremic syndrome (HUS) and was transferred to specialty care facility. Lauren’s bout with HUS was severe. Her renal failure was prolonged, and she required 20 days of dialysis. She also suffered from pancreatitis and persistent high blood pressure. In late September, her kidneys finally began producing urine again, and she was gradually prepared for discharge. She was then discharged on October 3, but only briefly. A seizure led to a re-admittance to the hospital from October 6 through October 14. Since her second discharge, Lauren has continued to show residual kidney deficiency, and remains under the care of a nephrologist. To date, medical expenses exceed $280,000. Renal experts believe that Lauren is likely to suffer severe renal complications in the future. These complications include end stage renal disease (ESRD) and kidney transplant.

Herb Depot/Autum Olives Farms

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.

Noah Ennis developed an E. coli O157:H7 infection in May, 2008 after consumption of raw goat’s milk. He was two years old at the time. He suffered from bloody diarrhea, nausea, vomiting, and painful cramps. He received medical treatment on multiple occasions at both his regular physician’s office, and the emergency room. Medical bills totaled over $1,600.

Alexandre EcoDairy Farm

Mari Tardiff was one of those sickened in the 2008 outbreak of campylobacter connected to raw milk sold by Alexandre EcoDairy Farm. As a result of her campylobacter infection, Mari developed
Guillain-Barré syndrome, or GBS, a potentially fatal inflammatory disorder. GBS is an infrequent, but well known risk of campylobacter infection. By the time she was hospitalized in mid June, Mari was essentially paralyzed. On June 15, Mari was intubated and placed on mechanical ventilation. For weeks on end, Mari’s condition remained unchanged. She was heavily sedated, unable to move, and entirely dependent on mechanical ventilation for survival.

In August, there were indications of slight improvement, and the very slow process of weaning Mari off mechanical ventilation began. At the outset, it was not clear that the process was successful. Through incredible effort on Mari’s part, she was fully weaned off mechanical ventilation by August 20, and discharged to a rehabilitation facility. She spent more than two months at the rehabilitation facility diligently attempting to re-acquire the ability to speak, breathe, and move her arms and legs on her own. She was discharged home on November 1, still in need of essentially 24 hour care. Since that time, she has worked every day toward achieving her goal, as yet unreached, of walking again. Medical expenses to date exceed $800,000.

Dee Creek

Nicole and Megan Beyers both suffered E. coli O157:H7 infections linked to raw milk consumption in December, 2005. Nicole fell ill first, and by December 6, both girls were suffering from diarrhea, nausea, and cramps. On December 10, the girls were treated in the emergency room, and tests indicated that Nicole was likely suffering from hemolytic uremic syndrome (HUS). Nicole was then transferred to a hospital better equipped to handle her serious condition. Nicole remained hospitalized through December 15. Her renal function will have to be monitored for the rest of her life. The girls’ medical expenses were approximately $20,000.

Annalise Selby was one year old in December of 2005 when she developed an E. coli O157:H7 infection from consumption of raw milk. Annalise was treated on multiple occasions at her family physician and the local urgent care center between December 5 and December 13. At that point, concerns over unusual lab results and possible HUS prompted consultation with a pediatric nephrologist. Annalise was accordingly admitted to the hospital from December 13 through December 15. Fortunately, her condition did not deteriorate further. The cost of medical treatment exceeded $8,000.

Simsbury Town Farm Dairy

Margot Standish was seven years old in June, 2008, when she became infected with E. coli O157:NM as the result of consumption of raw milk. Her symptoms began in late June, with diarrhea, vomiting, and abdominal cramps. Margot was treated over the period of more than a week by her regular physician, but her condition began to deteriorate, and she was admitted to the hospital on July 8. Laboratory tests conducted that day provided evidence that Margot had been suffering from hemolytic uremic syndrome (HUS). Thankfully, Margot’s renal insufficiency did not deepen to the point that dialysis was required. She remained hospitalized through July 14. Medical bills exceeded $30,000. As a result of her HUS, Margot will need to have her renal function monitored regularly for the rest of her life.

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 hemolytic uremic syndrome (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 over $230,000 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.

Dancer Paralyzed by E. coli Infection Sues Meat Giant Cargill for $100 Million

The Story of Stephanie Smith Captivated a Nation

Stephanie Smith, the twenty-two year old Minnesota dance instructor left paralyzed by a burger tainted with E. coli filed suit today against Cargill, who produced the contaminated meat. Ms. Smith, whose “The Burger that Shattered Her Life” profile in the New York Times was emailed all over the country, covered by hundreds of media outlets and galvanized legislators to change food laws, attempted mediation with the company, but was unable to come to a fair agreement with them. The lawsuit was filed on behalf of Stephanie’s guardian, William R. Sieben, in the United States District Court for the District of Minnesota by Bill Marler of the Seattle foodborne illness law firm Marler Clark, and by Jardine, Logan and O’Brien of St. Paul.

“I have handled foodborne illness cases since the Jack in the Box outbreak nearly seventeen years ago, and I have never seen someone sickened this severely and survive,” said Ms. Smith’s attorney, Bill Marler. “This young woman has been on a horrifying and unimaginable journey just to regain basic motor and communication skills. She has lost the ability to walk, to dance, to have a family, to work or care for herself. She is tied to a wheelchair and a pharmacy of medications to address all the medical issues she struggles with. She will likely need multiple kidney transplants. I don’t think it’s possible to adequately convey in a sentence or two the massive challenges Stephanie has faced and continues to face.”

After eating a hamburger produced by Cargill in September 2007, Stephanie became ill and was diagnosed with an E. coli infection. She rapidly deteriorated and was determined to have hemolytic uremic syndrome (HUS), a complication of E. coli that causes kidney failure. In Stephanie’s case, she also began having seizures, which lead to a coma, where she remained for three months, on a ventilator and dialysis. When doctors were able to bring her out of the coma, the full extent of the injury to her brain, organs, and abilities began to be apparent.

Stephanie has spent 2 years in rehabilitation, both inpatient and at home. She is still in a wheelchair, where she will likely remain. She will require constant care and medical attention for the rest of her life. Her medical bills—already more than two million dollars—will continue to add up to tens of millions of dollars.

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:

Illinois Health Department Report on McDonald's Hepatitis A Outbreak - Full Report

E. coli Lawsuit to be filed against food giant Cargill on behalf of Stephanie Smith

In early October the New York Times profiled Stephanie Smith, the 22-year-old former dance who ate a hamburger in 2007, suffered severe Hemolytic Uremic Syndrome and subsequent brain and kidney damage. She was hospitalized for nine months. She is in ongoing rehabilitation. She now is wheelchair bound, unable to care for herself, unable to have children and is facing kidney transplants. Her medical bills to date are nearly $2M. Her future needs are nearly incalculable. Her losses break your heart. Dancing was Stephanie’s life. Because of a Cargill hamburger, her life is forever changed

The New York Times also identified Cargill’s failings in attempting to produce a product that was even close to being reasonably safe. The Cargill hamburger was sold at Wal-Mart’s throughout the country, sickening dozens along with Stephanie in 2007.

I spent the last two days in Minneapolis with Stephanie, her family and guardian meeting with Cargill, its lawyers and insurance company to try and resolve Stephanie’s claim against Cargill. We were unable to do so. A lawsuit is now her only option.

One moment at the mediation will be forever seared in my mind. Stephanie wanted to meet with Cargill’s representatives. She wanted to tell them what their hamburger did to her life. However, when the time came to meet, Stephanie was not feeling well – many of the medications she needs to take on a daily basis make her nauseous. Even being pale and lightheaded, she was determined to meet.

As she and I waited for the meeting, Stephanie suddenly vomited – multiple times. I begged off the meeting and helped clean-up Stephanie and the law office. Stephanie, however, was even more determined to meet. What both she and I did not know was that while she was vomiting she had also voided her bowels and bladder. I am not sure why I did not notice it, but Stephanie’s excuse – she feels nothing – very little – from the waist down.

Stephanie still had her meeting.  I wonder if Cargill noticed.

Illinois Department of Health Links Hepatitis A Outbreak to Employee Handwashing (lack thereof)!

The Illinois Health Department has released its investigation into this summer's hepatitis A outbreak. It concluded the source of most of cases was food eaten at the Milan McDonald's.  A state investigation has concluded most of the cases originated at the Milan McDonald's and most of the cases *would have been prevented* if only that one employee had properly washed hands.

The findings of the investigation by the Illinois Department of Public Health concludes "the index case was a food handler at the McDonalds in Milan, Illinois and had onset of illness June 11." Investigators also found "other possible sources in the community were ruled out."  And, "The source of the outbreak for the majority of outbreak cases was food eaten at the McDonalds, Milan, Illinois where a food handler worked while infectious and handled foods that were not later cooked."

The state investigation goes on to say that "if the first employee with hepatitis A had used proper hand-washing technique while working the transmission of hepatitis A through food would not have occurred."

And, "proper hand-washing by the index case would have prevented the majority of the cases in the community. Reporting of the index case by designated reporters before June 25 would have.. reduced the number of cases in the community."

The first case of hepatitis A in the Quad city area was discovered last June. As we first reported back then, the first confirmed case of the liver illness was an employee at the Milan McDonald's. Over the next two months, a total of 34 confirmed hepatitis A cases were reported.

E. coli O157:H7 in your hamburger can cause Hemolytic Uremic Syndrome

Elizabeth Weise from USA Today, who has covered most of the E. coli outbreaks over the last dozen years, did a great job in her article, “Family's nightmare began with secondary infection.” Faith suffered with Hemolytic Uremic Syndrome linked to a 1998 taco meal served at Finley Elementary School in rural Eastern Washington. Although Faith did not eat the taco meal, her sister and sister’s friends did. All experts at trial agreed that this “secondary contact” resulted in her infection.

Ms. Weise outlines the horror the family experienced during the acute phase of Faith’s illness:

“Faith "was in the hospital for 30 days, and she was on dialysis for 17," he [father John] says. He and his wife "just stayed at the parking lot for a while — we didn't leave her side….”

It was a grim month. Faith's skin turned yellowish as her kidneys stopped working. "You couldn't touch her because she hurt all over," John says. Then she began to hallucinate. "She'd see little dark people running around on the floor."

Eventually John had to stop working. "They wanted me to go back on the road, and I just told them, 'I can't leave,' " he says. Despite the financial struggle, he doesn't regret it. "A job can be replaced, but your child can't be."

And, what Faith and her family live with today:

Once Faith got home, the nightmare didn't end. "She has to take so many medications, you just watch everything, bacterial, everything. She was on high blood pressure meds for a long time," her dad says.

Now if Faith she gets sick, her parents take her straight to the hospital. "You want to make sure to catch it in time," John says. She has to see specialists in Seattle every six months to get her kidney function checked. "They say it will never get better. We just hope it won't get worse."

And, to those who think that all lawsuits are frivolous, keep reading:

It was hard suing the school district in the town he grew up in, but they had to do it, John says. "We had hospital bills coming at us, and we ended up having to file (for) bankruptcy," he says.

To pay their bills, the Maxwells joined in a suit with 10 other families against the Finley School District and the beef supplier. The district and Northern States Beef said there had never been E. coli O157:H7 in the ground beef. Northern States reached a confidential settlement with the families before the case went to trial.

John Maxwell is convinced Faith and the other children got sick because adults — at the meat company or the school district — were trying to save money by cutting corners.

School food shouldn't be the cheapest possible, he says. "This is the future, this is our kids, they should have the best of everything," he says.

"All the money in the world isn't worth the life of one child, especially if it's your child. How would they feel if it were their child?"

Perfectly Healthy to Dead in Twelve Days - Hemolytic Uremic Syndrome

My hero, Barb Kowalcyk.  Please listen to her story and her fight for Kevin’s Law:

Two More E. coli Lawsuits Filed Against Ixtapa

We filed two more lawsuits yesterday against the Ixtapa Family Mexican Restaurant in Lake Stevens, Washington.  Laurie Bunney and Amanda Vest ate at Ixtapa on October 9, 2008 and became ill with E. coli O157:H7 infections in the following days. Both women incurred medical expenses and wage loss as a result of their E. coli infections.

In October of 2008, Snohomish County Health Department (SCHD) epidemiologists investigated the E. coli O157:H7 outbreak among Ixtapa patrons. Dates of illness onset ranged from October 7-17, 2008.



SCHD ultimately identified twenty-three confirmed and probable cases, and forty-one suspect cases of E. coli linked to the consumption of food at Ixtapa restaurant. Four confirmed cases were hospitalized, and one developed hemolytic uremic syndrome, a severe complication of E. coli infection that can lead to kidney failure.

CDC Reports on California, Connecticut, Massachusetts, Maryland, Maine, New Hampshire, New York, and Vermont Outbreak of E. coli O157:H7 Infections Associated with Beef from Fairbank Farms

State health departments, CDC, and the United States Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) are investigating a multi-state outbreak of Escherichia coli O157:H7 infections. On October 31, 2009, FSIS issued a notice about a recall of approximately 545,699 pounds of ground beef products from Fairbank Farms that may be contaminated with E. coli O157:H7. Health officials in several states who were investigating a cluster of E. coli O157:H7 illnesses, with isolates that match by “DNA fingerprinting” analyses, found that most ill persons had consumed ground beef, with several purchasing the same or similar product from a common retail chain. A number of the illnesses appear to be associated with products subject to these recalls. Two samples from opened packages of ground beef recovered from a patient's homes were tested by the Massachusetts and Connecticut Departments of Health and yielded an E. coli O157:H7 isolates that matched the patient isolates by DNA analysis.

The cluster includes 26 persons from 8 states infected with matching strains of E. coli O157:H7. The number of ill persons identified in each state is as follows: California (1), Connecticut (6), Massachusetts (8), Maryland (1), Maine (4), New Hampshire (4), New York (1), and Vermont (1). Of these, the genetic associations of 24 human isolates and both of the product isolates have been confirmed by an advanced secondary DNA test; secondary tests are pending on others. Depending on the results of continuing laboratory testing and ongoing case finding, the number of persons determined to be in this cluster may increase or decrease.

The first reported illness began on September 17, 2009, and the last began on November 6, 2009. Nineteen patients are reported to have been hospitalized and 5 developed a type of kidney failure called hemolytic uremic syndrome (HUS). Two deaths have been reported. Fifty percent of patients are male and 38% are less than 18 years old (range 1 to 88 years).

Most of the beef packages in the recall bear the establishment number "Est. 492" inside the USDA mark of inspection and have identifying package dates of "091409", "091509" or "091609". Consumers are urged to check their refrigerators and freezers for beef products produced by this firm and purchased on or after September 15, 2009 and discard or return the recalled beef products to the place of purchase for a refund. Customers with questions about the source of a package of beef should contact the place where they purchased it (e.g., grocery store, club store, or meat market).

Settlements Reached in E. coli Lawsuits Against Aunt Mids and Santa Barbara Farms

On September 15, 2008, Ingham County Health Department (ICHD) was notified that nine students of Michigan State University (MSU) were seen in the emergency department over the weekend with gastrointestinal symptoms of abdominal pain, diarrhea, and bloody diarrhea. Lab cultures had confirmed that at least two of them were positive for E. coli O157:H7. The ICHD then launched an investigation with help from the Michigan Department of Community Health (MDCH), and both the United States & Michigan Department of Agriculture (MDA).

Over the ensuing days it became clear that the outbreak was not limited to MSU. While at MSU, the reported number of E. coli O157:H7 cases had risen to 18 (3 confirmed, 15 probable), there were also a reported 12 cases at Lenawee County Jail (5 confirmed, 7 probable). In fact, by September 29, a total of 26 confirmed cases of E. coli O157:H7 with the same genetic fingerprint had been reported to MDCH, from eight Michigan counties. Additionally, nine individuals in Illinois and three from the Province of Ontario had also been identified with the same genetic strain of E. coli O157:H7.

By this point, there was also strong epidemiological evidence linking the outbreak to institutional size, bagged iceberg lettuce. Two separate case-control studies had been conducted by MDCH at MSU and the Illinois Department of Public Health, and both implicated iceberg lettuce as the source of contamination. As a result, the MDA coordinated a traceback investigation of iceberg lettuce and found that the common supplier of all iceberg lettuce to MSU, the Lenawee County Jail, a restaurant in Illinois, as well as other foodservice locations identified by ill individuals, was Fresh-Pak Inc., distributed under the name, “Aunt Mid’s.”

The MDA subsequently conducted product and environmental sample testing at Aunt Mid’s. Though the tests did not find E. coli, testing was on current products, not on products from the outbreak timeframe. Lettuce from the outbreak timeframe was not available for testing during the investigation due to the perishable nature of the product.

Meanwhile, the toll of people affected by the E. coli O157:H7 outbreak had increased. By October 3rd, Michigan had identified 34 cases in nine counties with the same PFGE pattern by two enzymes. This included: nine students from MSU (Ingham County), five inmates at the Lenawee County Jail, three students at the University of Michigan and one in Washtenaw County, five in Macomb County, five in Wayne County, three in Kent County, and one each in St. Clair, Oakland, and Genesee Counties. The onset dates of symptoms of these confirmed genetically linked E. coli O157:H7 patients ranged from September 8 to 19.

The epidemiological investigation by MDA, which had already identified Aunt Mid’s as the common supplier of iceberg lettuce, soon revealed the likely origin of the contamination Using illness dates, ship dates, and delivery dates, the MDA was able to narrow the origin to California. The California Department of Public Health then assisted the investigation by surveying 15 possible supplier farms. By October 10, Michigan and California had both traced the lettuce supplied to the initial cases to Santa Barbara Farms in Santa Barbara, California.

We represented several MSU students.

Yet another E. coli O157:H7 Outbreak Linked to a Children's Animal Petting Zoo

Colorado health officials said yesterday that a Denver-area E. coli outbreak in January and February was likely caused by exposure to animals at the National Western Stock Show in Denver. The report Friday from the Colorado Department of Public Health and Environment said the outbreak probably originated in a "Feed the Animals" exhibit in the children's area. Investigators weren't able to pinpoint the exact animal that may have caused the outbreak.

Thirty E. coli cases were identified in the outbreak. Of those, nine people were hospitalized. Stock show President and CEO Pat Grant said there will now be signs warning of potential risks at stock and agricultural shows and of the need to wash hands and observe proper hygiene.

This report comes after reported outbreaks in Canada in September that sickened over a dozen.  Also in September nearly 75 children were sickened in England while visiting at least two farms.

Several years ago I started a website – www.fair-safety.com to document the number of outbreaks linked to animal exhibits. There are more than you would think. What is amazing about each of the outbreaks is the similarity of the cause (children being near animals that poop) and the uniformity of inaction by health officials. I clearly need to update my site.

E. coli Lawsuit Filed in Maine Against Fairbank Farms

Settlement Reached in Yet Another E. coli Raw Milk Case

A confidential settlement was reached yesterday in the following 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.

We represent two of the HUS cases. Nicole Riggs is 9 years old. She lives in Willard, Missouri with her mother, Julie; father, Dustin; and her younger sister, Christina. Larry Pedersen is a 2-year-old toddler. He lives in Monett, Missouri with his parents, Brian and Angela, and his two older sisters, Hailey and Kelsey. Both had a severe episode of HUS as demonstrated by over a week of anuria [no urine output], oliguria [low urine output] for an additional week. Both needed dialysis to survive. Both were hospitalized for over a month. Medical bills were over $100,000 for each.

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.”

Given the above, I find the below odd:

Alamosa Salmonella Outbreak Linked to Leaky Water Tank

A state report has indicated the city of Alamosa ignored a recommendation to have a deteriorating drinking water tank inspected years before the 2008 outbreak that sickened hundreds. The final Department of Public Health and Environment Report on the outbreak was released Wednesday along with an Executive Summary and Appendix.

The report found animal waste likely contaminated an in-ground storage tank that had been identified as a problem in 1997. The 2008 outbreak included 442 reported cases of illness, but state health officials estimate as many as 1,300 of the towns 8,900 residents were sickened. One death was associated with the outbreak.

Also see Youtube Links:

Alamosa Outbreak Photo Journal Slideshow

Alamosa Outbreak Investigation

Barbecue Pit E. coli O157:H7 Outbreak and Nebraska Beef's Problem History

The E. coli Outbreak at the Barbecue Pit

The E. coli O157:H7 outbreak that is the subject of this claim is but one part of a big, multistate outbreak that seriously injured dozens of innocent victims. The source of the E. coli O157:H7 that infected all these victims was adulterated meat manufactured and sold by Nebraska Beef, a company from which no reasonable restaurant, grocery store, or any other retail outlet should have ever been doing business. For its part, the Barbecue Pit, a restaurant that very definitely used Nebraska Beef meat—top sirloin butt—may or may not have known that Nebraska Beef was its source. But there is no question that the outbreak was caused by cross-contamination in the restaurant.

At the request of the Southwest Georgia Public Health District, Barbecue Pit shut-down temporarily, on July 2, to give investigators full access in their hunt to determine if the restaurant was the source of infection that had sickened scores of people in the area. It was subsequently confirmed that the restaurant was in fact the source of infection. Tests of meat samples from the restaurant were positive for E. coli O157:H7, and PFGE testing of the bacterial isolated were found to be indistinguishable from patient isolates. The tests also found that these isolates were indistinguishable from national outbreak pattern—i.e., the previously-identified strain that had caused infections in other parts of the country.

An environmental investigation conducted at the restaurant found much evidence of cross-contamination attributable to unsafe practices. The restaurant used the gooseneck cuts to make shredded beef and ground beef, which it ground itself. There were no grind-logs kept, however. More troubling, there was no designated hand-washing sink, and the one available sink for hand-washing was also used to wash lettuce. The meat grinder was also found to be in close proximity to the coleslaw chopper, and cutting boards were old, deeply cracked, and used interchangeably for cutting meat and other food items. Finally, raw meat was stored in cracked plastic dishwashing bins that were difficult to clean. As a result, there was ample proof that customers were infected by the consumption of tainted food made that way through cross-contamination from adulterated Nebraska Beef meat.

Nebraska Beef’s Six-Plus Years of Serious Food Safety Violations

Nebraska Beef and its meat-processing plant not only has a long history of safety and health violations, it has repeatedly been the target of USDA efforts to shut it down, including this year. This sordid history is summarized in a recent front-page, investigative news article that was published in the Washington Post, which stated:

Nebraska Beef has a contentious history with the USDA. Over the past six years, federal meat inspectors have repeatedly written it up for sanitation violations, and the company has fought back in court.

From September 2002 to February 2003, USDA shut down the plant three times for problems such as feces on carcasses, water dripping off pipes onto meat, paint peeling onto equipment and plugged-up meat wash sinks, according to agency records.

After the third suspension, Nebraska Beef took USDA to court, arguing that another shutdown would put the company out of business. A judge agreed and temporarily blocked the department. The USDA and the company then settled out of court and inspections resumed. However, when federal meat inspectors found more violations, Nebraska Beef sued the department and the inspectors individually, accusing them of bias. The suit was later dismissed.

In 2004 and early 2005, Nebraska Beef ran afoul of new regulations aimed at keeping animal parts that may be infected with bovine spongiform encephalopathy, or mad cow disease, out of the meat supply. Meat processors are required to remove certain high-risk parts, such as brains and spinal cords. Between July 2004 and February 2005, federal meat inspectors wrote up Nebraska Beef at least five times for not removing spinal cords and heads, according to USDA records obtained by Food and Water Watch, a Washington advocacy group. The company corrected the problems.

In August 2006, federal meat inspectors threatened to suspend operations at the packing house for not following requirements for controlling E. coli. The company corrected the problem a week later, USDA records show.

The hundreds of safety and sanitation violations from April 2002 through February 2003 include dozens of instances of documented fecal contamination—the major source of E. coli O157:H7—on beef carcasses and other cut meat items, like chuck rolls. There were also repeated instances where failures were identified in the plant’s E. coli testing program. And nearly every violation for that time period involved the plant’s failure “to prevent insanitary conditions or the adulteration of product.”

Ultimately, it was the regrettable history of food safety violations, and the threat the plant and its meat products posed to the public health, that prompted the USDA to conduct a “comprehensive public health assessment…during the week of September 2, 2002.” According to the legal brief later filed by the USDA in its attempt to shut down Nebraska Beef’s plant and operations:

That assessment was conducted because Nebraska Beef was one of the few suppliers of meat products used to prepare ground beef which was identified to contain E. coli O157:H7. The evidence…will show that Nebraska Beef provided a large amount of the meat products used to prepare the contaminated ground beef.

Accordingly, USDA argued that the Court should not prevent it from shutting the plant down, explaining:

FSIS has determined after extensive oversight that Nebraska Beef’s HACCP system is not working, and that its products are being produced under insanitary conditions that may make them unsafe for human consumption….Anyone who might handle or consume Plaintiffs’ [Nebraska Beef] products is therefore being exposed to greater than normal risk.

There is ample evidence that Nebraska Beef continued to run its meat-processing plant in a way that put the public at a “greater than normal risk” when consuming its products. This risk was because the plant’s HACCP and other safety systems—e.g., Standard Sanitation Operation Procedures (SSOP’s) and E. coli testing program—were insufficient or simply not working. The earlier E. coli outbreak caused by Nebraska Beef meat that occurred during the summer of 2006 is but one piece of such evidence. Indeed, in a striking replay of what had occurred in 2003, the USDA once more tried to shut down Nebraska Beef’s plant. Specifically:

On August 3, 2006, the Food Safety and Inspection Service (FSIS) issued establishment 19336, Nebraska Beef, a Notice of Intended Enforcement (NOIE). This decision was based on the finding noted during the Comprehensive Food Safety Assessment performed at [its] establishment from July 10, 2006 through August 3, 2006.

Not coincidentally, this time period was the one leading up to and including the same time period as the first Nebraska Beef E. coli Outbreak.

The NOIE Letter that FSIS sent to Nebraska Beef on August 3, 2006 is replete with examples of unsafe and insanitary practices and conditions at the plant in the months—if not years—leading up to the Longville E. coli outbreak. FSIS notes numerous noncompliances, including: the insufficiency and failure of its E. coli testing program; the failure to maintain or implement SSOP’s in compliance with regulatory requirements; and HACCP system that was inadequate because it “allowed adulterated product to be produced,” and failed to meet numerous other regulatory requirements.

Another Outbreak, and FSIS Attempt to Shut Nebraska Beef Down

Since the Longville E. coli outbreak, Nebraska Beef has been involved in another E. coli O157:H7 outbreak linked by FSIS, CDC, and other public health officials to contaminated meat products like those implicated in the present case—i.e., 60-pound boxes of Nebraska Beef chuck rolls. See, e.g. FSIS Recall No. 022-2008, dated June 30, 2008. According to FSIS:

[it] 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 [including chuck rolls] may have been produced under insanitary conditions.

See, e.g. FSIS Recall No. 022-2008, dated June 30, 2008. The cited practices and conditions have also been explicitly linked to insufficiencies that were subject to FSIS Noncompliance Reports as far as April 25, 2002 involving, among other things, insanitary practices in the fabrication area—i.e., the part of the plant where carcasses are turned into primal and subprimals. The Nebraska Beef plant has been operating with a broken safety system for over six years, and all aspects of its plant and operations are evidence of Nebraska Beef’s long history of continuing negligence—indeed, negligence so severe that it appears consciously indifferent to the safety and well-being of the consuming public, including the plaintiffs in this present action.

Unfortunately, not many ordinary consumers know of the systemic problems at Nebraska Beef, and those who are unaware have regrettably placed their faith in this company who so woodenly adheres to its intransigent, dilapidated, and mostly non-existent, food safety practices. The world would certainly be a better place if Nebraska Beef simply vanished as a link in our country’s food chain.

Perhaps more reprehensible than Nebraska Beef, however, are the companies that continue to buy or use Nebraska Beef’s products. These companies, which include many otherwise respectable organizations like Kroger and Whole Foods, simply have no excuse for what transpired in summer 2008. These companies have actual knowledge of the USDA’s repeated efforts to shut Nebraska Beef down.

Food Poisoning is Serious - Read Mari's Story of a Campylobacter Illness Linked to Raw Milk

I am in Beijing at yet another food safety conference.  It is odd really that at each of these conferences - regardless the continent - all tend to talk about the victims of food safety failures in the abstract.  Mari's story is jarringly real.  Click on the below and read the three part story of a food poisoning victim - a raw milk Campylobacter outbreak.

Lawsuits Filed in Multistate Outbreaks of E. coli O157:H7 Infections Associated with Beef from Fairbank Farms and South Shore Meats

I am heading to a food safety conference here in Beijing sponsored by the Chinese Government.  However, we still had time to keep on top the food safety situation in the United States.

The parents of Andrea Munro, 12, of Marshfield, say their daughter became infected with E. coli after eating Fairbank Farm’s beef on September 24.

On October 31, 2009, FSIS issued a notice about a recall of 545,699 pounds of beef products from Fairbank Farms that may be contaminated with E. coli O157:H7. Health officials in several states who were investigating a cluster of E. coli O157:H7 illnesses, with isolates that match by “DNA fingerprinting” analyses, found that most ill persons had consumed ground beef, with several purchasing the same or similar product from a common retail chain. At least some of the illnesses appear to be associated with products subject to these recalls. A sample from an opened package of ground beef recovered from a patient's home was tested by the Massachusetts Department of Health and yielded an E. coli O157:H7 isolate that matched the patient isolates by DNA analysis.

The cluster includes twenty-eight persons from 12 states infected with matching strains of E. coli O157:H7. Of these, the genetic association of 7 human isolates and the product isolate have been confirmed by an advanced secondary DNA test; secondary tests are pending on others. The number of ill persons identified in each state is as follows: California (1), Connecticut (4), Massachusetts (8), Maryland (1), Maine (2), Minnesota (1), New Hampshire (4), New Jersey (1), New York (1), Pennsylvania (2), South Dakota (2), and Vermont (1).

In the second case, the mother of Austin Richmond, 11, of Lincoln, R.I., says her son was infected with E. coli after eating a hamburger on a school trip to Camp Bournedale in Plymouth. Richmond’s burger was reportedly produced using meat from South Shore Meats, Inc., a subsidiary of Crocetti’s Oakdale Packing. Crocetti's Oakdale Packing Co., doing business as, South Shore Meats, Inc., a Brockton, Mass., establishment, is recalling approximately 1,039 pounds of fresh ground beef patties derived from bench trim as well as mechanically tenderized beef cuts that may be contaminated with E. coli O157:H7.

E. coli O157:H7 Outbreak Grows

ABC News Reports the growing E. coli O157:H7 Outbreak is spreading West after killing two and sickening dozens in the Northeast.  Now - Maine, Maryland, Massachusetts, Minnesota, New York, New Hampshire, Pennsylvania, Connecticut, Rhode Island, South Dakota, Vermont according to the CDC.

E. coli Outbreak Update - Two Deaths and Twenty-Six Illnesses Linked to Fairbank Farm E. coli Recall

The CDC now says that two deaths and 26 other illnesses may be linked to contaminated ground beef recalled by Fairbank Farms.  Lola Scott Russell, a spokeswoman for the Centers for Disease Control and Prevention, says one of the deaths involved a New York adult with several underlying health conditions. The other is a death previously reported by New Hampshire officials.

She says all but three of the suspected E. coli infections are in the northeastern U.S. and 18 are in New England. The CDC is investigating all the cases.  Ashville, N.Y.-based Fairbank Farms recalled almost 546,000 pounds of fresh ground beef that may be tainted with E. coli bacteria. The meat was distributed in September to stores from Virginia to Maine.

South Shore Meats and Fairbank Farms E. coli Outbreaks and Recalls Appear Separate - For Now

On October 26, South Shore Meats in Brockton recalled more than 1,000 pounds of hamburger and steak after 20 Rhode Island students and adults became sick after eating E. coli O157:H7 contaminated meat at Camp Bournedale in Plymouth. A sixth-grade class from Lincoln, Rhode Island and adult chaperones spent several days at an environmental education program at Camp Bournedale in mid-October. Two of the students were hospitalized but were released on October 23.

Then on October 31, Fairbank Farms recalled almost 546,000 pounds of ground beef because E. coli O157:H7 contaminated meat has caused illness and one death. USDA has said that Fairbank Farms is linked to cases of E. coli-related illness in New Hampshire, Connecticut, Maine and Massachusetts. At least on child remains hospitalized in Massachusetts. The USDA says the ground beef was sold at numerous retail stores, including B.J.’s Wholesale, Giant, Lancaster, Price Chopper, Shaw’s, Trader Joe’s and Wild Harvest. In addition, ground beef packaged under the Fairbank Farms name was distributed to stores in Maryland, Massachusetts, North Carolina, New Jersey, New York, Pennsylvania and Virginia, and was likely repackaged for sale.

In nearly 17 years doing E. coli cases, I do not recall two separate outbreaks and recalls occurring in the same geographical area in the same time frame.  It will be interesting to see during litigation (we represent children linked to the Camp and to illnesses in Massachusetts) and discovery, if Fairbanks supplied meat to South Shore.  It will also be interesting to see if any of all of these cases are linked genetically via PFGE.  Bottom line is that people getting sick and dying are still how we do outbreak investigations and issue recalls.  It will be certain that we will be looking hard at finished hamburger testing for E. coli from both plants.

New Hampshire Illnesses and Death Linked to E. coli O157:H7 Hamburger Recall

New Hampshire health officials are advising residents to take part in a beef recall after one person has died and two others became ill after eating contaminated ground beef.

"E. coli is a bacteria that produces a toxin that is potentially deadly to people," said Dr. Jose Montero, Director of Public Health at DHHS, a press release.

Montero urges residents to check their freezers for any affected products.

Health officials said Saturday the products were packaged between Sept. 15-16 and may have been labeled with sell-by dates from Sept. 19-28, and were sold at various stores throughout the state.

Health officials say the three became sick because of possible E. coli contamination.

They say the contaminated meat may be related to the recall of almost 546,000 pounds of ground beef in Connecticut, Maine and Massachusetts. That meat was sold by Fairbank Farms in Ashville, N.Y.

Each package carried the number "EST. 492" inside the USDA inspection mark or on the nutrition label.

First Lawsuit to be filed in Northeast E. coli O157:H7 Outbreak as More Tainted Meat is Recalled

NY Firm Recalls 546,000 pounds tied to E. coli Illnesses - 45,000,000 pounds recalled in last two years.

The first lawsuit stemming from the E. coli outbreak in Massachusetts and likely Rhode Island will be filed Monday in the Trial Court of the Commonwealth of Massachusetts, Superior Court, against Crocetti-Oakdale Packing, doing business as South Shore Meats, Inc., which had recalled 1.039 pounds of E. coli tainted beef linked to illnesses.

The E. coli lawsuit was filed on behalf of a Marshfield, Massachusetts family, whose grandmother and children were infected with the pathogenic E. coli strain O157:H7 after eating ground beef purchased from the Star Market in Marshfield. The plaintiff is represented by Marler Clark, a Seattle law firm dedicated to representing victims of foodborne illness.

In addition, on Saturday (10/31/09), Ashville NY firm Fairbank Farms recalled 546,000 pounds of beef products due to E. coli contamination. According to the USDA release, the meat has been linked to illnesses in Maine, Massachusetts, and Connecticut, and distributed via retail outlets including Trader Joe's, Price Chopper, Lancaster, Wild Harvest, Shaw's, BJ's, Ford Brothers, and Giant.
Ground beef packaged under the Fairbank Farms name was also distributed to stores in Maryland, Massachusetts, North Carolina, New Jersey, New York, Pennsylvania, and Virginia.

It appears that this recall is an expansion of the Crocetti-Oakdale Packing, doing business as South Shore Meats, Inc., recall of 1.039 pounds of E. coli tainted beef linked to illnesses in Massachusetts and likely Rhode Island. “This expansion is a massive recall, and the danger cannot be overstated,” said foodborne illness expert and attorney Bill Marler, who represents several families in the outbreak. “The last recall of this size—Nebraska Beef in August of 2008—sickened dozens. It means that tainted meat is in homes across the country, and we have to do our best to get the word out to consumers so that they don’t suffer the illnesses that these families have.”

In addition, a cluster of at least 20 E. coli illnesses were reported by middle schoolers and chaperones who visited Camp Bournedale in Plymouth, MA in mid-October. “At this time it is unclear if these illnesses are linked to either recall, however, the timing is quite suspicious,” added Marler.

Fairbank Farms Recalls Fresh Ground Beef Products Due To E. coli O157:H7 Illnesses in Connecticut, Maine and Massachusetts possibly linked to Trader Joes, Price Chopper, Lancaster and Wild Harvest, Shaw's, BJ's, Ford Brothers, and Giant

Recall Release CLASS I RECALL
FSIS-RC-059-2009 HEALTH RISK: HIGH

Fairbank Farms, an Ashville, NY, establishment, is recalling approximately 545,699 pounds of fresh ground beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

FSIS became aware of the problem during the course of an investigation of a cluster of E. coli O157:H7 illnesses. Working with the Centers for Disease Control and Prevention (CDC) and state health and agriculture departments, FSIS determined that there is an association between the fresh ground beef products subject to recall and illnesses in Connecticut, Maine and Massachusetts. FSIS is continuing to work with the Massachusetts Department of Public Health, the Connecticut Department of Public Health, other state health and agriculture departments and the CDC on the investigation. Anyone with signs or symptoms of foodborne illness should consult a physician.

The products subject to recall include: [View Labels, PDF Only]

Trader Joes

* 1-pound packages of "TRADER JOE'S BUTCHER SHOP FINE QUALITY MEATS GROUND BEEF 85/15."
* 1-pound packages of "TRADER JOE'S BUTCHER SHOP FINE QUALITY MEATS GROUND BEEF 80/20."
NOTE: The sell-by dates for the above two products may be October 6 or 7, 2009.
* 1-pound trays of "TRADER JOE'S BUTCHER SHOP FINE QUALITY MEATS GROUND BEEF PATTIES 96/4 EXTRA LEAN."
* 1-pound trays of "TRADER JOE'S BUTCHER SHOP FINE QUALITY MEATS GROUND BEEF PATTIES 85/15."

Price Chopper

* 1- and 2.5-pound trays of "PRICE CHOPPER MEATLOAF & MEATBALL MIX."
* 1-pound trays of "PRICE CHOPPER EXTRA LEAN GROUND BEEF 96/4."
* 1-pound trays of "PRICE CHOPPER FRESH GROUND BEEF CHUCK FOR CHILI 80% LEAN 20% FAT."

Lancaster and Wild Harvest

* 1-pound trays of "LANCASTER BRAND 96/4 EXTRA LEAN GROUND BEEF."
* 1- and 2-pound trays of "LANCASTER BRAND 90/10 GROUND BEEF."
* 1-pound trays of "WILD HARVEST NATURAL 85/15 ANGUS GROUND BEEF."

Shaw's

* 1- and 2-pound trays of "SHAW'S FRESH GROUND BEEF 93/7."
* 1-, 2- and 3-pound trays of "SHAW'S FRESH GROUND BEEF 80/20."
* 1- and 3-pound trays of "SHAW'S FRESH GROUND BEEF 75/25."
* 1.3-pound trays of "SHAW'S FRESH GROUND SIRLOIN BEEF PATTIES 90/10."
* 1.3-pound trays of "SHAW'S FRESH GROUND ROUND BEEF PATTIES 85/15."
* 1.3-pound trays of "SHAW'S FRESH GROUND BEEF PATTIES 80/20."
* 3-pound trays of "SHAW'S FRESH GROUND BEEF PATTIES FAMILY PACK 80/20."
* 1-pound trays of "SHAW'S ANGUS GROUND BEEF 85/15."
* 1-, 2- and 3-pound trays of "SHAW'S FRESH GROUND ROUND BEEF 85/15."
* 1-pound trays of "SHAW'S 90% NATURAL GROUND BEEF."
* 1-pound trays of "SHAW'S 85% NATURAL GROUND BEEF."
* 1-, 2- and 3-pound trays of "SHAW'S FRESH GROUND SIRLOIN 90/10."
* 1-pound trays of "MEATLOAF & MEATBALL MIX."

BJ's

* 5-pound trays of "FRESH GROUND BEEF, CONTAINS 15 % FAT" patties.
* 3- and 5-pound trays of "LEAN GROUND BEEF, CONTAINS 7% FAT."
* 2.5-pound trays of "MEATLOAF & MEATBALL MIX."

Ford Brothers

* 3-pound trays of "FRESH GROUND BEEF, CONTAINS 20% FAT" patties.

Giant

* 1-pound trays of "GIANT EXTRA LEAN GROUND BEEF 96/4."
* 1-pound trays of "GIANT MEATLOAF & MEATBALL MIX."
* 1-pound trays of "GIANT NATURE'S PROMISE GROUND BEEF."
* 1-pound trays of "GIANT NATURE'S PROMISE GROUND BEEF PATTIES."

Each package bears the establishment number "EST. 492" inside the USDA mark of inspection or on the nutrition label. These products were packaged on September 15 and 16, 2009, and may have been labeled at the retail stores with a sell-by date from September 19 through 28, 2009, unless otherwise noted above. Consumers should ask at their point of purchase if the products they have are subject to recall. The products were sent to distribution centers, intended for further distribution to retail establishments in Northeast and Mid-Atlantic regions. When available, the retail distribution list(s) will be posted on FSIS' Web site at http://www.fsis.usda.gov/FSIS_Recalls/ Open_Federal_Cases/index.asp.

Products for further processing:

* Cases of 10-pound "FAIRBANK FARMS FRESH GROUND BEEF CHUBS."

Each case bears the establishment number "EST. 492" inside the USDA mark of inspection; has package dates of "09.14.09," "09.15.09," or "09.16.09;" and sell-by dates of "10.3.09," "10.4.09," or "10.5.09. These products were distributed to retail establishments in Maryland, Massachusetts, North Carolina, New Jersey, New York, Pennsylvania, and Virginia for further processing. However, these products at retail will likely not bear the package dates and sell-by dates listed above. Customers with concerns should contact their point of purchase.

E. coli O157 Update - With 1,039 Pounds of Hamburger Recalled at Midnight by South Shore Meats, the Total Since 2007 is Now 41,412,504 Pounds

At midnight Crocetti's Oakdale Packing Co., doing business as, South Shore Meats, Inc., a Brockton, Massachusetts establishment, "voluntarily" recalled approximately 1,039 pounds of fresh ground beef patties derived from bench trim as well as mechanically tenderized beef cuts that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.  Hamburger recalls since 2007 have now reached 41,412,504 pounds.

And, this is not counting another recall from 2008.  Then, Hallmark/Westland Meat Packing Co., a Chino, California establishment, voluntarily recalled approximately 143,383,823 pounds of raw and frozen beef products that FSIS has determined to be unfit for human food because the cattle did not receive complete and proper inspection. Through evidence obtained by FSIS, the establishment did not consistently contact the FSIS public health veterinarian in situations in which cattle became non-ambulatory after passing ante-mortem inspection, which is not compliant with FSIS regulations.

This recall was initiated after the Massachusetts Department of Public Health confirmed a positive sample for E. coli O157:H7 in hamburger which it collected during an epidemiological investigation at the home of our client.  She and family members are now ill. 

FSIS is continuing to work with the Massachusetts Department of Public Health, the Rhode Island Department of Health and the Centers for Disease Control and Prevention on the investigation. CDC had determined that the product sampled is associated with the illnesses being investigated related to illnesses in Massachusetts and in illnesses linked to Camp Bournedale in Plymouth, Massachusetts of 20 children from Rhode Island.  Total number of illnesses are now near 30.

Crocetti's Oakdale Packing Company dba South Shore Meats, Inc., Recalls Fresh Ground Beef Patties And Beef Steak Products Due To E. coli O157:H7 Contamination

Crocetti's Oakdale Packing Co., doing business as, South Shore Meats, Inc., a Brockton, Mass., establishment, is voluntarily recalling approximately 1,039 pounds of fresh ground beef patties derived from bench trim as well as mechanically tenderized beef cuts that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

This recall was initiated after the Massachusetts Department of Public Health (DPH) confirmed a positive sample for E. coli O157:H7 which it collected during an epidemiological investigation. FSIS is continuing to work with the Massachusetts DPH, the Rhode Island Department of Health and the Centers for Disease Control and Prevention on the investigation. CDC had determined that the product sampled is associated with the illnesses being investigated. Anyone with signs or symptoms of foodborne illness should consult a physician.

The products subject to recall include:

* 10-pound boxes containing 40, 4-ounce packages of "Beef Sirloin Patties, Manufactured by South Shore Meats."
* 7.5-pound boxes containing 12, 10-ounce packages of "Beef Teres Major Steaks Seasoned."
* Boxes of 24, 5-ounce packages of "BEEF BUTT STEAKS, (Filet Style)."
* 9-pound boxes containing 12, 12-ounce packages of "BEEF BUTT STEAKS, Center Cut, (sirloin style)."
* 9-pound boxes containing 12, 12-ounce packages of "BEEF BUTT STEAK, Center Cut, (filet style)."
* 6.75-pound boxes containing 12, 9-ounce packages of "BEEF BUTT STEAK, Center Cut, (sirloin style)."
* Boxes of 16, 10-ounce packages of "Beef Top Butt Steaks Sirloin Style."
* Boxes of 20, 8-ounce packages of "Beef Butt Steaks Club Style."
* Boxes of 26, 6-ounce packages of "Beef Top Butt Steaks Sirloin Style."
* Boxes of 12, 10-ounce packages of "BEEF BUTT STEAKS, (Filet Style)."
* 6-pound boxes containing 16, 6-ounce packages of "Beef Filet Of Sirloin, Executive Cut."
* Boxes of 12, 8-ounce packages of "BEEF BUTT STEAKS, (Filet Style)."

Each box bears the establishment number "EST. 6336" inside the USDA mark of inspection and may also bear a date code of "281." The beef products were produced on October 8, 2009, and were distributed to wholesale distributors and institutions in Massachusetts. If available, the retail distribution list(s) will be posted on FSIS' Web site at http://www.fsis.usda.gov/FSIS_Recalls/ Open_Federal_Cases/index.asp

Rhode Island Department of Health Recalls Ground Beef Due to E. coli Contamination Linked to Camp Bournedale and Massachusetts Star Market

The Rhode Island Department of Health (HEALTH) advises Rhode Islanders that the South Shore Meat packing plant in Brockton has initiated a voluntary recall on certain ground beef products based on confirmed laboratory evidence of the presence of E. coli O157:H7 in leftover ground beef samples obtained from Camp Bournedale in Plymouth, Massachusetts. The ground beef was tested by the Massachusetts Department of Public Health (MDPH) after more than 20 students and chaperones from Lincoln Middle School became ill. Other Massachusetts residents are also sickened from meat purchased at Star Market in Marshfield.

USDA is investigating what lot codes are involved at this time and will be updating their website with detailed information on a regular basis. HEALTH continues to work with MDPH and federal partners to determine if any other products are involved with this recall and where the product(s) were distributed.

Like Obama, I generally can not stand FOX, especially Beck and Hannity, but FOX does not like E. coli either

The New York Times story on my client, Stephanie Smith, has been an old and new media sensation.  More blogs and twitters have reprinted her struggle with E. coli O157:H7 than any recent story.  All that said, when FOX covers the story with the same level of concern, I think the meat industry and FSIS need to pay attention.  Hmmm, perhaps Obama needs to reconsider that ban on FOX?

Raw Milk Outbreaks do happen despite what the Weston A. Price Foundation and The Complete Patient (a.k.a. David Gumpert) say

Raw milk related bacterial outbreaks have been an unfortunate and expanding part of business at Marler Clark.  What now seems to be at least a yearly occurrence (we do not get retained in all outbreaks) raw milk illnesses are on the rise. And, because the proponents of the consumption of raw milks spend most of their time rejecting that the outbreaks – and illnesses related to them – even occurred, we expect continued business growth. 

Until the proponents admit that the outbreaks are more than FDA conspiracies against them and learn something, they can never take the high moral ground that they desire.  The fact is that Raw Milk produced by your favorite local farmer or hamburger or cookie dough made by some faceless mega-corporation, can sicken or kill your child if it is contaminated with a food borne pathogen like E. coli O157:H7, Campylobacter, Listeria or Salmonella.  In this instance - size does not matter.

Below is a summary of the Raw Milk Outbreaks that we have been directly involved in representing victims. In each of the outbreaks, many of the victims, primarily children, were severely injured by the consumption of raw milk containing either E. coli O157:H7 or Campylobacter.  Yes, Weston A. Price Foundation and The Complete Patient (a.k.a. David Gumpert), these outbreaks happened and people got sick, some horribly so.

Continue Reading...

So, I made Letterman Tuesday Night

Well, not really, it was just the tape of my reaction when Larry King butchered the word "E. coli."  Click on the below image and watch the last part of the third monologue segment:

Cargill issued this statement in response to the New York Times story about Stephanie Smith

In the Minneapolis Star Tribune Newspaper:

"In October 2007 when we learned there may be a problem, we immediately instituted a voluntary recall. A number of people were sickened, including Ms. Smith. Our hearts go out to Ms. Smith and her family, as well as the others whose lives have been so affected by O157:H7. Cargill conducts nearly 400,000 tests for pathogens each year using a testing methodology that exceeds U. S. Department of Agriculture standards. We also require our suppliers to test using a methodology that exceeds USDA standards. A complete food safety system combines antimicrobial interventions, employee training and safe food-handling procedures with testing. The testing verifies the effectiveness of all of these procedures. Over the past 10 years, Cargill has invested $1 billion in ongoing meat science research and new food safety technologies and interventions. We are committed to continuous improvement in the area of food safety."

Another Reason that Food Safety is Important to Business - Another Settlement Reached In Spinach Lawsuit

An 86 year old Wisconsin woman has reached a confidential out-of-court settlement with the fresh produce growers and processors who she says poisoned her three years ago with a bag of spinach contaminated with E. coli O157:H7.  Jane Majeska of Fond du Lac sued Dole, National Selection Foods, Mission Organics and Pick 'n Save on Sept. 1st for injuries she received from eating fresh bagged spinach, which was contaminated E. coli bacteria.

The parties agreed not to disclose the terms or the amount of the settlement that comes at the end of a series of litigation that follows one of the most troubling E. coli O157:H7 outbreaks in history because it involved fresh produce and spread across the country so quickly.

The bagged spinach outbreak involved 26 states. Half of the 205 confirmed cases required hospitalization and 31 developed the type of kidney failure called hemolytic uremic syndrome (HUS). Five deaths in confirmed cases are associated with the outbreak. A 2-year old in Idaho and elderly women in Wisconsin, Washington, Nebraska, and Maryland were among the fatalities.

It also cost Salinas Valley growers an estimated $100 million in lost sales.  Litigation costs ans settlements are not reported.

Majeska was one of the HUS victims and was one of the most critically ill survivors of the E. coli outbreak. Her fight for life cost a half million in hospital and doctor bills, and put her on feeding tubes and a ventilator for an extended period.

U.S. Agriculture Secretary Tom Vilsack says the Obama administration is working to improve food safety.

U.S. Agriculture Secretary Tom Vilsack vacated Washington DC today to give a speech at the University of Minnesota.  He was interviewed by Minnesota Public Radio following a major New York Times report over the weekend on flaws in the food safety system cited cases in Minnesota. 

Here is the Press Release that went out this afternoon from FSIS in response to the New York Times article:

Statement by Agriculture Secretary Tom Vilsack Regarding Recent E. Coli Story
October 05, 2009

"The story we learned about over the weekend is unacceptable and tragic. We all know we can and should do more to protect the safety of the American people and the story in this weekend's paper will continue to spur our efforts to reduce the incidence of E. coli O157:H7. Over the last eight months since President Obama took office, USDA has been aggressive in its efforts to improve food safety, and has been an active partner in establishing and contributing to President Obama's Food Safety Working Group.

"Protecting public health is the sole mission of the USDA Food Safety and Inspection Service. FSIS has continued to make improvements to reduce the presence of E. coli O157:H7 and the agency is committed to working to reduce the incidence of foodborne illnesses caused by this pathogen.

"Shortly after coming into office, the Administration created a high-level Food Safety Working Group to coordinate food safety policies, focus greater resources on prevention, and improve response to outbreaks. Since doing so, we have taken the following actions:

* Launched an initiative to cut down E. Coli contamination (including in particular contamination from E. Coli O157:H7) and as part of that initiative, stepped-up meat facility inspections involving greater use of sampling to monitor the products going into ground beef.
* Appointed a chief medical officer within USDA's Food Safety Inspection Service to reaffirm its role as a public health agency.
* Issued draft guidelines for industry to further reduce the risk of O157 contamination.
* Started testing additional components of ground beef, including bench trim, and issuing new instructions to our employees asking that they verify that plants follow sanitary practices in processing beef carcasses.
* Designed the Public Health Information System (PHIS) in response to lessons learned in past outbreaks.

"USDA is also looking at ways to enhance traceback methods and will initiate a rulemaking in the near future to require all grinders, including establishments and retail stores, to keep accurate records of the sources of each lot of ground beef.

"No priority is greater to me than food safety and I am firmly committed to taking the steps necessary to reduce the incidence of foodborne illness and protect the American people from preventable illnesses. We will continue to make improvements to reduce the presence of E. coli O157:H7."

Now, back to his actual words to Minnesota NPR.  If he had called I would have driven him and Mr. Cargill up to Cold Spring, Minnesota to meet the young woman profiled by the New York Times.  Perhaps, they could help change her diapers?  Help her in and out of her wheelchair? Explain that she will never walk again?  Explain to her that she will never have children?  That she will need multiple kidney transplants to live?  Never have a meaningful job?  And, never dance again?

 

Eat Hamburgers At Your Own Risk (AUDIO) - Ron Reagan Interviews Me

Do you know what's in your hamburger? The truth might frighten you. According to the New York Times, tens of thousands of people get sick annually by the food-born pathogen E. coli. 22-year-old Stephanie Smith was one of those people. A dance instructor, she came down with an illness so severe that it shut down her kidneys, caused seizures and ultimately left her paralyzed from the waist down and partially brain damaged.

William Marler, Stephanie Smith’s lawyer, spoke with Ron Reagan about the seriousness of this issue.

Eat Hamburgers At Your Own Risk (AUDIO)

Senator Reid - It is Time - Past Time - To Move on Food Safety Legislation

Judging from my email and twitter traffic, people are opening up (actually they do not even need to do that) their New York Times this morning to the shocking and tragic story of my client's, Stephanie Smith's, struggle with a severe E. coli O157:H7 illness linked to Cargill hamburger.  It is a difficult read.  A few weeks ago another shocking and tragic story of yet another client, Linda Rivera, was on the front page of the Washington Post.  Linda, who now has been hospitalized for 155 days is also struggling with a severe E. coli illness, this linked to Nestle Toll House Cookie Dough.

Senator Reid, I hope you have read both articles.  I would also ask you to read the below:

Subject: Linda Rivera Condition 10-2-2009

10-2-2009 @ 11:15pm PDT

Linda’s condition is improved though she is still seriously ill. She is still on the breathing machine (ventilator) but is being weaned off of it. Room air to supply good levels of oxygen in our blood is about 22% oxygen. Linda needs 30% to maintain the same level of good oxygenation. Just a few weeks ago she required around 50% and above, so things are looking good and improved. She is taking more of her own breaths with backup mandatory breaths being delivered. She has a tracheostomy to which the ventilator hose is attached.

She is able to move her left extremities more so than a few weeks ago. Her blood pressure is stable and low normal without any special medications to keep it up in the normal range. She has occasional fevers. She tries to talk, is now moving her mouth to attempt word formation, moves her hands, shows thumbs up or thumbs down as appropriate to questions or statements, and is moving her head. She is unable to speak out loud due to the tracheostomy, which must eventually be fitted for a special tracheostomy tube that will allow talking while it is in. Alternatively, but unlikely, she will eventually have the tracheostomy closed first before she can speak. To qualify for the special tracheostomy tube called a fenestrated tracheostomy tube, she would have to be able to breathe on her own while the tube is in. This will happen further on down the road.

Overall her condition has improved from critical, to now, serious condition. Her prognosis is guarded, not as poor as a few weeks ago. Richard is quite happy with her progress. Hopefully as her strength improves and she is more independent of the ventilator, she can become more communicative. I would think they should be getting her out of bed and into a chair for brief periods. Perhaps they can wheel her out of her room and into a more open area with a not so monotonous views.

I am encouraged at what Rich has told me. Perhaps the biggest threat to her is hospital acquired infection. There is room for cautious optimism, however, with prayer sealing the deal.

God Bless,
Ron R

A Dancer's Battle Against E. coli

New York Times Quotation of the Day:

"I ask myself every day, ‘Why me?’ and ‘Why from a hamburger?

Michael Moss does a Pulitzer Prize winning job of exposing the underbelly of how our meat is produced in the United States.  E. coli O157:H7 is a deadly bacteria that nearly took Stephanie Smith's life.  Every day is a struggle for her now.  Despite the odds, she promises to dance again.  Read her story and see the video the NYT produced - "The Burger That Shattered Her Life."  Click on picture to see video done by NYT.

And this guy should be fired:

Dr. Kenneth Petersen, an assistant administrator with the department’s Food Safety and Inspection Service, said that the department could mandate testing, but that it needed to consider the impact on companies as well as consumers. “I have to look at the entire industry, not just what is best for public health,” Dr. Petersen said.

Victims of Oklahoma E. coli Outbreak File Suit Against Country Cottage Restaurant

Lawsuit Seeks to Cover Millions In Medical Expenses

Victims of an August, 2008 outbreak of E. coli O111 have joined together to file suit against the Country Cottage restaurant, where they were sickened. The lawsuit was filed today in the District Court in the State of Oklahoma, in and for the County of Mayes, on behalf of twelve families.

“Many of us regularly entrust restaurants with our health and safety,” said the families’ attorney, William Marler. “There are stringent rules and regulations that restaurants must follow, because any deviation from those rules can cause illnesses. Sadly, this outbreak shows how very wrong things can go, and how much suffering can result.”

The outbreak at the Country Cottage Restaurant in Locust Grove, Oklahoma sickened 341 people, hospitalized 70, and caused the death of one man. Investigators quickly pinpointed the restaurant as the source of infection, but were unable to determine the specific vehicle. E. coli is often contracted by consuming food or beverage that has been contaminated by animal (especially cattle) manure. E. coli outbreaks have been tied to meat, produce, unpasteurized milk, cheese, and cider, sprouts, juice, and even water. The lawsuit cites the restaurant’s use of water from an unpermitted, on-site well just before the outbreak—in violation of Department of Environmental Quality (DEQ) regulations – as a basis for punitive damages.

“These fourteen people collectively spent 250 days in the hospital, 84 of them on dialysis for kidney failure,” continued Marler. “Their medical bills are almost two million dollars, not to mention ongoing medical care that many will continue to need. Our job is to make sure that they don’t struggle to carry that immense burden by themselves.”

Enterobacter sakazakii or Cronobacter sakazakii - either way - in Infant Formula it is Devastating

Over at E. sakazakii blog there is a discussion of the naming and renaming of this very nasty bug.

Whatever the name it is a rare, but life-threatening cause of neonatal meningitis, sepsis, and necrotizing enterocolitis. In general, E. or C. sakazaii kills 40-80% of infected newborns diagnosed with this type of severe infection. E. or C. sakazakii meningitis may lead to cerebral abscess or infarction with cyst formation and severe neurologic impairment. E. or C. sakazakii can cause a variety of infections, though central nervous system infection has been most commonly described. For infants, infection typically manifests through signs of sepsis in the first week of life: irritability or lethargy, temperature instability, and feeding intolerance. Meningitis often produces overwhelming infection that rapidly moves through cerebral hemorrhage, infarct, necrosis, liquefaction, and eventually, cyst formation.

E. or C. sakazakii invasive infections occur more frequently in infants than in older children. The neonate's immature immune system may increase the risk of acquiring an E. or C. sakazakii infection. In a study of E. or C. sakazakii cases over a 47-year period, investigators found that the median age at infection onset was two days and 94% of cases were less than 28 days old.

While the reservoir for E. or C. sakazakii is unknown in many cases, a growing number of reports have established powdered infant formula as the source and vehicle of infection. In several investigations of outbreaks of E. or C. sakazakii infection that occurred among neonates in neonatal intensive care units, investigators were able to show both statistical and microbiological association between infection and powdered infant formula consumption.

The Weeks Top Six Stories on Food Safety News

It has been another week with too much news in food safety.  Here are six that you should not have missed.

Food Safety Education Month Winds Down

Shootout in Tulsa – OK vs Big Chicken

Q&A: Nestle on Food Safety Politics

Outbreak Victims to Sue OK Restaurant

Updated: Produce E. coli Outbreak in 3 States

Former Under Secretary For Food Safety Speaks Up

About Botulism - An Updated Resource - Botulism Blog

Botulism is a rare, life-threatening paralytic illness caused by neurotoxins produced by an anaerobic, gram-positive, spore-forming bacterium, Clostridium botulinum. Unlike Clostridium perfringens, which requires the ingestion of large numbers of viable cells to cause symptoms, the symptoms of botulism are caused by the ingestion of highly toxic, soluble exotoxins produced by C. botulinum while growing in foods.

Overview

These rod-shaped bacteria grow best under anaerobic (or, low oxygen), low-salt, and low-acid conditions. Bacterial growth is inhibited by refrigeration below 4° C., heating above 121° C, and high water-activity or acidity. And although the toxin is destroyed by heating to 85° C. for at least five minutes, the spores formed by the bacteria are not inactivated unless the food is heated under high pressure to 121° C. for at least twenty minutes.

The incidence of foodborne botulism is extremely low. Nonetheless, the extreme danger posed by the bacteria has required that “intensive surveillance is maintained for botulism cases in the United States, and every case is treated as a public health emergency.” This danger includes a mortality rate of up to 65% when victims are not treated immediately and properly. Most of the botulism events that are reported annually in the United States are associated with home-canned foods that have not been safely processed. Very occasionally, however, commercially- processed foods are implicated as the source of a botulism events, including sausages, beef stew, canned vegetables, and seafood products.

Symptoms

Continue Reading...

BBC reports that Godstone Farm animals test positive for E. coli - No Shit!

Experts from the Veterinary Laboratories Agency (VLA) said 33 of 102 samples were likely to contain the O157:H7 strain of the infection. This included samples from Lambs, pigs, goats, cattle, ponies and rabbit droppings at a Surrey farm at the centre of an E. coli outbreak. During its visit to Godstone Farm scientists found two samples of E. coli O157 on the floor of the main barn. Nigel Gibbens, Defra chief Veterinary officer, said: "Joint HPA and VLA investigations have confirmed the presence of E. coli O157:H7 bacteria in faeces from a wide range of animals on a premises in Surrey.

The Health Protection Agency (HPA) said the total number of E. coli cases linked to Godstone Farm had risen to 67. Eight children remain in hospital in a "stable or improving condition".

Let’s see, there is a long history of animal to human bacterial contamination in both England and the United States – see www.fair-safety.com. Here are a few that we have litigated – and continue to do so:

Lane, Oregon - County Fair E. coli O157:H7 Litigation - Marler Clark represented many of the 82 people, most of them young children, who were sickened by E. coli O157:H7 at the Lane County Fair in Eugene, Oregon, in the summer of 2002.

North Carolina State Fair E. coli O157:H7 Outbreak Litigation - The North Carolina State Department of Health and Human Services (DHHS) announced on November 8 that the North Carolina State Fair was the source of over 106 cases of E. coli O157:H7 amongst persons who attended the fair. On December 16, N.C. DHHS released an outbreak report, and stated that “Many activities in the Crossroads Farm Petting Zoo were associated with illness.”

AgVenture Farms E. coli O157:H7 Outbreak Litigation - The Florida State Department of Health (DOH) identified 22 confirmed cases of E. coli O157:H7 and Hemolytic Uremic Syndrome in Central Florida during March, 2005. At least 35 additional cases were suspected as of April 1, 2005.

What I find most bothersome is that each time it happens in either England or the United States, health officials and petting zoo owners seem to pretend it is happening for the very first time.  Here is a PowerPoint I presented in 2004 - we seem never to learn.

E. coli O111 Lawsuit against Country Cottage of Locust Grove coming soon

This coming week we will be filing suit against Country Cottage Restaurant and its owners on behalf of a dozen seriously injured victims of this outbreak.  Combined, our clients' medical bills are over $1,000,000 to date.  Kim Archer of the Tulsa World has done a great job of recalling the horrors of the United States’ largest E. coli O111 outbreak.

• 341 were sickened

• 70 people were hospitalized, including 22 children

• 17 people received kidney dialysis, including eight children

• 1 man died

Although, we offered the owners, the restaurant, it's lawyers and insurance company the opportunity to resolve the case, they did not respond.  Here is the final report of the outbreak:

I predict that Food Safety Legislation passes both Houses of Congress by Thanksgiving and is signed by the President before Christmas

Senator Harry Reid, majority leader of Senate, reached out by letter to my clients, the Rivera's, of Las Vegas. 

Linda Rivera is one of 80 sickened by E. coli O157:H7-tainted Nestle Toll House Cookie Dough.  She has struggled with her illness since May 1.  She has lost her large intestine, gall bladder, and has been on dialysis.  She is presently on life support.  Here is Reid's letter:

Dear Rivera Family:

I want to express my personal thoughts and prayers to you as you struggle with Linda’s illness. I hope you will keep your faith strong and your hopes up that Linda will recover and find peace and comfort.

I want you to know that the seriousness of Linda’s illness highlights the need for action to improve our food safety laws and inspection systems. This fall, I plan to bring food safety legislation before the Senate so that we can strengthen our laws, better detect food borne pathogens, and better trace our food supply. As I work on this legislation it will be with the goal of ensuring that more families do not suffer as you do now.

Best wishes to you, Linda and your entire family.

It is great to have a leader like Senator Reid.

Petting Zoos Sickening Kids in Britain and Canada - Please Take Precautions

The ongoing problems in the US led the US Centers for Disease Control (CDC ) to publish recommendations for reducing the risk of transmitting E. coli and other human pathogens at animal exhibits. In the wake of devastating E. coli outbreaks, several states including Pennsylvania and North Carolina have enacted laws requiring similar precautions. Yet in representing dozens of children sickened in these outbreaks over the years, Marler Clark has seen animal exhibitors continue to disregard these basic precautions:

1. Source control: Animals need to be screened for pathogens, and removed if `shedding` those pathogens.

2. Effective manure management: Sanitary removal of animal manure followed by sanitation of bins and traffic areas.

3. Dust control: Fecal dust can spread infectious agents onto surfaces, which results in human illness through hand to mouth transfer of pathogens.

4. Clean up and sanitation: Sanitize all contact surfaces.

5. Environmental sanitation: Prevent cross contamination of areas adjacent to animal holding areas, particularly food courts and drinking fountains.

6. Hand washing and sanitation facilities: Require visitors to wash and sanitize upon entry and exit to animal holding areas and petting zoos.

7. Clear protocol for petting zoo and animal contact areas: Hand-to-mouth activities such as eating, drinking, smoking, carrying toys and pacifiers should be strictly prohibited in the interaction area. Gloves should be available for additional protection.

8. Information should be provided: Wherever there is public access to farm animals, information about the risk associated with the transmission of pathogens should be provided to visitors.

9. Heightened precautions should be applied to high-risk groups: Children under age 5, people with weakened immune systems, and pregnant women fall in the category of high-risk for serious infection, and hence should strictly follow all the precautions enforced in the animal contact area.

We have been keeping track of most outbreaks involving petting zoos and county fairs and have compiled most of the information at www.fair-safety.com.  Looks like I have to update it.

Strict Product Liability - Question of the Night?

Which multi-billion dollar company raised this defense in response to a recent lawsuit where the consumer ate its product?

Under what circumstances should a consumer be held responsible when the purchased food product contains a bacteria or virus?  Should the parent?  Should the child?

Salmonella Typhimurium outbreak may be linked to shredded lettuce and 124 Illnesses Nationwide

On the third anniversary of the Dole Spinach E. coli outbreak, once again Lynne Terry of The Oregonian and Bill Keene super, senior epidemiologist, break yet another food poisoning story. This time, according to Ms. Terry, “[f]ederal and state health authorities are investigating a salmonella outbreak that peaked in Oregon in August.”

According to Dr. Keene, “[a]t least 124 were sickened across the country, with a clustering of cases in the West. In Oregon, seven people became sick between Aug. 4 to 16, including three in the Portland metro area. Two people got so sick they had to be hospitalized, and one had severe symptoms [a Marler Clark Client], Keene said.”

Scientists from the Centers for Disease Control and Prevention and the Food and Drug Administration still do not know exactly what poisoned people, though shredded lettuce is a leading suspect, Keene said.

Question - where did lettuce come from?

Interestingly, Tanimura & Antle, Inc. of Salinas, California expanded the geographic scope of its voluntary recall of bulk and wrapped romaine head lettuce last week due to positive Salmonella tests.  The company extended the U.S. recall to all 50 states. The recall also included Puerto Rico and Canada.  Originally, the recall was issued after a random test conducted by the Wisconsin Department of Agriculture tested positive for Salmonella.  At the time of the recall no illnesses had been linked to the finding.  Romaine lettuce included in the recall was harvested June 25 - July 2. Shelf life of the product typically is 14 n 16 days.  At this point it is unclear if Tanimura & Antle is the source of this outbreak reported by Ms. Terry.

Or, perhaps it is not lettuce?

Muranaka Farm Inc. recalled 1,005 cases of parsley distributed in 10 states because it may be contaminated with Salmonella.

Frontera Produce of Edinburg, Texas recalled one lot of cilantro due to Salmonella.  The recalled cilantro was available at select store chains in Texas, Oklahoma, Colorado, Louisiana and New Mexico.

And, what the hell is wrong with leafy greens?  Some examples:

August 1993 - E. coli O157:H7 outbreak linked to a salad bar; 53 reported cases in Washington State

July 1995 - Lettuce (leafy green; red; romaine) E. coli O157:H7; 70 reported cases in Montana
September 1995 - Lettuce (romaine) E. coli O157:H7; 20 reported cases in Idaho

September 1995 - Lettuce (iceberg) E. coli O157:H7; 30 reported cases in Maine

October 1995 - Lettuce (iceberg; unconfirmed) E. coli O157:H7; 11 reported cases in Ohio

May-June 1996 - Lettuce (mesclun; red leaf) E. coli O157:H7; 61 reported cases in Connecticut, Illinois, and New York

May 1998 - Salad E. coli O157:H7; two reported cases in California

February.-March 1999 - Lettuce (iceberg) E. coli O157:H7; 72 reported cases in Nebraska

July-August 2002 - Lettuce (romaine) E. coli O157:H7; 29 reported cases in Washington and Idaho

October 2003 - thirteen residents of a California retirement home were sickened, and two people died, after eating E. coli-contaminated, pre-washed spinach

October 2003-May 2004 - Lettuce (mixed salad) E. coli O157:H7; 57 reported cases in California

April 2004 - Spinach E. coli O157:H7; 16 reported cases in California

September 2005 - Lettuce (romaine) E. coli O157:H7; 32 reported cases in Minnesota, Wisconsin, and Oregon

November-December 2006 - Taco Bell and Taco Johns E. coli shredded lettuce sickened hundreds in Mid-west and East

Kilwin's Quality Confections, Inc. Conducted Nationwide Recall of Chocolate-Covered Peanuts Because of Possible Health Risk Due to Peanut Corporation of America

Several months after the Peanut Corporation of America forced the recall of over 4,000 different peanut products from some 200 companies, another company announced a recall on the FDA Website.

Kilwin's Quality Confections, Inc. of Petoskey, MI, is recalling all of our 7 ounce packages of chocolate-covered peanuts, and bulk chocolate-covered peanuts, sold in our retail stores, which were sold prior to April 1, 2009, 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 chocolate-covered peanuts were sold in Kilwin's retail stores located in the following states: Michigan, Florida, Illinois, Wisconsin, Colorado, Rhode Island, Georgia, Maryland, Pennsylvania, Tennessee, North Carolina, and South Carolina.

The product comes in a 7 ounce, gold foiled plastic package with a clear center section, and is labeled "Milk Chocolate Peanuts" and "Fresh dry roasted peanuts covered in creamy milk chocolate", Kilwin's Quality Confections, Petosky, MI 49770. The barcode on the package is 001615. Additionally, the product was sold in bulk bins, by weight, at Kilwin's retail stores.

The potential for contamination was noted after our peanuts supplier voluntarily recalled their product because these peanuts were subject to the PCA Texas facility recall.

Linda Rivera, Mother of Six, Fights for Her Life Tonight Due to E. coli O157:H7

A picture is worth multiple, multiple, millions of words:

I spent the day today being feted at the University of Arkansas School of Law and meeting with Tysons and Wal-Wart.  Linda, her parents, her husband and six kids spent the day watching Linda being admitted into another ICU, again.  It is unlikely she will survive the weekend.

I won't recount the horror that Linda and her family have experienced since May when she ate E. coli-tainted Nestle Toll House Cookie Dough.  I won't try my case on my blog.

By the way, this is a picture of Linda before E. coli O157:H7:

The only thing the President missed tonight in the Health Care Speech - Real Health Care Reform Requires Safe Food

President Obama once said:

"There are certain things only a government can do. And one of those things is ensuring that the foods we eat are safe and do not cause us harm.”

A few days ago I penned this Op-ed (declined by the Washington post) - it seems a bit more on point tonight after our President's speech:

Linda Rivera’s excruciating case of food poisoning (Severe Case Gives Context to Issue of Food Safety Washington Post 9/1/09) should shine some light on a crucial reality that is missing from most health care reform plans: you can’t fix America’s health care unless you provide Americans with a safe food supply.

The mother of six lies comatose in her Las Vegas hospital room as a consequence of eating cookie dough contaminated with E. coli O157:H7 - a vicious microbe previously associated with hamburger, spinach, lettuce, and raw milk as well as other products. But she is not an isolated case. According to federal health authorities, she is just one of the 76 million Americans sickened each year by tainted food, adding billions in costs to individuals, to food-producers and to our beleaguered medical system.

Yet food safety is rarely mentioned in the scream fest that has been national health care debate in and around Congress. In fact, our national squabble threatens to scuttle any hope for the much-needed food safety legislation that overwhelmingly passed the House this summer. The Food Safety Enhancement Act would give the Food and Drug Administration (FDA) the authority it needs to inspect food-processing plants and stop the distribution of food tainted with E. coli, Salmonella, Listeria or any of the other usual suspects. It would increase the agency’s ability to use emerging technologies to trace contaminated foods and additives back to their source, while imposing new safety standards on both domestic and imported food products.

The potential benefits - to our children, our parents, and our neighbors and to the U.S. economy - are enormous. While the food industry insists that we have the world’s safest food supply, the authoritative Centers for Disease Control suggest otherwise: 76 million sick people per year, 208,000 per day, 8,675 per hour. Most of those cases are relatively mild, but the CDC says 325,000 people will be hospitalized, and at least 5,000 of them will die of food poisoning.

Consider the costs to the health care system, such as it is. The Department of Agriculture estimates the combined medical costs, productivity losses, and the costs of premature death at a minimum of $6.9 billion per year. But that estimate excludes costs such as lost business opportunities, public costs, pain and suffering and much more. The Food and Drug Administration assigns a cost of $5 million per death, reaching a total cost of $17 billion per year. But using a more complex FDA formula that factors in the full societal cost, the savings reach an astronomical $357 billion.

There may be argument over the calculations, but these are not paper costs; they are real. In the 17 years I have been representing the victims of food-borne illness, we have collected more than $500 million in settlements and verdicts against food manufacturers. Most of that goes to cover the costs of medical bills, lost wages and the pain and suffering incurred by people whose only crime was to believe processors` claims that their products were safe. So what if we passed meaningful food safety legislation? What if we saved billions of dollars in medical care and treatment by avoiding poisoning in the first place? What if Linda Rivera and thousands of Americans like her never became infected with E. coli or Salmonella or Listeria?

It’s time to tone down the rhetoric on health care and do something positive: pass meaningful food safety legislation that will put lawyers like me out of business, while saving money and the lives and well being of innocent Americans.

Wisconsin Spinach E. coli O157:H7 Lawsuit filed against Dole, Natural Selection Foods, Mission Organics and Pick'n Save

Wisconsin Woman Severely Sickened by E. coli in Spinach Forced to Sue Dole, Natural Selection Foods, Mission Organics and Pic-n-Save to Recover Massive Medical Expenses

The 2006 outbreak of E. coli tied to spinach sickened more than 205 people nationwide, many gravely. More than 31 developed Hemolytic Uremic Syndrome (HUS) and five lost their lives. One of the most critically ill was Jane Majeska of Fond du Lac, Wisconsin, an 85-year old woman whose fight to stay alive in the months after she consumed the Dole E. coli O157:H7-tainted spinach cost almost a $500,000 dollars. William Marler of the Seattle-based foodborne illness law firm Marler Clark, along with the Fond du Lac firm of Sager, Colwin Samuelsen, will file a lawsuit today in the Fond du Lac branch of the Wisconsin Circuit Court against Dole, Natural Selection Foods, Mission Organics and Pic-n-Save.

“This amazing woman fought through serious medical traumas and has continued to fight to win back her health,” said Marler. “Jane Majeska is alive today because she was incredibly healthy and active before she ate contaminated food, because she had tremendous medical care, and because she fought every hour of every day to get better,” continued Marler. “No one should have to go through that, but if they do, they certainly shouldn’t have to sue to be compensated for it. But sometimes, that’s what it takes.”

Jane Majeska ate Dole spinach in late August 2006. Within days, she was experiencing nausea, vomiting, and diarrhea that became bloody. She was admitted to the hospital as her kidneys failed and she was diagnosed with HUS. Her months in the hospital were marked by increasingly invasive procedures to address her cascading illnesses. In addition to renal failure, she experienced stroke, cognitive impairment, a collapsed lung, a pulmonary embolism, and the inability to eat or breathe on her own. She was given dialysis, blood transfusions, plasmapheresis, and survived on a feeding tube and ventilator. Even as she began to improve, she required aggressive physical, occupational, and speech therapy, as well as rehabilitation nursing.  For more about here struggle, see summary.  For copy of complaint, click below:

Although E. coli outbreaks are often associated with meat, produce-borne outbreaks have become more frequent in recent years. The Center for Science in the Public Interest noted that fully 25 percent of E. coli outbreaks from 1990-1998 were traced to produce. Data from the Centers for Disease Control show that over the last 12 years, twenty-two E. coli outbreaks have been traced specifically to leafy greens.  Interestingly, just before the 2006 E. coli outbreak, the St. Croix Wisconsin Health Department investigated Natural Selection Foods-linked Earthbound Farms after a vole was found in a salad served to a restaurant customer.  Here is a PowerPoint presentation on that investigation, click below:

ABOUT MARLER CLARK: William Marler has been a major force in food safety policy in the United States and abroad. His food safety blog, Marler Blog, is read by over 1,000,000 people around the world every year. He and his partners at Marler Clark have represented thousands of individuals in claims against food companies whose contaminated products have caused serious injury and death. His advocacy for better food regulation has led to invitations to address local, national, and international gatherings on food safety, including recent testimony to US Congress Committee on Energy and Commerce. In 1998, Mr. Marler formed the not for profit, Outbreak Inc. He spends much of the year speaking on how to prevent foodborne illnesses.

Another Victim of the 2006 Dole Spinach E. coli O157:H7 Stands Up - Lawsuit to Follow

I am always a bit humbled when a victim of food poisoning stands up to the corporations who poisoned them with food – especially food labeled “triple washed” and “ready to eat.”

Jane and Ben Majeska have been married 60 years in August 2009. Their marriage never faced a challenge in those years of the sort that they endured in the fall of 2006. Were it not for her consumption of Dole spinach, September and October of 2006 would have been two more precious months spent active, happy, and together. Instead they were excruciating and terrifying. The impacts of Jane’s HUS involved nearly every body system. The extraordinary efforts of her doctors and Jane’s remarkable strength and will meant the difference between life and death. Jane reflects, and recalls her children consulting the folders where they kept their parent’s funeral plans and end of life wishes. Medical bills to date are nearly $500,000. The Majeskas deserve to be compensated for their deep suffering. To quote, I am sure someone famous, “We will see you in Court!” Here is the Majeska’s story:

Continue Reading...

"I have a dream" - Linda Rivera gets out of the hospital and the House and Senate do something about food safety

"People just don't really understand how horrible food-borne illness is," said William Marler, a prominent Seattle-based food-safety lawyer who is representing the Rivera family and 23 other victims in the cookie dough outbreak. "They think food-borne illness is a tummy ache and diarrhea."

I was much younger when Martin Luther King gave his famous speech – “I have a dream.”  But, if I could borrow that phase, I too “have a dream.”  I dream that Tuesday morning the President and House and Senate members and their staff would read Lyndsey Layton’s story – “This Woman Might Die From Eating Cookie Dough - Severe Case Gives Context to Issue of Food Safety” and get to work - really get to work.  In fact, I bet Mr. Rivera would love a call of support from the folks in Washington who could help fix this mess.  Call me and I will set it up.

More Bad Raw Milk Stories

Summer, or at least August, is drawing to a close in the Northwest – temperatures have dropped below 100 and rain is expected. Really, no global warming?

I spent most of last week being supportive, but feeling helpless, as a client who ate E. coli O157:H7-tainted Nestle Toll House Cookie Dough, may well be slowing dying after spending over 100 days in the hospital (still there), loosing her large intestine and gall bladder and spending weeks on dialysis. It is crazy that people think a foodborne illness is a “tummy ache.”

I have a very busy September coming up. I am looking forward to mediation in a few days on the last of the 2006 Dole Spinach E. coli O157:H7 outbreak cases. This client spent 51 days hospitalized, 18 days on dialysis and incurred $500,000 in medical bills. Will Dole, Natural Selection Foods and Mission Organics play hardball with this 80ish lady? We shall see.

I then have speeches at the Arkansas Law School, in Washington DC (with some insurance executives) and then off to China too yet another food safety conference.

So, I decided to take a “break” this weekend.  I decided to get out of Seattle to focus a bit on the upcoming mediation - the travel and speeches - by spending a few days working/fly-fishing in Idaho. So, after a working/hiking/fly-fishing day, I decided to get a massage. I do not do massages – I’m just not that in to having strangers rub you for money – but that is just me. So, halfway through the massage and being naked (underneath a sheet), the lady starts telling me about the benefits of drinking raw milk.  I decided to not tell her what I did for a living. So, on too the other bad raw milk stories:

Raw Milk Sickens 13 in Wisconsin

Wisconsin state agencies are cautioning residents to discard any unpasteurized milk. Selling or distributing raw milk and its products is illegal in Wisconsin.  The state says the victims have tested positive for campylobacter jejuni. All victims had consumed raw milk or been in households where someone else consumed raw milk and became ill. Symptoms started Aug. 14 through Aug. 20.

3 Los Angeles Firms Charged with Selling Raw Milk Cheese

The Los Angeles city attorney has filed criminal charges against three local businesses for the alleged sale of dangerous, unpasteurized cheese from Mexico. The office said in a statement Thursday that it has charged El Agave Restaurant Oaxaqueno, Mario Brothers Market and Expresion Oaxaquena Market with misdemeanor violations of the Food and Agriculture Code for the sale of raw milk cheese and other unpasteurized dairy products.

The Largest E. coli O111 Outbreak Remembered - Victims Still Mourning - Victims Still Suffering - The Restaurant and Government Still Has Done Nothing to Help

Kim Archer of the Tulsa World has done a great job of recalling the horrors of the United States’ largest E. coli O111 outbreak.

• 341 were sickened

• 70 people were hospitalized, including 22 children

• 17 people received kidney dialysis, including eight children

• 1 man died

Excerpts from the Article about just one of the victims:

His entire life, Kenneth Birkes has worked seven days a week from dawn to dark. Then he ate a meal in honor of his father's 85th birthday at Country Cottage in Locust Grove. It was Sunday, Aug. 17, 2008. Five days later, Birkes fell ill. The 61-year-old Grove man hasn't worked since.

"I was up in Kansas to get a drilling rig out in the country," he said. "It hit me so quick."  He had just put the rig on a trailer and driven to the town of Edna, all the while calling his wife to tell her he needed help.

"That's really the last thing I remember," Birkes said. His wife initially took him to a hospital in Coffeyville, Kan., but he continued to get worse. He didn't wake up until six weeks later at St. Francis Hospital.

Birkes said he went from making $12,000 a month to nothing.

"This pretty well wiped us out," he said. After three months in the hospital, he had to learn to walk again. Now, he has migraines four days a week and is only able to go three hours at a time before needing to rest.

"I'm still alive, and that's all that matters," Birkes said.

Birkes is among a group of clients of Seattle attorney Bill Marler asking for a settlement from the restaurant's insurance company.

"If they turn us down, we have no choice but to sue the restaurant and the owners for the policy and all personal assets," Marler said.

Third E. coli Lawsuit to be Filed Against JBS Swift Beef Company

Three Family Members Sickened in Wisconsin, One Gravely.

A Wisconsin family sickened in the JBS Swift Beef Company outbreak of E. coli O157:H7 will file suit against the company Wednesday. The lawsuit will be brought by the Seattle-based foodborne illness law firm Marler Clark in the Federal Court, Eastern District of Wisconsin. This is the third lawsuit filed by Marler Clark in the aftermath of the JBS Swift outbreak, which sickened at least 23 people in nine states, 12 of whom had to be hospitalized.

“This has been a very difficult summer for contaminated meat,” said the family’s attorney, Drew Falkenstein. “Not only have there been several E. coli recalls, but now there is also a large recall of beef contaminated with Salmonella by Beef Packers Inc. With the huge uptick of tainted meat in the last several years, it’s vital that we dedicate resources on every level to prevent more families from going through what the Rosplochs had to endure.”

Nicole and Gerard Rosploch purchased ground beef from a Pick N Save near their home in Brookfield; the meat was later determined to be part of the recall of 420,000 pounds of beef by the JBS Swift Company of Greeley, Colorado. The family (except for Nicole, a vegetarian) made and consumed hamburgers on Sunday, July 19. By Thursday, Gerard and their two sons began to have abdominal cramps and nausea. On Friday, the 7-year-old began to experience frequent episodes of vomiting and frequent diarrhea, some of it bloody. His parents took him to the ER, where he was checked and released, having submitted a stool sample. Meanwhile his older brother, 11, began to show increased signs of illness including vomiting and diarrhea. Gerard’s illness also continued, although not as severe as his sons’.

When the youngest child continued to worsen, he was returned to the ER, where it was learned that the stool sample he previously submitted was positive for E. coli O157:H7. He was admitted to the hospital, where he continued to be very ill. By July 28, tests revealed that he had developed hemolytic uremic syndrome, or HUS—a complication of E. coli infection. The child had to have dialysis for the next 10 days, as well as blood transfusions.

Meanwhile, Gerard began to improve, but his 11-year-old son was still sick at home. For several weeks, the parents split hospital and home care responsibilities.

Their younger son is now also at home, and continues to recover from his illness. He is still on medication to regulate his blood pressure. The genetic fingerprint of the E. coli in his stool sample was a match to that of the JBS Swift outbreak.

Milan McDonald's Inspection Reports from 2008 - 2009 Paint an Ugly Picture - Hepatitis A Outbreak was Bound to Happen

I must admit having the video of a former employee saying that she worked at McDonald's while infectious with Hepatitis A, and that she told her manager that she had Hepatitis A after the employee was released from the hospital, is priceless.  However, having the inspection reports from the Rock Island County Health Department for 2008-2009 is even better.  Click on the below to download and read the reports.  Most interesting is the store manager's March 14, 2009 letter outlining what the restaurant would and would not do:

Why the CDC has it right - It was Nestle Toll House Cookie Dough that Sickened 80 with E. coli O157:H7

In early June 2009, public health investigators noticed an increase in isolates submitted by multiple state public health laboratories to PulseNet with a two-enzyme pattern combination of EXHX01.0224 and EXHA26.0536. This is a relatively common pattern combination, appearing at least 364 times in the PulseNet database since 2005. Newly submitted isolates were tested by MLVA to further characterize genetic differences among isolates with PFGE pattern EXHX01.0224 and EXHA26.0536. MLVA pattern “A” was common to most of the newly submitted isolates.

Once investigators recognized the cluster, they administered a hypothesis-generating questionnaire to case patients to identify common exposures to the bacteria. Twenty-seven of 30 case-patients reported eating raw cookie dough before symptom onset.

The CDC developed protocol for a case-control study. Cases were defined as patients with E. coli O157:H7 with symptom onset on or after March 1, 2009, sharing an indistinguishable PFGE pattern combination of EXHX01.0224 /EXHA26.0536 and having an indistinguishable MLVA pattern A (or having a MLVA pattern differing at a single locus by one repeat).

One control (not ill) per case-patient was selected. Cases and controls were matched by sex, age group, and state of residence. Study participants were asked about a variety of foods consumed in the week before onset of illness of the matched case patients. As shown in the table below, a variety of food items were considered as the possible vehicle of E. coli O157:H7.

 

(Note: these data are preliminary and may change slightly)

The only food item statistically associated with illness was raw cookie dough (Odds Ratio 55.6, 95% confidence limits 14.14-282.07). The association was highly significant (p = <0.0001), implying that there is a less than a 1 in 10,000 chance that the finding of an association between eating raw cookie and becoming ill with E. coli O157:H7 occurred by chance.

Strong epidemiologic data showing an association between consuming raw cookie dough and illness and molecular microbiologic data showing a 2-enzyme PFGE match and MLVA match, prompted Nestle USA to issue a recall on June 19, 2009 of Nestle Toll House refrigerated cookie dough products.

Nestle Toll House Cookie Dough E. coli Outbreak, PFGE, MLVA = CSI

There are a lot of things I love about my job, but one is the science behind linking people in dozens of states to food that they consumed that poisoned them. Once that link is scientifically determined, and the outbreak stopped, then the time comes to learn from the mistakes so the next outbreak can be avoided. Frankly, we all need to appreciate (can you say increase funding) those public servants who toil in local, state and federal health agencies tracking food borne diseases. Without the work of dedicated people interviewing victims, testing stool and analyzing data, most outbreaks would never be determined, most victims would never be fairly treated, and most outbreaks would repeated without learning from past manufacturing mistakes. The science behind all the hard work is fascinating - especially, the "CSI" part.

The process of obtaining the DNA fingerprint is called PFGE (Pulse Field Gel Electrophoresis). This technique is used to separate the DNA of the bacterial isolate into its component parts. It operates by causing alternating electric fields to run the DNA through a flat gel matrix of agarose, a polysaccharide obtained from agar. The pattern of bands of the DNA fragments — or “fingerprints” — in the gel after exposure to the electrical current is unique for each strain and sub-type of bacteria. By performing this procedure, scientists can identify hundreds of strains of E. coli O157:H7 as well as strains of Listeria and campylobacter, and other pathogenic bacteria. The PFGE pattern of the bacteria can then be compared and matched up to the PFGE pattern of the strain of infected persons who consumed the contaminated product.

MLVA (Multiple Loci VNTR Analysis) is a method employed for the genetic analysis of particular microorganisms, such as pathogenic bacteria, that takes advantage of the polymorphism of tandemly repeated DNA sequences. "VNTR" means "Variable Number of Tandem Repeats". This method is well known in forensic science since it is the basis of DNA fingerprinting in humans. When applied to bacteria, it contributes to forensic microbiology through which the source of a particular strain might eventually be traced back. In a typical MLVA assay, a number of well-selected and characterized (in terms of mutation rate and diversity) loci are amplified by polymerase chain reaction (PCR) so that the size of each locus can be measured. From this size, the number of repeat units at each locus can be deduced. The resulting information is a code that can be easily compared to reference databases.

When PFGE and MLVA patterns match, they, along with solid epidemiological work (e.g., was the person exposed to the suspect food item), are proof that the contaminated product was the source of a person's illness.

In the Nestle Toll House Cookie Dough E. coli O157:H7 outbreak the science and epidemiological work produces the below partial “line list.” This list (as of June 25, 2009) lists 76 persons (that number is now 80) who are linked together by a common PFGE of E. coli O157:H7. Most have MLVA patterns reported - some were still pending. The bottom line is that this list, along with solid epidemiological work, show the “CSI” link between these 76 people and the Cookie Dough they consumed.

JBS Swift E. coli Beef Banned from Mexico - What Would Lou Dobbs Say?

OK, I admit, Lou Dobbs (and all the cable yammering heads) drive me nuts.  Mainly because they prey on peoples' fears (left and right) and they are smart and sane enough (O.K., exclude Beck and Hannity) to know better.  Lou is particularly bothersome with his constant complaints of illegal immigrants and the plagues (he yells loudly about) they allegedly bring across our borders.

So, today when Mexico's Sanitary Risk Agency banned the importation of JBS Swift ground beef (made in Colorado) out of concerns of E. coli O157:H7 contamination, I wondered what Lou had to say?  Surprisingly, I have not found a word on his website.  Perhaps, if I can stand it, I will watch his show tonight with a beer (preferably Mexican) in my hand.

As you might recall, the Centers for Disease Control and Prevention reported at least 23 people in nine states have been sickened by E. coli associated with contaminated meat produced by JBS Swift.  Mexico has now recalled JBS Swift ground beef from stores.  In June, JBS Swift recalled 380,000 pounds of beef due to connections with outbreaks of E. coli O157:H7.  We have sued JBS in Colorado and Washington and will sue them again in Wisconsin next week.

So Lou, what say you?  I wonder if he will notice that JBS is a Brazilian company?

Number rises to 30 of those infected with Hepatitis A at Milan McDonald's - Third lawsuit filed

Another lawsuit on behalf of a customer sickened in the Milan McDonald’s outbreak was filed today in the Circuit Court of the Fourteenth Judicial Circuit of Rock Island County. The lawsuit was filed against McDonald’s Inc., and Kevin Murphy, the owner of the McDonald’s restaurant at 400 West First Street in Milan, IL, by Marler Clark, the Seattle-based foodborne illness law firm, and Craig Mielke of the Illinois firm of Foote, Meyers, Mielke & Flowers LLC. This is the second illness lawsuit; a class action lawsuit was also filed on behalf of restaurant patrons who had to get a shot to avoid illness.

The lawsuit is being brought by Karie Fiegel and her 14-year-old daughter, both of whom ate at the Milan McDonald’s in early June, 2009. Hepatitis A Virus (HAV) has an incubation period of 15-50 days, and it was not until early July that Ms. Fiegel fell ill with nausea, vomiting, fever, and jaundice. She sought medical care, but her symptoms only intensified, and she was admitted to the hospital where she remained for three days. In the hospital, tests revealed that she had been infected with HAV. Hepatitis infects the liver, and Ms. Fiegel’s liver enzymes were found to be elevated during her hospitalization. Although she has been released, her liver enzymes remain elevated.

Meanwhile, her daughter also began experiencing symptoms of HAV infection. The teenager was tested and also diagnosed with Hepatitis A.

“There are 30 confirmed cases of HAV,” said William Marler, the family’s attorney. “Given the incubation period of hepatitis A, it’s possible that the outbreak is not over, and we may see additional illnesses. It is very important for anyone who ate at the Milan McDonalds in June to monitor their health—and their family’s heath—very carefully.”

A food worker at the Milan McDonald’s had Hepatitis A, and a series of mistakes exposed as many as 10,000 restaurant patrons to the virus before the restaurant was closed and cleaned (it has since re-opened). A separate class action lawsuit was filed July 21 on behalf of those who had to get Immune Globulin (IG) shots after exposure to HAV at the Milan McDonald’s restaurant. Almost five thousand people have already received shots in mass clinics coordinated by the Rock Island County Health Department. Eligible individuals are still joining the class action suit.

CDC Links 80 E. coli O157:H7 to Nestle Toll House Cookie Dough - 35 Hospitalized - 10 with Hemolytic Uremic Syndrome

CDC Published this Morning:

CDC is collaborating with public health officials in many states, the United States Food and Drug Administration (FDA), and the United States Department of Agriculture Food Safety and Inspection Service (FSIS) to investigate an outbreak of E. coli O157:H7 infections.

As of Friday, July 31, 2009, 80 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 31 states. Of these, 70 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (5), Colorado (6), Connecticut (1), Delaware (1), Georgia (2), Iowa (2), Idaho (1), Illinois (7), Kentucky (2), Massachusetts (4), Maryland (2), Maine (3), Minnesota (8), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).

Most persons became ill during May and June. Ill persons range in age from 2 to 65 years; however, 66% are less than 19 years old; 69% are female. Thirty-five persons have been hospitalized, 10 developed hemolytic uremic syndrome (HUS).  We represent 24 people sickened - most of them were hospitalized (one still is) - 6 developed HUS.  Three lawsuits have been filed - Colorado, California and Washington.

So, what's up with Wisconsin Pic n' Saves and E. coli O157:H7

As of July 1, 2009, the CDC reported twenty-three persons infected with a strain of E. coli O157:H7 with a particular "DNA fingerprint" have been reported from 9 states – Wisconsin included. Of these, 17 (likely more now) have been confirmed by an advanced DNA test (MLVA) as having the outbreak strain. All have been linked to JBS Swift Meat Recall.

The number of ill persons identified in each state is as follows: California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6). The first reported illness began on April 2, 2009, and the last began on June 13, 2009. This number is growing. Among 17 ill persons for whom hospitalization status is known, 12 (70%) were hospitalized. Two patients developed a type of kidney failure called hemolytic uremic syndrome (HUS).

Interestingly, last evening I got a call from a concerned father. Both son’s have been hit by E. coli O157:H7 – one still hospitalized with HUS. Both children, as of last night, have been linked to JBS Swift meat purchased at a Brookfield Wisconsin Pic n’ Save. I assume that FSIS and CDC will update their numbers.

What is also interesting is that during the 2006 Dole Spinach E. coli O157:H7 outbreak, 49 E. coli O157:H7 cases where confirmed in Wisconsin out of 205 nationally. Dozens of those Wisconsin cases purchased their spinach at Pic n’ Save and several specifically in Brookfield. Go figure

2008 E. coli O157:H7 Raw Goat Milk Outbreak Sickened Four - Two with Hemolytic Uremic Syndrome

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. LCHD began an investigation of the illness. 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, LCHD 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, LCHD 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 (not stool culture positive but Epidemiologically linked to the outbreak). Each of these individuals resided in different counties in Southwest Missouri, and did not 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. LCHD reported, “no other plausible sources of exposure common to all four cases were identified [other than the milk.]” LCHD 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 Children

We represent two of the HUS cases. Nicole Riggs is 9 years old. She lives in Willard, Missouri with her mother, Julie; father, Dustin; and her younger sister, Christina. Larry Pedersen is a 2-year-old toddler. He lives in Monett, Missouri with his parents, Brian and Angela, and his two older sisters, Hailey and Kelsey.

Their Acute Illness

Both had a severe episode of HUS as demonstrated by over a week of anuria [no urine output], oliguria [low urine output] for an additional week. Both needed dialysis to survive. Both were hospitalized for over a month. Medical bills were over $100,000 for each.

Their Future

It is likely that both children will develop renal complications in the future, including hypertension and renal insufficiency. Hypertension and renal insufficiency eventually lead to end stage renal disease (ESRD). The development of ESRD means they will require dialysis or transplantation for survival. Most Americans who suffer ESRD opt for a kidney transplant, but the wait for a donor kidney is often a year or more. The preferable course in a transplant situation is for a deceased or living relative (e.g. a parent or sibling over age 18 and compatible) to donate a kidney. While awaiting a donor, an ESRD patient must undergo dialysis treatment while on the waiting list for a deceased donor transplant. Children have the shortest waiting time on the deceased donor transplant list. The average waiting time for children age 0-17 years is approximately 275-300 days; the average waiting time for a transplant candidate who is 18-44 years old is approximately 700 days.

The Effects

Following transplantation the children will require immunosuppressive medications for the remainder of their lives to prevent rejection of the transplanted kidney. Medications used to prevent rejection have considerable side effects. Corticosteroids are commonly used following transplantation. The side effects of corticosteroids are Cushingnoid features (fat deposition around the cheeks and abdomen and back), weight gain, emotional instability, cataracts, decreased growth, osteomalacia and osteonecrosis (softening of the bones and bone pain), hypertension, acne, and difficulty in controlling glucose levels. The steroid side effects, particularly the effects on appearance, are difficult for children, particularly teenagers, and non-compliance with the treatment regimen is a problem with teenagers due to unsightly side effects. Cyclosporine and tacrolimus are also commonly used immunosuppressants. Side effects of these drugs include hirsutism (increased hair growth), gum hypertrophy, interstitial fibrosis in the kidney (damage to the kidney), as well as other complications. Meclophenalate and imuran are also commonly used, each of which can cause a low white blood cell count and increased susceptibility to infection. Many other immunosuppressive medications and other medications (anti-hypertensive agents, anti-acids, etc) are prescribed in the post-operative period. Immunosuppressants like those described above function to reduce the body’s immune response, thereby preserving the transplanted kidney, which the body would otherwise recognize as foreign and dangerous, thereby setting off a chain of events that would culminate in kidney rejection. But because a healthy and timely immune response is a critical host defense against illness, life-long immunosuppression necessarily dictates a life-long, heightened susceptibility to infection, accelerated atherosclerosis (hardening of the arteries), cancer, and chronic kidney rejection.

Bone disease is nearly universal in patients with chronic renal failure. As a result, the children will be prone to develop bone pain, skeletal deformities and slipped epiphyses (abnormal shaped bones and abnormal hip bones) and have a propensity for fractures with minor trauma. Treatment of the bone disease associated with chronic renal failure includes control of serum phosphorous and calcium levels with restriction of phosphorus in the diet, supplementation of calcium, the need to take phosphorus binders and the need to take medications for bone disease.

Another common complication of chronic renal failure is anemia. Patients with chronic renal failure gradually become anemic. The anemia can be treated with human recombinant erythropoietin (a shot given under the skin one to three times a week or once every few weeks with a longer acting human recombinant erythropoietin).

Another complication of ESRD is growth failure. Growth failure ultimately leading to short height as an adult is a very common complication of chronic renal failure in children. Growth hormone therapy with human recombinant growth hormone has been approved for use in children with chronic renal failure and such therapy has been shown to accelerate growth, induce persistent catch up growth and lead to normal adult height in children with chronic renal failure. Growth hormone therapy requires giving a shot under the skin once a day.

As the children develop ESRD, they will not immediately receive a kidney transplant. Instead they will require dialysis. There are two modes of dialysis he might undergo. They can be on peritoneal dialysis or on hemodialysis. Peritoneal dialysis has been a major modality of therapy for chronic renal failure for several years. Continuous Ambulatory Peritoneal Dialysis (CAPD) and automated peritoneal dialysis also called Continuous Cycling Peritoneal Dialysis (CCPD) are the most common form of dialysis therapy used in children with chronic renal failure. CAPD/CCPC. In this form of dialysis, a catheter is placed in the peritoneal cavity (area around the stomach); dialysate (fluid to clean the blood) is placed into the abdomen and changed 4 to 6 times a day. Parents and adolescents are able to perform CAPD/CCPD at home. Peritonitis (infection of the fluid) is a major complication of peritoneal dialysis. Hemodialysis has also been used for several years for the treatment of chronic renal failure during childhood. During hemodialysis, blood in taken out of the body by a catheter or fistula and circulated in an artificial kidney to clean the blood. Hemodialysis is usually performed three times a week for 3-4 hours each time in a dialysis unit.

Finally, no kidney transplant lasts forever. United States Renal Data Systems states that the half-life—i.e. the time at which 50% of transplanted kidneys are still functional and 50% have stopped functioning—is 10.5 years for children 0-17 whose transplanted kidney came from a deceased, unrelated donor, and 15.5 years where the kidney comes from a living, related donor. Similar data for a transplant at age 18 to 44 years is 10.1 years and 16.0 years for a deceased donor and a living related donor, respectively. Each transplant will be preceded by ESRD, dialysis, an increase in kidney-related medical problems and then the recovery from transplantation.

The Lesson?

Was and is the consumption of raw goats milk worth the risk?

The Quad-Cities - Hepatitis A Ground Zero - McDonalds Linked to 26 Illnesses and 5,366 Injections

According to the Quad-City Times, the total of hepatitis A cases in the Quad-City region has grown by one, and the latest patient lives in Henry County. The Rock Island County Health Department has finished a series of free inoculation clinics to provide protection against the illness.

A total of 5,366 doses of either hepatitis A vaccine, or a product called immune globulin, were given out in public clinics run by Rock Island County. All of those receiving free inoculations had visited a McDonald's restaurant at 400 W. 1st St., in Milan during July 13-14.

Henry County reported an additional documented case of hepatitis A, raising that county's total to two. There are now at least 26 actual cases in the region, with 15 in Rock Island County, five in Mercer County, one each in Warren and Woodford counties, all in Illinois, as well as two cases in Scott County, Iowa. County officials have said the reported cases are part of the same outbreak and are connected to the Milan McDonald's.

The incubation period for Hepatitis A can be greater than one month, so the number of ill may well rise over the coming weeks.

Tennessee Salmonella Lawsuit Filed in Memphis against A & R Bar-B-QUE

Salmonella is a bacterium that causes one of the most common enteric (intestinal) infections in the United States – Salmonellosis. In some states (e.g. Georgia, Maryland), salmonellosis is the most commonly reported cause of enteric disease, and overall it is the second most common bacterial foodborne illness reported (usually slightly less frequent than Campylobacter infection).

The reported incidence of Salmonella illnesses is about 14 cases per each 100,000 persons (MMWR Weekly, 2006), amounting to approximately 30,000 confirmed cases of salmonellosis yearly in the U.S. (CDC, 2005, October 13). In 2005, just over 36,000 cases were reported from public health laboratories across the nation, representing a 12 percent decrease compared with the previous decade, but a 1.5 percent increase over 2004 (CDC, 2007).  Click below to download complaint:

E. coli O157:H7 Settlement reached in Hemolytic Uremic Syndrome Case Linked to Hamburger

A confidential settlement was reached this morning on behalf of twelve-year-old Rebecca Gosla, who was sickened in a 2007 E. coli O157:H7 outbreak linked to contaminated ground beef that were manufactured by United Foods. Rebecca’s illness stands apart from most E. coli O157:H7 infections, even for children who develop hemolytic uremic syndrome (HUS).  She was hospitalized for over a month, suffered weeks of dialysis, and her medical bills were nearly $200,000.

The severity and duration of her HUS-related complications, including the complete failure of kidney function as indicated by the lack of urine-production, makes Rebecca’s prognosis concerning. It is possible that her kidney-function will decline over time to a point that kidney transplantation or maintenance-dialysis will be necessary for her survival.

Rebecca’s Illness was a result of E. coli O157:H7-tainted hamburger that was part of a recall announced on June 3, 2007 by United Food Group, LLC (“United Foods”). 75,000 pounds of ground beef products was recalled after testing conducted by health departments in California and Colorado revealed contamination with E. coli O157:H7. The company reported that the ground beef had been produced on April 20, 2007 and shipped to retail distribution centers in Arizona, California, Colorado, Oregon, and Utah. Three days later, on June 6, 2007, United Foods expanded its recall to 370,000 pounds of ground beef. Investigation by the CDC and state health department had uncovered a link between United Foods’ ground beef and illnesses “in several states.” The expanded recall included products produced on April 13, in addition to April 20, 2007. Additional states were now also involved, including Idaho, Montana, Nevada, Washington, and Wyoming.

Three days later, on June 9, 2007, United Foods was again forced to expand its recall, this time dramatically enlarging its scope. More United foods fresh ground beef, not originally included in the recall, had tested positive for E. coli O157:H7 in Arizona. The strain of E. coli O157:H7 isolated was genetically indistinguishable from the strain that had led to the original recall. The newly recalled ground beef tested in the Arizona had been sold under a major grocery store label as opposed to a pre-packaged chub shipped from United Foods. At this time, United expanded its recall to include 5.7 million pounds of its ground beef. The recall now extended to both fresh and frozen ground beef. By this time, United Foods ground beef had been linked to fourteen culture-confirmed E. coli O157:H7 infections in the following states: Arizona (6); California, (3); Colorado (2); Idaho (1); Utah (1); and Wyoming (1).

It is time to prevent the next Rebecca.

Salmonella Lawsuit Filed On Behalf of Memphis Father and Son Hospitalized by Tainted Barbeque

A lawsuit stemming from the recent outbreak of Salmonella illnesses was filed today in the Circuit Court for Shelby County, Tennessee against A&R Bar-be-que, LLC. The lawsuit was filed on behalf of a Memphis father and son by Seattle foodborne illness law firm Marler Clark and by John Day of the Tennessee firm Day & Blair.

Foodborne illnesses reported to the Shelby County Health Department by patrons of the A&R Bar-be-que restaurant at 3701 Hickory Hill Road prompted the Health Department to launch an investigation on July 14. The restaurant closed voluntarily on July 25 and remains closed at this time.

Eric Phillips Sr. bought food at the Hickory Hill A&R Bar-be-que on July 9, 2009. He and his son ate food from the restaurant on July 9 and 10. On Friday, July 10, the 15-year-old began to feel nauseous and ill. His condition worsened over the weekend, and he was taken to the doctor on Tuesday. The doctor instructed the family to keep the boy hydrated, and he was sent home. However, his symptoms increased in severity and he experienced vomiting, nausea, and diarrhea over the next few days. On the following Monday, July 20, his mother took him to Le Bonheur Children’s Hospital, where he was admitted and diagnosed with Salmonella.

Meanwhile, Eric Phillips Sr. was experiencing similar symptoms over the same period of time. He was eventually admitted to Methodist Germantown Hospital in Memphis.

Both father and son suffered acute kidney failure as a result of their Salmonella infections, requiring extensive medical treatment, including dialysis. They both remain in the hospital.

“The impact on this father and son—and family—will be life-long,” said the family’s attorney, Andy Weisbecker. “No one can change that, but what we can do is to make sure that they have a way to pay for the care they will need.”

Salmonella is a bacterium that causes one of the most common intestinal illnesses in the US: Salmonellosis. It can be present in uncooked or undercooked meat, poultry, eggs, or unpasteurized dairy products, as well as other foods contaminated during harvest, production, or packaging. Symptoms can begin 6 to 72 hours from consumption, and include diarrhea, abdominal cramps, fever, nausea, and/or vomiting. Dehydration is a concern, especially with the elderly, very young, or immune compromised.

“Anyone experiencing these symptoms should ask their healthcare providers to culture a stool sample,” continued Weisbecker. “The culture will indicate if Salmonella is present and can assist in determining if the illness is part of a larger outbreak.”

The Cost of Foodborne Illness

The Food Safety Bill is being debated on Capitol Hill as I write this post.  Hopefully the human cost of foodborne illness will weigh on our Representatives' minds as they vote.  The folks below have been involved.  They have visited Washington DC, met with members and have testified.

Lindsey Jennings (below, center) was a healthy 21-year-old starting medical school in the fall of 2008. After eating lettuce contaminated with E. coli O157:H7, she was hospitalized for 11 days. Her medical bills to date total $55,444.49.



In 2006, Ashley Armstrong (below), age 2, became infected with E. coli O157:H7 after eating Dole brand baby spinach. She was hospitalized for 43 days with hemolytic uremic syndrome (HUS). She suffered acute renal failure and pancreatitis and was on dialysis for nearly 4 months. She has a 95 to 100 percent chance of end stage renal disease, and is expected to require a kidney transplant within three to ten years. Ashley will require a combination of kidney dialysis and transplants throughout the rest of her life. Ashley’s medical bills during her acute illness exceeded $200,000, and the value of her projected future medical expenses and future economic losses total between $6 and $7.5 million.

Heather Whybrew (below, in cap and gown) is a 20-year-old college student pursuing a double major in biology and psychology. In 2008, she was hospitalized for 18 days after consuming romaine lettuce contaminated with E. coli O157:H7. Her medical bills to date are $113.959.04.

Mora Lou Marshall (below) was functionally independent before her Salmonella Tennessee illness, which she contracted as a result of eating Con Agra’s Peter Pan Peanut Butter. As a result of her illness, Mora was hospitalized for more than 30 days at Willis-Knighton Medical Center and Life-Care Hospital. Furthermore, to date, Mora has never able to return home to her family. Since her multiple hospitalizations and illness, Mora Lou Marshall has lived at the Garden Park Nursing Home in Shreveport, Louisiana. Her medical expenses currently total $352,960.

Clifford Tousignant (below, with granddaughter) was a highly decorated Korean War veteran. He received 3 purple hearts and faithfully served his country for over 22 years. Mr. Tousignant became sick with Salmonella Typhimurium in December of 2008, as a result of eating peanut butter products manufactured by King Nut and the Peanut Corporation of America. Mr. Tousignant was hospitalized because of his infection and illness for 6 days at St. Joseph’s Hospital in Brainerd, Minnesota. As a result of his illness, Mr. Tousignant died on January 12, 2009. His medical expenses totaled $42,853.

With 25 Ill and over 10,000 exposed of Hepatitis A Milan McDonalds, Rock Island Health Department extends clinic dates

The incubation period (time from exposure to onset of symptoms) is 15-50 days, with an average of 30 days. Thus far at least 25 people have contracted Hepatitis A and over 10,000 or more were exposed. 5,000 have received IG or Hepatitis A vaccines to hopefully prevent illness onset.  It appears the second Ill McDonald’s employee last worked on July 13 or 14. That means that the number of ill may well rise over the next month during the height of the incubation period.

The Rock Island County Health Department will conduct walk-in clinics at its office at 2112 25th Ave., Rock Island, from 8 a.m. to 4:30 p.m. Monday and Tuesday. These additional dates are being made available for those who went to the Milan, Ill., McDonald's on July 13 or 14. If they went there previous to these dates, receiving either of these shots may be beyond the time period to provide protection from potential exposure.

A second dose of hepatitis A vaccine, administered six months after the first one, will provide additional effectiveness against the disease. Second doses will be available at the health department, but they will not be free as the first-dose clinics have been. The cost of the second dose will be $45 for adults and $15-$25 for pediatric patients, depending upon income guidelines.

McDonald's Patron Infected with Hepatitis A Files Lawsuit - Teen Sickened after Eating at Milan, Illinois McDonald's

The first lawsuit on behalf of a customer sickened in the Milan McDonald’s outbreak was filed today in the Circuit Court of the Fourteenth Judicial Circuit of Rock Island County. The lawsuit was filed against McDonald’s Inc., and Kevin Murphy, the owner of the McDonald’s restaurant at 400 West First Street in Milan, IL, by Marler Clark, the Seattle-based foodborne illness law firm, and the Illinois firm of Foote, Meyers, Mielke & Flowers LLC.

The lawsuit is being brought by the family of a Rock Island County teenager who fell ill after eating at the Milan McDonald’s and was diagnosed with hepatitis A virus (HAV). On July 12 the 16-year-old came down with a very high fever, aches, and fatigue. His fever continued for several days, and he became visibly jaundiced. When his symptoms continued to worsen, he was hospitalized for four days. He has returned home, but continues to recover from his illness.

“I’ve been concerned by some information surrounding this outbreak indicating that Hepatitis A is not a serious illness,” said William Marler, the family’s attorney. “Hepatitis A can make you very sick, and in rare cases, endanger the liver. This is not a disease to be taken lightly, and the medical costs associated with cannot be taken lightly either. These families need help, and our job is to get it for them.”

A food worker at the Milan McDonald’s had Hepatitis A, and in a cascade of mistakes and miscommunications, as many as 10,000 were exposed to the virus before the restaurant was closed and cleaned (it has since re-opened). At least 23 people in four counties are confirmed ill with Hepatitis A; eleven required hospitalization due to the severity of their illnesses.

23 Hepatitis A Victims Linked to Milan McDonalds - 21 in Illinois and 2 in Iowa - 4,000 Given IG Shots

According to the Quad-City Times, the number of people who have contracted Hepatitis A in the Quad-City region has grown to 23 confirmed cases – 2 of who are in Iowa. The 21Illinois Hepatitis A cases are in Rock Island, Henry, Mercer and Warren counties, as well as one in Woodford County

The cases are connected with Rock Island County businesses, including a McDonald's restaurant, 400 W. 1st St., Milan. Earlier this month, two food handlers at McDonald's were found to have hepatitis A, and the restaurant was closed for three days for a deep cleaning. Employees also received instructions on how to properly wash their hands, especially after using the restroom.

The Rock Island County Health Department finished on Tuesday a two-day clinic to vaccinate more than 4,000 individuals who ate at the McDonald's during the periods of July 6-10 and 13-14.

McDonalds Hepatitis A Lawsuit

Marler Clark is assisting people who were exposed to the Hepatitis A Virus at the Milan, Illinois McDonald's Restaurant. A class action lawsuit has been filed on behalf of those who had to get shots. Marler Clark is also preparing additional hepatitis lawsuits on behalf of those who have been infected with Hepatitis A.

McDonald's Job Applicant Poisoned with Hepatitis A

My daughter is 17 and took a partime job busing tables as a local restaurant.  Can you imagine being a parent and urging your kid to get a Summer job at McDonald's?  Here is an email I received tonight:

My son Dillon is 16 and had to be hospitalized because he caught Hepatitis A after he took back an application for a job and ate at McDonald's in Illinois.  He was admitted on a Thursday and hasn't eaten since Sunday while running a fever.  He became very jaundice and wasn't released from the hospital till Sunday evening. Thank you for your time.

Goodness!

Cheryl Schram, Milan McDonald's Hepatitis A Employee, Speaks Out and Names Names

A fast food worker at the Milan Illinois McDonald's tested positive for Hepatitis A back in mid-June, more than three weeks before the case was reported to county and state health officials. Cheryl Schram is going public tonight about who she says she told and when.

It is going to be interesting to see what McDonald's, the Health Department and the medical providers say about who knew what and when.

Hepatitis A Class Action Lawsuit Filed Against McDonald's

Case No. 09 L 0089 – Judge Vandewiele

 

Marler Clark Files Class Action Hepatitis Lawsuit Against McDonald's

Ten Thousand People May Have Been Exposed to Hepatitis A at Milan Restaurant

A class action lawsuit was filed today in the Circuit Court of the Fourteenth Judicial Circuit of Rock Island County against McDonald’s Inc., and Kevin Murphy, the owner of the McDonald’s restaurant at 400 West First Street in Milan, Illinois. Marler Clark, the Seattle-based foodborne illness law firm, and the Illinois firm of Foote, Meyers, Mielke & Flowers LLC, filed the lawsuit on behalf of the named plaintiff, Cody Patterson, and all others who were forced to receive Immune globulin (IG) shots after being exposed to the hepatitis A virus (HAV) at the Milan McDonald’s.

An estimated 10,000 people were exposed to Hepatitis A at the Milan McDonald’s. If a person exposed to HAV can get a shot of IG within 14 days of exposure, they can avoid getting sick.

“This lawsuit is on behalf of the thousands of people who have to get IG shots because of exposure to Hepatitis A at McDonald's,” said William Marler, attorney on behalf of the plaintiffs. “These consumers chose McDonald’s in part because of the convenience, and now they have to wait hours in line or pay for a shot, and very likely miss work in order to do either one. Filing a class action suit on their behalf is a way to compensate them for the time, wage loss, and expense.”

“Our experience in handling large Hepatitis A exposures has allowed us to develop a system for helping as many people as possible recover for injuries sustained without the process being too taxing on individuals or the legal system,” continued Marler. “We filed a class action on behalf of the exposed who are able to avoid infection, and then help individuals who fall ill on a case by case basis.”

In 2007, Marler Clark represented members of a class action arising out of a hepatitis A outbreak at a Houlihan’s in Southern Illinois, where 3000 people received IG shots. Marler Clark represented 9000 people who received shots after a 2003 outbreak at a Pennsylvania Chi-Chi’s along with nearly 100 who became ill with HAV. The case of one individual resolved for $6,250,000. The firm also represented the state of Pennsylvania in recovering the cost of the investigation of the outbreak.

Marler Clark represented customers of Boston-area Quizno’s and Friendly’s Restaurant, both of which had HAV outbreaks in 2004. Additional HAV class action suits handled by Marler Clark include over 1,500 people who received shots after an HAV outbreak at D’Angeleo’s Deli in Massachusetts (2001) and 1,400 people after exposure at a Carl’s Jr. in Spokane, Washington (2000). Marler Clark has represented many victims who were unable to avoid infection and fell ill with HAV including suits against McDonald's, Subway and Taco Bell. The most recent group of cases involved those sickened at a San Diego-area Chipotle Grill in 2008.

Hepatitis A is a viral infection of the liver. The hepatitis A virus is commonly spread through the fecal-oral route, and symptoms include nausea, abdominal cramping, fatigue, and fever. In young children these symptoms can appear flu-like, but in some cases do not appear at all. Symptoms most often begin two to six weeks after exposure and can last several weeks. Preventative treatment (the IG shot) is only effective when administered within 14 days of exposure to the virus, after 14 days there is no treatment.

ABOUT MARLER CLARK: William Marler has been a major force in food safety policy in the United States and abroad. His food safety blog, Marler Blog, is read by over 1,000,000 people around the world every year. He and his partners at Marler Clark have represented thousands of individuals in claims against food companies whose contaminated products have caused serious injury and death. His advocacy for better food regulation has led to invitations to address local, national, and international gatherings on food safety, including recent testimony to US Congress Committee on Energy and Commerce. In 1998, Mr. Marler formed the not for profit, Outbreak Inc. He spends much of the year speaking on how to prevent foodborne illnesses.

Second E. coli O157:H7 Hemolytic Uremic Syndrome Lawsuit Filed Against JBS Swift

JBS Swift E. coli Meat Sickens at least 23 in California, Maine, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York and Wisconsin - When will other states be reporting - like Washington?

Nearly two weeks ago, the CDC and FSIS reported that 23 persons infected with a strain of E. coli O157:H7 with a particular "DNA fingerprint" have been reported from 9 states. Of these, 17 have been confirmed by an advanced DNA test as having the outbreak strain; confirmatory tests are pending on others. The number of ill persons identified in each state is as follows: California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6).

In light of the illnesses, FSIS issued a notice about a recall of 41,280 pounds of beef products from JBS Swift Beef Company that may be contaminated with E. coli O157:H7. On June 28, the recall was expanded to include 380,000 pounds of assorted pieces of beef (beef primal products) from the same company.

Samples from unopened packages of ground beef recovered from a patient's home were tested by the Michigan Public Health Laboratory yielded an E. coli O157:H7 isolate that matched the "DNA fingerprint" of the outbreak strain.

It appears, however, that the outbreak may well be larger – more ill people - perhaps an expanded recall? 

We have been retained by several families in this outbreak and have already filed suit on behalf of a New Mexico boy who suffered HUS.  Yesterday we were contacted by a Washington State family whose child suffered severe HUS (weeks hospitalized on dialysis) that may well be linked to this outbreak after the purchased JBS Swift meat at [an unnamed store]. What we know thus far is:

[The] PulseNet database team has checked the profile against our database and it does seem to be indistinguishable from EXHX01.0074/EXHA26.0569 which is the pattern combination associated with 0906WIEXH-1 and the JBS Swift Company recall. Since this pattern combination is common, all isolates with this pattern combination are subtyped by MLVA and only isolates indistinguishable by both PFGE and MLVA are considered as possibly being outbreak related.

More to come today I imagine.

Nestle Toll House Cookie Dough E. coli O157:H7 By the Numbers - 76 Sickened in 31 States, 11 with Hemolytic Uremic Syndrome

According to the FDA, as of July 10, the CDC reports that 76 persons from 31 states have been infected with the outbreak strain of E. coli 0157:H7. Thirty-five persons have been hospitalized, 11 with a severe complication called Hemolytic Uremic Syndrome.

Hemolytic Uremic Syndrome (HUS) is a severe, life-threatening complication that occurs in about 10% of those infected with E. coli O157:H7 or other Shiga toxin (Stx) producing E. coli (E. coli). HUS was first described in 1955, but was not known to be secondary to E. coli infections until 1982. It is now recognized as the most common cause of acute kidney failure in infants and young children. Adolescents and adults are also susceptible, as are the elderly who often succumb to the disease.
I spent the last 24 hours traveling from Seattle to Atlanta, Atlanta to Columbus, and Columbus to Charlotte - home Wednesday.

I spoke to one family whose 55-year-old mother, who will be released from the hospital later this week, after being confined since early May. She has had a portion of her large intestine removed and was only recently removed from dialysis. She now faces a lifetime of complications and the loss of health insurance if she is unable to return to work as a special education teacher by Labor Day.

I spent time today with a wonderful family whose 4-year-old suffered severe HUS – three weeks of dialysis, CNS involvement (seizures) and months of hospitalization and Rehab. For any parent, you can imagine the nightmare.

When you meet the people, the numbers have meaning. Perhaps, the heads of FSIS and FDA should travel with me?

Where is the balance between food safety, consumer convenience, industrialized agriculture and the environment?

I had a long talk with Carolyn Lochhead, San Francisco Chronicle Washington Bureau Reporter about her article, “Crops, ponds destroyed in quest for food safety” that appeared this morning. It is a good opening discussion of the balance that we somehow have to forge between food safety, consumer convenience, industrialized agriculture and the environment.  The discussion reminds me a bit of a post I did nearly four years ago - "Bagged "Pre-Washed" Lettuce: Is Convenience Worth the Risk?"  Much to discuss. Here is part of the article:

Seattle trial lawyer Bill Marler, who represented many of the plaintiffs in the 2006 E. coli outbreak in spinach, said, "If we want to have bagged spinach and lettuce available 24/7, 12 months of the year, it comes with costs."

Still, he said, the industry rules won't stop lawsuits or eliminate the risk of processed greens cut in fields, mingled in large baths, put in bags that must be chilled from packing plant to kitchen, and shipped thousands of miles away.

"In 16 years of handling nearly every major food-borne illness outbreak in America, I can tell you I've never had a case where it's been linked to a farmers' market," Marler said.

"Could it happen? Absolutely. But the big problem has been the mass-produced product. What you're seeing is this rub between trying to make it as clean as possible so they don't poison anybody, but still not wanting to come to the reality that it may be the industrialized process that's making it all so risky."

Ms. Lochhead added in a few of the major outbreaks (all of which I am squarely in the middle of). I added in one she missed, corrected a date and added a bit – all in bold.

June 2009: E. coli O157:H7 linked to JBS Swift meat sickening 23 in nine state, two with acute kidney failure. FISS instituted a recall of 420,000 pounds of meat.

June 2009: E. coli O157:H7 found in Nestle Toll House refrigerated cookie dough manufactured in Danville, Va., resulted in the recall of 3.6 million packages. Seventy-two people in 30 states (now seventy-four in 32 states) were sickened. No traces found on equipment or workers; investigators are looking at flour and other ingredients.

February 2009: Salmonella found in peanut butter from a Peanut Corp. of America plant in Georgia. Nine people died, and an estimated 22,500 were sickened. Criminal negligence was alleged after the product tested positive and was shipped.

June 2008: Salmonella Saint Paul traced to Serrano peppers grown in Mexico. More than 1,000 people were sickened in 41 states, with 203 reported hospitalizations and at least one death. Tomatoes were suspected, devastating growers.

April 2007: E. coli O157:H7 found in beef, sickening 14 people. United Food Group recalled 5.7 million pounds of meat (at least four suffered acute kidney failure).

December 2006: E. coli O157:H7 traced to Taco Bell restaurants in New Jersey and Long Island, N.Y. Green onions suspected, then lettuce. Thirty-nine people were sickened, some with acute kidney failure.

September 2006: E. coli O157:H7 found in Dole bagged spinach processed at Earthbound Farms in San Juan Bautista (San Benito County). The outbreak killed four people (actually five), sent 103 to hospitals, and devastated the spinach industry (devastated over 30 families with hemolytic uremic syndrome).

Nestle Toll House Cookie Dough Plant - 201 Airside Drive Danville Virginia

Nestle Danville Toll House Cookie Dough "483" Posted.

After inspecting the Danville Plant on 06/18/2009(Thu), 06/19/2009(Fri), 06/22/2009(Mon), 06/23/2009(Tue), 06/24/2009(Wed), 06/25/2009(Thu), 06/26/2009(Fri), 07/07/2009(Tue), 07/08/2009(Wed), and 07/09/2009(Thu), the FDA posts a 1, yes, 1 page "483" online last night, or early this morning - yes, even I sleep sometimes.  Here are the 2, yes, 2 Observations.  Looks like I am heading to Danville soon.

OBSERVATION 1

The workmanship of equipment does not allow proper cleaning.  Specifically, inside the "Toll House" brand cookie dough preparation room, dry ingredients are placed inside hoppers. The dry ingredients are gravity fed to blending mixers through gate valves that are installed on the hoppers. As a result of this investigation, the firm disassembled all gate valves from all hoppers on production lines 8, 10, 11, and 12. The gate valves appear to have food contact surfaces that are not easily cleanable as evidenced by rough, pitted and discolored cast metal alloy.

OBSERVATION 2

Lack of appropriate design to enable manufacturing systems to be maintained in an appropriate sanitary condition. Specifically, as "Toll House" brand cookie dough was mixed on 6-18-09, ice build-up surrounded pipes that transport a processing aid to mixers on production lines 8, 10, 11, and 12. On line 8, condensate from the ice dripped onto a metal rake that personnel then used to scrape cookie dough from the mixer into a dough trough for transport to the filling line.

Click on image to download:

FDA's Inspection Report For Nestle's Danville, Virginia Facility - FDA's 483 - Released to Nestle on Thursday - The Rest of Us, When?

From a Nestle’s Press Release:

On June 29, 2009, the FDA confirmed evidence of E. coli O157:H7 in a retained production sample of 16.5 oz. Nestle Toll House refrigerated chocolate chip cookie dough bar. The product has a day code of 9041 and a "Best before 10 JUN 2009" notation.

"We are very concerned about those who have become ill from E. coli O157:H7 and deeply regret that this has occurred," said Paul Bakus, General Manager of Nestle's Baking Division.

Today, the FDA provided its summary findings resulting from its recent inspection of the Nestle Danville facility. The report is called a "Form FDA 483". The 483 reflects the inspector's observations and is designed to ensure that the company's manufacturing operations are in compliance with current regulatory requirements.

Federal investigators, who spent more than a week at the Danville facility, did not detect E. coli O157:H7 inside the factory or on equipment. Nestle testing reflects the same results.

The 483 reported two observations. Neither of these observations is believed to have any relationship to the presence of E. coli O157:H7 found in the retained production sample. The first observation was related to the design of a gate valve used on a hopper for dry ingredients. The valve required a smoother and more polished surface to allow for easier cleaning. The second observation noted by the FDA was condensate dripping from a refrigeration pipe onto a metal "rake" (i.e., a large metal spatula) used to scrape cookie dough from the mixer. Both of the observations have been corrected.

It will be interesting to see what the 483 says when the FDA releases it to the rest of us.  So much for transparency.

Richard Raymond, former USDA Undersecretary of FSIS, Unplugged, but Right On

I know, I know, a trial lawyer who reads the Wall Street Journal? Yes, a bit counter-intuitive, but you have to love Bill Tomson’s article today – “U.S. Beef Safety Plan Languishes Amid New Illnesses,” and getting some juicy quotes by an “R” I admire, Richard “Dick” Raymond. Now retired, but until last October, USDA Undersecretary of FSIS - SEND DICK RAYMOND BACK TO WASHINGTON - You know, the one Obama and Vilsack cannot seem to fill despite my resume sitting on their desks! Here is the poop, errr, E. coli:

A June beef recall by JBS Swift & Co. for deadly E.coli contamination could have been prevented if a plan devised during the Bush administration to build new barriers between the bacteria and the public had been enacted.

The proposed safety measures would have had U.S. Department of Agriculture inspectors testing more beef, a move the meat industry argued was unnecessary. Inspectors now routinely test ground beef for the E. coli bacteria and any meat that is designated to be turned into ground beef -- usually the part of the carcass called "trim," but nothing else.

That's a mistake and people continue to get sick because of it, former USDA Food Safety Under Secretary Richard Raymond told Dow Jones Newswires in an interview. "We first tested ground beef and now we're testing trim. We need to start testing whole cuts."

More than a year ago, USDA officials began warning that primal cuts -- the large chunks of beef from which whole cuts that produce steaks and roasts come -- can be dangerous sources of E. coli contamination. Although steaks are considered safe even if the bacteria is present, portions of the primals they come from are often used to also make ground beef, which has been sickening consumers.

Steaks and the whole cuts they come from aren't considered dangerous to human health, or "adulterated," even if E. coli bacteria is present because, unlike ground beef, steaks don't provide bacteria access into the meat below the surface.

But those whole cuts and other primal beef often get turned into ground beef even though that wasn't the intended purpose of the meat, especially in summer months when grilling weather drives up consumer demand for hamburger meat.

The USDA has been considering for more than a year a policy change that would allow whole beef cuts to be considered "adulterated" -- and thus subject to recall -- even if they aren't "intended for use in ground beef," according to Daniel Engeljohn, a deputy assistant administrator for USDA's Food Safety and Inspection Service, or FSIS.

The policy change is still under consideration, he said.

Also still under consideration is a method devised last year by the USDA for slaughterhouses to detect unacceptable levels of E. coli in the primals they are producing.

In an August 2008 draft "guidance guideline" for slaughterhouses, FSIS suggested that when four out of 91 trim tests show a positive result for E. coli in beef trim -- the material primarily used to make ground beef -- that should be considered a "high-event day." If that happens, Engeljohn said, all of the beef -- not just the trim -- could be dangerous.

However, the decision on whether to treat primals as a potential source of E. coli poisoning and whether to allow them into commerce is still up to the producers, Engeljohn said, and that won't change unless policy is changed.

"That issue didn't get changed in the prior administration, and so now it comes to this new administration," Engeljohn said.

American Meat Institute Foundation President Jim Hodges said there was no need to divert primals away from the raw market, just because E. coli was found in the carcass trim.

Primals are much more valuable to the producer when they can be sold and turned into raw beef cuts like the steaks sold by retailers. The alternative is to sell the beef to processors that produce only pre-cooked meat products.

Administering antimicrobial treatments to those primals at the slaughterhouse is sufficient to kill the bacteria before they are sold for further processing, he said.

In events leading up to the JBS Swift & Co. June 24 recall, the company's Greeley, Colo., plant detected E. coli in carcass trim, Chandler Keys, the company's vice president of government affairs & industry relations told Dow Jones Newswires. Back in April, the trim was diverted for the production of cooked product, as the cooking process kills the bacteria, but the steak- and roast-producing primals were not. They were supposed to have been treated to kill the bacteria, but for reasons that remain unclear, that didn't happen. Several weeks later, the recall was initiated.

Primals, or parts of them, were recalled in late June by JBS Swift & Co. after at least 18 illnesses were connected to the beef. The company recalled 41,280 pounds of beef, all of which was "intact cuts of beef" that are "typically used for steaks and roasts rather than ground beef."

Even though primals aren't considered a health threat, or adulterated, even in the event of E. coli contamination, JBS Swift & Co. voluntarily recalled the meat because people were getting sick.

Another separate but related safety gap is a lack of government testing for E. coli in "bench trim," which is the leftover material once steaks and roasts and other cuts are produced from beef primals. That bench trim is often turned into ground beef, but it isn't the original trim from the slaughterhouse that FSIS and company inspectors focus on for E. coli detection.

Representatives of the U.S. meat packing industry like the AMI have fought the USDA's FSIS "tooth and nail" since officials there began talking about allowing whole beef cuts to be considered adulterated with E. coli and government testing for bench trim, according to Tony Corbo, the senior lobbyist for the nonprofit consumer organization Food & Water Watch.

The JBS Swift & Co. recall, Corbo said, is an example of why the industry is wrong.

Nestle Toll House Cookie Dough E. coli O157:H7 Outbreak Expands to 74 Ill in 32 States

I spent the morning on the phone with two young fathers whose children are both victims of Hemolytic Uremic Syndrome caused by E. coli O157:H7 that has been linked by the CDC to Nestle Toll House Cookie Dough.  One child, an 8-year-old from Michigan has been hospitalized for nearly a week and has received at least one blood transfusion.  The other child is a 4-year-old from South Carolina.  She was recently released from an Atlanta Rehab center after three and a half weeks.  This is on top of nearly two months in the hospital, weeks on dialysis and suffering from a stroke.

I also followed up with a Nevada woman, who too has been linked to the outbreak, and who is still hospitalized after over two months in the hospital.  She has suffered the removal of a portion of her large intestine and was on dialysis until the last few days.  A week ago she was just learning how to walk again.  E. coli O157:H7 is a very, very nasty bug.  

The new CDC numbers also came out today:

* 74 cases from 32 states - all match by PFGE testing

* Onset ranges from March 16 to June 11

* 72% female, age range 2-65 years (median age 15)

* 34 Hospitalizations

* 10 with Hemolytic Uremic Syndrome (HUS)

ABC Brian Hartman Exclusive - Again: Nestle Cookie Dough Loaded With Three Kinds of E. coli - Minnesota Family Link

Mr. E. coli (aka Brian Hartman) once again scoops all in the ongoing Cookie Dough caper. Here is part of his story:

Federal investigators have linked at least three different kinds of E. coli to Nestle’s cookie dough but remain stumped about how the bacteria got into the product, ABC News has learned.

The U.S. Food and Drug Administration has completed DNA testing of E. coli recently found in an unopened package of cookie dough at Nestle’s plant in Danville, Va.

Those tests, according to sources familiar with the investigation and confirmed by the FDA, determined the genetic fingerprint of the E. coli found at the plant is different than E. coli that has been linked to a 30-state outbreak that has sickened at least six dozen people.

Sources also say an altogether different strain of E. coli was found in dough recovered from the home of a victim, meaning at least three different types of E. coli have been found in cookie dough made by Nestle.

It is my understanding that E. coli O157:H7 found in the stools of the 72 people in 30 states share the same PFGE pattern (outbreak strain) and that 51 of those have been linked by advanced testing methods (MLVA). Interestingly, but not surprisingly (1), a separate E. coli O157:H7 PFGE pattern was found in a retained sample of Nestle Cookie Dough for in the Danville Plant.

In addition, one of our client’s (a Minnesota Family) leftover Cookie Dough tested positive for a separate Shiga-toxin E. coli – E. coli O124. However, both sick children tested positive for the outbreak strain.

(1)  Proctor ME, Kurzynski T, Koschmann C, et. al. Four strains of Escherichia coli O157:H7 isolated from patients during an outbreak of disease associated with ground beef: importance of evaluating multiple colonies from an outbreak-associated product.  J Clin Microbiol. 2002 Apr;40(4):1530-3.

E. coli and Cookie Dough Should Not Mix

The CDC says 72 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 30 states. Of these, 51 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (6), Connecticut (1), Delaware (1), Georgia (1), Iowa (2), Illinois (5), Kentucky (2), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).

Now, here is a question - you must assume that some of these people had left-over cookie dough and that local, state and federal health authorities have tested some of it?  So, results?  Same E. coli?  Same E. coli O157:H7?  Different E. coli?  Different bugs?

And, what about the retained sample of cookie dough from the Nestle Danville, Virginia plant?  We know the FDA and CDC said it tested positive for E. coli O157:H7, but is it the same genetic fingerprint as the E. coli O157:H7 found in the stools of the 72 ill people?

Thursday should be interesting.

Guest Blog - The CDC Linking Raw Cookie Dough to an E. coli Outbreak

OK, so the CDC likely would not even recognize that they know me or that what I do is useful, but I must say, this post (unauthorized here) on the CDC Blog is perhaps the best explanation of why we need a CDC and Epidemiologists.  Plus the author is kinda hot - for a Doctor.  Here is her post:

Contaminated raw cookie dough wasn’t on anyone’s mind as my public health colleagues and I were searching for the cause of a multistate outbreak of E. coli infections.

I’m one of the Epidemic Intelligence Service officers in CDC’s Enteric Diseases Epidemiology Branch, which monitors and investigates foodborne diseases together with CDC’s Enteric Disease Laboratory Branch and state health departments. On any given day we are working on several clusters and outbreaks of illness.

In mid-May, CDC’s PulseNet Team alerted us about a cluster of E. coli O157 infections. We began working with state and local health departments to investigate these infections. We originally suspected ground beef, which is one of the “usual suspects” for E. coli O157, along with leafy greens and sprouts. As the labs in states and at CDC found more and more people infected with the same strain, the demographics shifted; patients were generally young and female, which isn’t what is normally seen with ground beef-associated outbreaks.

We got copies of the interviews on standard questionnaires that state investigators did with ill people and looked through them for other suspicious food sources, but nothing was conclusive. None of the food items implicated in past E. coli O157 outbreaks appeared to be associated with this one. Therefore, we decided to conduct what we call “open-ended hypothesis-generating interviews,” in which we call the people affected and just talk about everything that they had eaten and done the week before they became ill, looking for things in common among them. Standard questionnaires are useful, but they are only asking for answers to a series of questions. Sometimes something with a broader scope, like this sort of wide-ranging interview, is needed to find things that are unusual and might not be asked on our questionnaires.

Washington State was kind enough to let CDC do the interviews on their five patients. Mark Sotir and I reached the mother of the first patient on a Saturday. She mentioned that her child had eaten raw prepackaged cookie dough during the days before he got sick. On Sunday, I reached a second patient, and she told me she had eaten at an ice cream shop and had ice cream with cookie dough and brownie mix-ins.

Nestle toll house package.

Cookie dough? When cases three, four, and five all confirmed that they ate raw cookie dough, it appeared we had a surprising new possible culprit in our outbreak. (It wasn’t until later that we learned that the second patient also had eaten raw cookie dough at home.)

During an outbreak investigation, we hold a series of multistate conference calls in which CDC and affected states share what we’re finding. Representatives from many of the affected states were on our June 16, 2009 conference call, and I mentioned my cookie dough hypothesis. On the face of it, cookie dough was the most unlikely culprit, but epidemiologists in several other states said, “Oh, yes, I had a case mention that, too”. It became a “Eureka” moment for the group.

At the end of the call we agreed that cookie dough, strawberries, fruit roll-ups, apples, and ground beef were all possible causes. Time to go back to the cases and ask more questions!

A lot of our work is like that. Our branch chief, Patricia Griffin, sometimes says there is a certain “head banging quality” to what we do. It can take many, many interviews and requires a wide-ranging curiosity to consider all the possibilities.

There are no short cuts. We talk to the patients, we look at the combined information, and we generate hypotheses about the cause. Then we can refine our questions and go back to the patients again to see which hypothesis holds true.

Quotable Quotes on Food Safety

CDC acts to expedite foodborne data sharing

Such single-point reporting may be a weakness of the new system, because it cannot establish trends in the way that multi-year analyses do, said prominent food-safety attorney Bill Marler of Seattle. "It you looked just at 2006, you would think that produce is a terrible risk, but in 2007 and 2008 there were fewer outbreaks in produce and many more in meat," he said.  Marler and other food-safety advocates, though, applauded the move to get data out to the field more quickly.

Administration Urged to Boost Food Safety Efforts

"Part of the problem with how we currently deal with food-borne illness cases is we wait until people get sick and die and then we announce an outbreak," said Bill Marler, a veteran food safety litigator who writes a blog about the issue. "It seems that the focus here is a bit on preventing it before we have sick and dead people as opposed to counting the bodies after salmonella or E. coli is out of the barn."

Suit Says NM Boy Was Sickened By JBS Swift Beef

Their lawyer, Bill Marler, said Tuesday that Alex developed hemolytic uremic syndrome, a type of kidney failure, after eating shish kabobs made from the meat in May. Marler's firm also represents a California client who developed the illness after eating the meat.

N.M. teen sues Swift over E. coli

Roerick's family ate the same meat, but he had more than the others, said his attorney, William Marler.  Of concern is that Roerick was sicked by whole muscle meat, not ground beef, as is typically the case with E. coli.  "It just shows how virulent the bacteria is," Marler said. "This is more than just a hamburger problem."

Federal Court Complaint Filed in JBS Swift E. coli O157:H7 Beef Case

Food Safety Advocates Marler Clark File First E. coli Lawsuit against JBS Swift Beef Company on Behalf of Gravely Ill Victim

The first lawsuit stemming from the current E. coli O157:H7 (E. coli) recall by JBS Swift Beef Company of Greeley, Colorado that has been linked to 23 E. coli illnesses in California, Maine, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York and Wisconsin was filed today on behalf of an Albuquerque-area child who was infected with E. coli after eating kabobs prepared by his grandmother on Mother’s Day. The lawsuit was filed on behalf of the family of 14 year old Alex Roerick by his attorneys, William Marler of the Seattle-based foodborne illness law firm Marler Clark and Kara Knowles of the Denver firm Montgomery, Little, Soran, & Murray.

Alex ate dinner with his grandma on May 10, 2009. He began to experience flu-like symptoms including fatigue, fever, nausea, diarrhea, and vomiting by May 13. Alex’s symptoms worsened and he was admitted to Presbyterian Hospital on May 15. He was released several days later, before being rushed back again due to severe bloody diarrhea. His doctors determined that Alex had developed hemolytic uremic syndrome, or HUS, a devastating complication of his E. coli O157:H7 infection. The genetic fingerprint of the E. coli found in Alex’s stool matches that of others sickened in the nationwide outbreak tied to recalled JBS Swift Beef. He continues to experience effects of his illness.

“JBS Swift and the FSIS were much too slow about releasing information on where the beef was distributed,” said Marler. “Even with widespread consumer pressure, the information was only released a day before the 4th of July holiday, not nearly enough time to get the word out to families that might have the contaminated meat in their homes. Our government agencies need to work faster in recall situations to prevent more people from suffering what Alex and his family have experienced.”

In the early morning hours of Sunday, June 28, the JBS Swift Beef Company expanded its earlier recall of 41,280 pounds of beef contaminated with the highly toxic pathogen E. coli to include an additional 380,000 pounds. The beef recalls are FSIS (Food Safety and Inspection Service) Class I, meaning that the "use of the product will cause serious, adverse health consequences or death." After years of large recalls, focused efforts by meat regulators brought down E. coli contamination recalls to a low of 182,000 pounds in 2006. Recalls shot up again in 2007, and in the ensuing years (2007-2009), over 41 million pounds of beef have been recalled due to contamination with E. coli.

ABOUT MARLER CLARK: William Marler has been a major force in food safety policy in the United States and abroad. His food safety blog, Marler Blog, is read by over 1,000,000 people around the world every year. He and his partners at Marler Clark have represented thousands of individuals in claims against food companies whose contaminated products have caused serious injury and death. His advocacy for better food regulation has led to invitations to address local, national, and international gatherings on food safety, including recent testimony to US Congress Committee on Energy and Commerce. In 1998, Mr. Marler formed the not for profit, Outbreak Inc. He spends much of the year speaking on how to prevent foodborne illnesses.

Before You Light the Grill Check the FSIS Retail List of JBS Swift Recalled E. coli Beef

Good to see USDA/FSIS and JBS Swift are working on the 4th.  The list of retailers is now is 82 pages long.  The E. coli O157:H7 Illnesses are at least 23 in 9 states.

I am off to California and New Mexico in the morning to meet with two HUS victims of this recall.

The Net Tightens Around Retailers Who Received JBS Swift E. coli Meat - 23 Reported Ill in California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6).

JBS Swift USA and the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) have released a list of retailers that received meat that may have been tainted with E. coli.  JBS Swift USA has recalled more than 420,000 pounds of beef that left the Greeley packing plant in April.  The retail outlets include:

»Price Chopper stores.

»Hannaford stores in Maine, New Hampshire, Vermont, Massachusetts and New York.

»Stop & Shop stores in Maine, Massachusetts, Rhode Island, Connecticut, New Hampshire, northern Kentucky, southeastern Indiana, western Tennessee and Arkansas.

»Kroger stores in Mississippi and Illinois.

»Food 4 Less in the Chicago area

»Fry's stores in Arizona.

»Smith's stores in Arizona, Utah and other Western states.

» Costco.

The Centers for Disease Control and Prevention (CDC) and FSIS say illnesses have been reported in California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6).

Just in Time for the 4th of July Weekend Another Warning About the Meat We Eat - NPR Interview of Marler

Health officials with The Atlanta based Centers for Disease Control and Prevention say at least twelve people have been hospitalized in connection with a possible E. coli outbreak in beef. WGPB's John Sepulvado reports some three hundred eighty thousand pounds (actually 420,000) of beef have been recalled in connection to the outbreak:

Colorado's JBS Swift Beef Company processed the suspect meat in April, and the recall began last week. While many national grocery chains have begun pulling meat from the shelves, some stores and vendors that sell JBS products have not been identified publicly. Food safety advocates, like Seattle based attorney Bill Marler, are urging federal authorities to reveal those vendors as the July 4th holiday approaches.

We know that this meat has gone to every state and internationally, we know it has sickened at least twenty three people in nine states, we as the public have an absolute right to know where this meat went.

Marler represents two men (actually kids) who suffered kidney failure (HUS) after eating the meat. Federal officials have ten days from the date of the recall to compile a list of all the vendors---meaning by law, that list must be finished by July 3rd.

72 People Linked to Nationwide Nestle Cookie Dough E. coli O157:H7 Outbreak

We have been retained by 20 of these linked cases (4 HUS) and have thus far filed suit in 3 cases.  We have not filed any suits this week waiting to see if Nestle will offer to pay the acute phase medical expense and wage loss of its customers.  From the CDC last night:

72 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 30 states. Of these, 51 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (6), Connecticut (1), Delaware (1), Georgia (1), Iowa (2), Illinois (5), Kentucky (2), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).

Ill persons range in age from 2 to 65 years; however, 65% are less than 19 years old; 71% are female. Thirty-four persons have been hospitalized, 10 developed hemolytic uremic syndrome (HUS); none have died. Reports of these infections increased above the expected baseline in May and continue into June.

In an epidemiologic study, ill persons answered questions about foods consumed during the days before becoming ill and investigators compared their responses to those of persons of similar age and gender previously reported to State Health Departments with other illnesses. Preliminary results of this investigation indicate a strong association with eating raw prepackaged cookie dough. Most patients reported eating refrigerated prepackaged Nestle Toll House cookie dough products raw.

On June 29, 2009, the U.S. Food and Drug Administration announced that a culture of a sample of prepackaged Nestle Toll House refrigerated cookie dough currently under recall yielded E. coli O157:H7. The contaminated sample was collected at the firm on June 25, 2009. Further laboratory testing is underway to determine whether the E. coli strain in the product matched the strain causing the outbreak.

"Hot off the Grill" in Time for 4th of July Weekend - FSIS List of Retail Outlets that Received JBS Swift E. coli Meat

A few days before many of us light up the barbeque, JBS Swift and the FSIS finally publish the list of retailers who received the tainted-meat (click on below).

Frankly, the retailer names had trickled out over the last few days as responsible stores alerted thier customers.  Whats a bit odd, it that the location of the stores that received the meat do not seem to completely match up to where the illnesses are located.  According to the CDC, twenty three persons infected with a strain of E. coli O157:H7 with a particular "DNA fingerprint" have been reported from 9 states. Of these, 17 have been confirmed by an advanced DNA test as having the outbreak strain; confirmatory tests are pending on others. The number of ill persons identified in each state is as follows: California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6).  So, begs the question?  "Where is ALL of the beef?"

California, Maine, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York and Wisconsin Report 23 E. coli O157:H7 Sicknesses Linked to JBS Swift - When will FSIS Release the Names of Stores Where Meat Was Sold?

On June 24, FSIS issued a notice about a recall of 41,280 pounds of beef products from JBS Swift Beef Company that may be contaminated with E. coli O157:H7. On June 28, the recall was expanded to include 380,000 pounds of assorted pieces of beef (beef primal products) from the same company.

The CDC reports today that twenty three persons infected with a strain of E. coli O157:H7 with a particular "DNA fingerprint" have been reported from 9 states. Of these, 17 have been confirmed by an advanced DNA test as having the outbreak strain; confirmatory tests are pending on others. The number of ill persons identified in each state is as follows: California (4), Maine (1), Michigan (6), Minnesota (1), New Hampshire (1), New Jersey (2), New Mexico (1), New York (1) and Wisconsin (6).

Among 17 ill persons for whom hospitalization status is known, 12 (70%) were hospitalized. Two patients developed a type of kidney failure called hemolytic uremic syndrome (HUS).

Now, a week into the recall FSIS and JBS Swift Beef has not disclosed the names of all stores that received the E. coli-tainted beef.  Why?  As I said to ABC News:

But Bill Marler, an attorney focused on food poisoning cases with the Seattle-based law firm Marler Clark, said if the FSIS waits 10 days, the information would be of little help to consumers who have already prepared for the holiday weekend -- even if the FSIS is following the rule.

"It just seems inconceivable to me that they can't release this information more timely so people who have this in their refrigerator know what to do with it or know what not to do with it," Marler said.

"Whether they're absolutely following the rule or not, this is the kind of information that JBS Swift should have at their fingertips," he added.

Nestle's E. coli Cookie Dough Problem Grows to 72 in 30 States

72 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 30 states. Of these, 51 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (6), Connecticut (1), Delaware (1), Georgia (1), Iowa (2), Illinois (5), Kentucky (2), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).

Ill persons range in age from 2 to 65 years; however, 65% are less than 19 years old; 71% are female. Thirty-four persons have been hospitalized, 10 developed hemolytic uremic syndrome (HUS); none have died. Reports of these infections increased above the expected baseline in May and continue into June.

ABC Brian Hartman Reports - "Smoking Gun" Found in Nestle Cookie Dough E. coli Scare

Brian Hartman of ABC reports that FDA investigators today found E. coli O157:H7 at the plant in Danville, Virginia where Nestle makes Toll House Cookie Dough.

The bacteria, according to an FDA official, was found at the plant in an unopened package of raw chocolate chip cookie dough. It had been manufactured on February 10, 2009 but had not yet been shipped.

Investigators still do not know how the E. coli got into the dough. But finding this “smoking gun” package confirms they pushed for a recall of the correct product.

Well done Brian.

69 Ill in 29 States with E. coli O157:H7 Linked to Nestle Toll House Cookie Dough - 34 Hospitalized - 9 with Hemolytic Uremic Syndrome

69 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 29 states. Of these, 46 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (5), Connecticut (1), Delaware (1), Georgia (1), Iowa (2), Illinois (5), Kentucky (3), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (2), Virginia (2), Washington (6), and Wisconsin (1).

Ill persons range in age from 2 to 65 years; however, 64% are less than 19 years old; 73% are female. Thirty-four persons have been hospitalized, 9 developed hemolytic uremic syndrome (HUS); none have died. Reports of these infections increased above the expected baseline in May and continue into June. 

Nestle Cookie Dough Plant Inspection Reports - Click to Download

Tip 'o the pen to WSJ.

When Jane Zhang of the Wall Street Journal Weighs into Nestlé E. coli Cookie Dough Case Businesses and Government Need to Pay Attention

I spent time yesterday visiting with a feisty “50 something” woman and her adoring husband (they have six kids) in a Nevada hospital as she spent her 50th day hospitalized with severe complication of Hemolytic Uremic Syndrome from an E. coli O157:H7 infection linked directly to Nestlé Cookie Dough. For a woman who has lost part of her large intestine, is still on dialysis, and is learning to walk again, her spirit was amazing. Still on a feeding tube and between retching because of ongoing gastroenterological problems, she still was able to lovingly tease her husband and make a lawyer feel welcome.  The husband kept saying, "I would not wish this on my worst enemy."

I was stuck at their lack of anger towards Nestlé whose product contained a bacteria that has nearly taken her life and for a government that over the years failed to protect the public.  I am not sure they will feel the same after they read Jane Zhang’s article in this mornings Wall Street Journal – “Nestlé Unit Denied FDA Requests.” Here are excerpts:

The Nestlé USA plant at the center of a federal probe into an E. coli outbreak involving cookie dough refused to give inspectors access to pest-control records, environmental-testing programs and other information, according to newly released inspection reports covering the past five years.

In a September 2006 visit, for example, managers at the Danville, Va., plant refused to allow a Food and Drug Administration inspector to review consumer complaints or inspect its program designed to prevent food contamination. The inspector found dirty equipment and "three live ant-like insects" on a ledge but nothing severe enough to give the plant a failing grade.

A year earlier, officials at the Nestlé plant presented another FDA inspector with a list of things it wouldn't do. "Among these are the refusal to review the firm's consumer complaint file, refusal to permit photography, refusal to sign affidavits or receipts and refusal to provide specific information on interstate commerce," the inspector wrote.

Companies aren't required to show those records to FDA inspectors and Nestlé's practice isn't out of line with the rest of the food industry, FDA and industry officials said.

When will companies realize that it really is a bad idea to poison customers? When will government realize that standing up for consumers is the right thing to do? And, when will us taxpayers realize that we need to compel our lawmakers to pass laws and regulations, and then to spend the money necessary to protect the public?

Marler Clark Files Third Lawsuit in Nestle Toll House Cookie Dough E. coli Outbreak - Lawsuits Now in California, Colorado and Washington

Lindsay Phillips, age 18, consumed Nestle cookie dough on several occasions in early May 2009. On May 11, 2009, Lindsay began to suffer from severe lower abdominal pain accompanied by profuse diarrhea that turned bloody. After Lindsay’s symptoms failed to subside, on May 13, 2009 her mother took her to the emergency room (“ER”). Initially diagnosed with dysentery, she was treated and given a prescription for antibiotics and anti-cramping medication and instructed to return if her symptoms did not improve or worsened. Lindsay returned home after the ER visit, but her symptoms continued to worsen. She returned to the ER a short time later and was admitted to the hospital for further evaluation. During her hospitalization a stool sample was obtained and cultured. It ultimately tested positive for E. coli O157:H7, and was later determined to match the strain of E. coli O157:H7 associated with the Nestle cookie dough outbreak. On May 16, 2009, Lindsay was discharged from the hospital and taken home to continue her recovery. Cause No. C09-05337RBL

List of Nestles Toll House Cookie and Brownie Dough Products Voluntarily Recalled Because of E. coli O157:H7 Risk

Nestlé Toll House Cookie & Brownie Dough Product Description Consumer Unit Code (UPC)

 

COOKIE & BROWNIE DOUGH BAR

Chocolate Chip bar 16.5oz

0 50000 62231 3
Chocolate Chip bar 16.5oz 0 50000 11308 8
Chocolate Chunk bar 16.5oz 0 50000 62235 1
Walnut Chocolate Chip bar 16.5oz 0 50000 62233 7
Jumbo Chocolate Chip bar 16.5oz 0 50000 62237 5
Oatmeal Raisin bar 16.5oz 0 50000 06219 5
Sugar Cookies bar 16.5oz 0 50000 62244 3
Sugar Cookies bar 16.5oz 0 5000012178 6
Mini Chocolate Chip bar 16.5oz 0 50000 62242 9
Mini Chocolate Chip bar 16.5oz 0 5000012188 5
Mini Brownie Bites bar 16oz 0 50000 62227 6
Fudgy Brownie With Peanut Butter Filling 19oz 0 50000 00820 9

 

COOKIE DOUGH TUB

Chocolate Chip tub 40oz 0 50000 62246 7
Chocolate Chip tub 80oz (5 lb) 0 50000 00934 3
Sugar tub 40oz. 0 50000 62253 5
Gingerbread tub 40oz 0 50000 44060 3
Peanut Butter tub 40oz 0 50000 44062 7

 

TUBE (CHUB) DOUGH

Chocolate Chip tube 16.5oz 0 50000 62239 9
Chocolate Chip tube 32oz 0 50000 00400 3

 

ULTIMATES COOKIE BAR DOUGH

Ultimates Peanut Butter Cups, Chips & Chocolate Chunks bar 16oz 0 50000 00922 0
Ultimates White Chip Macadamia Nut bar 16oz 0 50000 00923 7
Ultimates Chocolate Chip & Chunks with Pecans bar 16oz 0 50000 00925 1
Ultimates Chocolate Chip Lovers 16oz 0 50000 00926 8
Ultimates Turtles bar 16oz 0 50000 00928 2
Ultimates Peanut Butter Lovers bar 16oz 0 50000 00507 9
Ultimates Chocolate Chip with Caramel Filling bar 16oz 0 50000 44066 5
Ultimates Chocolate Chip with Chocolate Filling bar 16oz 0 50000 44069 6


SEASONAL COOKIE & BROWNIE DOUGH

Valentine Hearts Sugar Cookie Shapes 15.5oz 0 50000 12009 3
Valentine Swirled Chocolate Chip bar 16oz 0 50000 00931 2
Fudgy Brownies With Raspberry Filling 19oz 0 50000 20090 0
Easter Eggs Sugar Cookie Shapes 15.5oz 0 50000 52009 1
Easter Swirled Chocolate Chip bar 16oz 0 50000 00932 9
Easter Swirled Mini Brownie Bites bar 18 oz 0 50000 20093 1
Red, White & Blue Swirled Choc Chip bar 16oz 0 50000 00937 4
Halloween Pumpkin Pals Sugar Cookies 13.5oz 0 50000 06217 1
Halloween Swirled Chocolate Chip bar 16oz 0 50000 00929 9
Halloween Swirled Fudgy Brownies bar 18oz 0 50000 00088 3
Christmas Shapes Sugar Cookies 15.5oz 0 50000 00505 5
Christmas Swirled Chocolate Chip bar 16oz 0 50000 00930 5
Christmas Swirled Fudgy Brownies bar 18oz 0 50000 00089 0
Limited Edition Mint Swirled Chocolate Chip 16oz 0 50000 00827 8

 

DISCONTINUED VARIETIES

Valentine Hearts Sugar Cookies 13.5oz 0 50000 44056 6
Easter Brownie Bar 18oz 0 50000 00518 5
Easter Bunnies Sugar Cookies 13.5oz 0 50000 44058 0
Halloween Sugar Shapes 15.5oz 0 50000 00829 2
Christmas Sugar Cookie Tube 16oz 0 50000 00448 5
Oatmeal Cranberry Cookie Tub 48 oz. 0 50000 62229 0

 

Summons Issued in Second Nestles Toll House Cookie Dough E. coli O57:H7 Outbreak

Food Poisoning Seems to Never Rest

Still in Atlanta at the National Environmental Health Association Conference on my way home (or not) in a few hours.  In between doing a mock deposition of a Health Inspector, I had time to talk to California, Minnesota and Oregon press about the state of Food Poisonings - specifically E. coli:

When food sickens, he heads for courthouse - With outbreaks of food poisoning becoming more and more common, lawyer Bill Marler is in high demand

By Matt McKinney, Star Tribune

No one really wants to meet Bill Marler, a food safety lawyer from Seattle, because those who do are likely A) critically sickened by contaminated food and in need of legal help, or B) responsible for selling the food.

Yet there seems to be no shortage of people who know Marler after several high-profile food illness outbreaks in recent years from spinach, tomatoes, frozen pizza, peanut butter, hamburger meat and, last week, Nestlé Tollhouse cookie dough. He has a national practice, but has had several cases in Minnesota recently, including several in which he's sued Cargill on behalf of clients such as the 10-year-old girl from Mahtomedi who became seriously ill in December after eating hamburger contaminated with E. coli O157:H7.

Marler rose to prominence during the Jack in the Box E. coli outbreak of 1993. He maintains multiple food-related blogs while crisscrossing the country to speak about food safety. He's supportive of federal legislation winding its way through Congress that would require more inspections of food plants and give more authority to the Food and Drug Administration (FDA) to order food recalls, among other things. Marler, who's often quoted saying that he wishes food companies would put him out of business, also says that people must learn how to properly handle risky foods while companies must own up to the risks inherent in their products.

Marler's reaction to the Nestlé Tollhouse cookie dough outbreak: "It's almost un-American."

Ill girl's Highlands Ranch family sues over dough

By Jennifer Brown, The Denver Post

The lawsuit is the first in Colorado related to the outbreak and follows one filed Monday in California by an 18-year-old woman. Both cases were filed by William Marler, a Seattle attorney who specializes in food-safety cases.

It's unknown how this E. coli strain, one usually found in cattle manure, could have gotten into dough, but Marler speculated there could have been a contaminated ingredient, such as flour.

"That's pretty remarkable that it found its way into cookie dough," the attorney said. "A lot of Americans tend to eat cookie dough raw. It's pretty well-known, certainly in the industry, that people do consume cookie dough in that way."

Nestle ready to apologize to sickened Gresham teen

By Lynne Terry, The Oregonian

With the investigation under way, a Seattle attorney filed a second lawsuit against Nestle USA on Tuesday. The first, filed Monday, was on behalf of an 18-year-old California woman who was hospitalized for seven days after eating Nestle cookie dough, said attorney Bill Marler, who specialized in foodborne illness cases.

Tuesday's suit, filed in Colorado, concerns a 6-year-old girl who was hospitalized twice after eating cookie dough. She developed a type of kidney failure associated with E. coli O157:H7 known as hemolytic uremic syndrome, which often brings lifelong complications such as dialysis.

Nestle's labels carry warnings not to eat raw dough, but Marler brushed them off as insufficient to protect consumers.

"The warning issue is not very relevant, especially in light of the fact in that all the reported literature on what consumers do with cookie dough is that they eat it raw," Marler said. "The reality is that Nestle knew or should have known that their consumers were consuming that product raw and that they were handling it raw."

Another lawsuit filed in cookie dough E. coli scare

By Matt Tomsic, Danville Register & Bee

William Marler is one of the attorneys representing the child, Madison Sedbrook. He works for Marler Clark, a firm that represents victims of food poisoning.

According to Marler’s blog, Sedbrook, 6, ate the cookie dough several times in April. The Denver-area child developed flu-like symptoms and kept eating the cookie dough into May, when she developed ab-dominal cramps, fever and bloody diarrhea. Sedbrook was admitted to the hospital and released before being taken back.

She developed hemolytic uremic syndrome, a type of kidney failure that can be fatal. Doctors tested the genetic fingerprint of Sedbrook’s illness and compared it to the fingerprint of the nationwide outbreak of E. coli that may be linked to eating raw cookie dough. The two prints matched.

Colorado Child Sickened by E. coli Cookie Dough Files Lawsuit

An E. coli lawsuit was filed today on behalf of a Denver-area child who became gravely ill with E. coli O157:H7 after eating refrigerated Nestle Toll House cookie dough.  The lawsuit was filed on behalf of the family of Madison Sedbrook by her attorneys, William Marler of the Seattle-based foodborne illness law firm Marler Clark and Kara Knowles of the Denver firm Montgomery, Little, Soran, & Murray.

Six-year-old Madison ate Nestle Toll House refrigerated cookie dough several times in mid-April, 2009.  She began to experience flu-like symptoms including fatigue, fever, nausea, and vomiting.  Not knowing the source of her illness, she continued to eat Nestle cookie dough, and by the first week of May, she had abdominal cramps, fever, and bloody diarrhea.  Over the next several weeks, the family sought medical care several times for Madison’s illness, which deepened in severity.  She was admitted to the hospital and then released before being rushed back and admitted to pediatric intensive care.  It was determined that Madison had hemolytic uremic syndrome, or HUS, a complication of her E. coli infection, which was not diagnosed until her second hospital stay.  The genetic fingerprint of the E. coli O157:H7 found in her stool matches that of the nationwide outbreak tied to cookie dough.

“This child – and this family – have been through a terrible ordeal, not the least of which is how many times they sought care before E. coli was detected,” said Marler, who spoke from the National Environmental Health Association (NEHA) convention..  “In order to detect and limit foodborne illness outbreaks, we have to make changes in our healthcare system; doctors and emergency health providers need to be encouraged to test for foodborne pathogens any time these symptoms – especially bloody diarrhea - are present.”   

On Monday, the CDC released updated information on the nationwide outbreak, which now encompasses 70 ill in 30 states.  Thirty people have been hospitalized, and 7 have developed HUS.  Almost seventy percent of the victims are female and under the age of 19.  Nestle USA has voluntarily recalled the product, and stopped production at the facility that made it and are cooperating with FDA and CDC to pinpoint the cause.

“State health departments did a great job of getting to the bottom of this outbreak, and getting the word out,” continued Marler.  “But more resources are needed to speed the process up.  Every day saved means dozens, maybe hundreds of families spared the Sedbrook family experience.”

ABOUT MARLER CLARK: William Marler has been a major force in food safety policy in the United States and abroad.  His food safety blog, Marler Blog, is read by over 1,000,000 people around the world every year.  He and his partners at Marler Clark have represented thousands of individuals in claims against food companies whose contaminated products have caused serious injury and death.  His advocacy for better food regulation has led to invitations to address local, national, and international gatherings on food safety, including recent testimony to US Congress Committee on Energy and Commerce.  In 1998, Mr. Marler formed the not for profit, Outbreak Inc.  He spends much of the year speaking on how to prevent foodborne illnesses.

CDC - 70 now Ill with E. coli O157:H7 Linked to Nestle Toll House Cookie Dough - 30 Hospitalized, 7 with Hemolytic Uremic Syndrome (HUS)

According to the CDC, 70 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint (Pulsed Field Gel Electrophoresis - PFGE) have been reported from 30 states. Ill persons range in age from 2 to 65 years; however, 66% are less than 19 years old; 75% are female. Thirty persons have been hospitalized, 7 developed hemolytic uremic syndrome (HUS). Interestingly, this PFGE pattern has been seen on PulseNet before with over 300 being seen in last four years.

Of 70 linked in this outbreak, 41 have been confirmed by an advanced DNA test (likely MLVA, or Multiple Loci VNTR Analysis) as having the outbreak strain; these confirmatory test results are pending on the others. Most patients reported eating refrigerated prepackaged Nestle Toll House cookie dough products raw.

The number of ill persons identified in each state is as follows: Arizona (2), California (3), Colorado (5), Connecticut (1), Delaware (1), Georgia (1), Hawaii (1), Iowa (2), Illinois (5), Kentucky (3), Massachusetts (4), Maryland (2), Maine (3), Minnesota (6), Missouri (2), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (2), Virginia (2), Washington (5), and Wisconsin (1).

We have been contacted by over a dozen culture-confirmed cases in the last few weeks.  We filed suit yesterday in California on behalf of and 18 year old young woman hospitalized for seven days and will be filing this morning on behalf of a Colorado 6 year old who developed HUS - acute kidney failure.

Lawsuit in E. coli Cookie Dough Outbreak Filed by Marler Clark

A young woman who was hospitalized for seven days after eating raw cookie dough made by Nestle USA filed suit today against the company in California Superior Court, San Mateo County. The lawsuit was filed on behalf of 18-year-old Jillian Collins by her attorneys, William Marler of the Seattle-based foodborne illness law firm Marler Clark and Terry O’ Reilly of the San Mateo firm O'Reilly Collins.

San Mateo resident Jillian Collins ate uncooked Nestle Toll House cookie dough in late May, 2009. On May 26, she fell ill with painful abdominal cramps and diarrhea that soon turned bloody. Her symptoms worsened to the point where she sought urgent care. She was later admitted to the hospital, where tests revealed that she was infected with E. coli O157:H7. The genetic fingerprint of her test matched that of the outbreak strain which has infected 65 people in 29 states to date.

This outbreak is an example of how virulent E. coli bacteria can be, and how many people can be affected when it enters the national food supply,  Nestle USA is a company with a good food safety record, and they worked very quickly to get a voluntary recall of the product started. But even that isn’t enough for those who were sickened in this outbreak. It points to how vigilant we need to be in our food safety regulation and oversight.

The first announcement about the multi-state outbreak was made on Thursday, June 18 by the Colorado Department of Health and Environment (CDPHE), warning consumers about consuming the uncooked Nestle Toll House cookie dough product, and revealing that more than sixty were confirmed ill in 28 states. It wasn’t until late Friday, June 19 that the CDC released their outbreak information, which updated the totals to 65 ill in 29 states.

Nestle has stopped production at the Virginia facility that produced the cookie dough.  Everyone I talk to is stumped by how a bacteria normally associated with cattle feces made its way into the facility, and then into such a highly processed product. We may not solve that mystery; what we can do is work to prevent this type of event from happening again. The way to do that is better food safety surveillance – and that comes down to legislation and funding.

First Lawsuit to be Filed in Nestle's Toll House Cookie Dough E. coli O157:H7 Outbreak

Between speaking at the American College of Trial Lawyers in Minnesota on Friday, visiting on Saturday with a young dancer who now is confined to a wheelchair because of an E. coil O157:H7-tainted hamburger, and seeing an Ohio family today who lost their seven-year-old daughter to E. coli O157:H7, I am a bit tired and saddened, but determined.  I am now in Atlanta for the National Environmental Health Association Convention.  Tomorrow too we are also launching both a lawsuit and an investigation in how nearly 70 of our fellow citizens were sickened by E. coli O157:H7-contaminated cookie dough.  Click on below to download complaint:

Nestles has sickened at least 66 with E. coli O157:H7, with 25 hospitalized and 7 with Hemolytic Uremic Syndrome (HUS) - Nestles, pay the medical bills - Hell, that's what even the Cookie Monster would do

The average E. coli O157:H7 victim without hospitalization will spend at least $1,000 in medical expenses and loose a week’s wages. For those hospitalized, medical bills can run from $10,000 to $100,000 in a very short time period. Those families whose children develop HUS, bills can push well into $1M depending on the severity of the illness. If the HUS is severe, future complications – including kidney transplant can add untold millions.

Nestle should step up now and pay E. coli 0157:H7 culture-positive victims’ medical bills and lost wages.

Without assistance in the form of monetary compensation for medical expenses and lost wages, many of the families with members in the hospital will face financial hardship in the coming months when the bills start coming in. Nestle should do the right thing and begin compensating victims of this outbreak for those most basic needs now. Of course, Nestles will still be responsible for the costs of long-term medical care for victims, but it is better to step up now.

This is not as odd as it might sound. Other companies like Dole, Odwalla, ConAgra and Jack in the Box willingly paid medical bills and wage loss when their products were identified as the source of E. coli outbreaks. Nestles knows it’s going to pay those medical expenses in the end in the form of a settlement or jury verdict. The question is, since they know their product was the cause of these illnesses, why wait?

In other news:

New York Times - Nestlé Cookie Dough Is Recalled

Bill Marler, a food-safety lawyer, scoffed at that statement.

“Those three words do not constitute an adequate warning,” Mr. Marler said, “and Nestlé should not be blaming their victims for doing what everyone in America does, and that is to eat and handle cookie dough before it’s cooked.”

Reuters - Raw Cookie Dough: So Tasty, So Dangerous

The outbreak "points to the need for better funding for health surveillance," said lawyer Bill Marler, who sues food companies for a living. Oddly quoting himself on his blog, Marler wrote that the " 'fact that this outbreak was not detected until more than sixty people were ill in 28 states is precisely why we urgently need increased funding for the agencies responsible for public health,' said Marler. 'From the CDC to state and local health agencies, many dedicated people are working hard to protect consumers from tainted food, but they just don't have enough resources to do the job we ask of them.

Washington Post - Nestlé Recall Leaves A Mystery in Its Wake

William Marler, a prominent food safety lawyer in Seattle who is representing six of the E. coli O157 victims, said Nestlé's warning label is not a defense. "It doesn't absolve them of liability," he said.

ABC - Nestle Voluntarily Recalls Raw Cookie Dough

Bill Marler, an attorney focused on food poisoning cases with the law firm Marler Clark, said he recently noticed that this season's cases of E. coli did not look like others.

"Summer season is high season for E. coli cases -- normally you'd expect them to be related to hamburger consumption," Marler told ABCNews.com on Friday. "So we started tracking cases in May and June, and not very many of them had hamburger consumption."

Still, cookie dough "was certainly not on the list of things we've asked them," Marler said, adding that he is "surprised" the possible contamination may have occurred in such a "highly processed product."

"We're now going back and getting all the health department records on the people who contacted us over the last three months to see if they match this outbreak," Marler said.

Yet Another Death of a Child Due to E. coli - This Time Eight-Year-Old Joseph Coning

The Blount Daily Times reports on yet another death caused by E. coli O157:H7 and Hemolytic Uremic Syndrome (HUS) – this time it is eight-year-old Joseph Coning.  I received an email tonight from his devastated family.

Just a few weeks ago, seven-year-old Abby Fenstermaker died of E. coli O157:H7 and HUS in Ohio.  I will be meeting with yet another anguished family on Father’s Day.

When will it stop?

Some People Have No Shame - Stewart Parnell Makes a Claim Against the Company He Drove into the Ground

I was reviewing the 300 plus claims amounting to over $300,000,000 that companies and individuals have filed against the Peanut Corporation of America and found a claim for $601,506.96 by Stewart Parnell - No, really, the Stewart Parnell - the guy who took the 5th in front of Congress.  I need to stop being amazed by what people do.

Bar Date Extended to October 31, 2009 for Filing of Personal Injury Claims Against Peanut Corporation of America

Federal judge extends deadline for Peanut Corp. salmonella claims

Yet Another Reason NOT to Poison Your Food Customers - Peanut Corporation Claims Top $200 Million

Ray Reed of the Lynchburg News and Advance reported today that “[c]laims totaling $202 million had been filed Thursday against the Peanut Corporation of America in U.S. Bankruptcy Court in Lynchburg, as next Monday’s deadline for filing claims approached."

He continued:

Among the claims were eight involving deaths attributed to a nationwide salmonella outbreak that was traced to PCA plants in Blakely, Ga., and Plainview, Texas, according to the Centers for Disease Control. PCA was headquartered in suburban Lynchburg, on Wiggington Road in Bedford County. Its president, Stewart Parnell, asserted his Fifth Amendment rights and refused to answer questions during appearances this year before Congress and in U.S. Bankruptcy Court in Lynchburg.

The Marler Clark law firm in Seattle, Wash., filed the death claims, each of which seeks $10 million for the victims’ estate or relatives. Marler Clark also had filed 86 [actually 87] claims of $1 million each for people who said they were sickened by salmonella. Another claim was being filed Thursday, said William Marler, a principal in the firm….

The CDC said a total of 714 illnesses nationwide were caused by the strain of salmonella identified in the PCA plants, and nine of those victims died.

CDC Data - Surveillance for Foodborne Disease Outbreaks in the United States, 2006

CDC just today published its 2006 data on Foodborne Disease Outbreaks.  Here is the Report - no wonder I have been so busy:

Foodborne illnesses are a major health burden in the United States. Most of these illnesses are preventable, and analysis of outbreaks helps identify control measures. Although most cases are sporadic, investigation of the portion that occur as part of recognized outbreaks can provide insights into the pathogens, food vehicles, and food-handling practices associated with foodborne infections. CDC collects data on foodborne disease outbreaks (FBDOs) from all states and territories through the Foodborne Disease Outbreak Surveillance System (FBDSS). This report summarizes epidemiologic data on FBDOs reported during 2006 (the most recent year for which data have been analyzed). A total of 1,270 FBDOs were reported, resulting in 27,634 cases and 11 deaths. Among the 624 FBDOs with a confirmed etiology, norovirus was the most common cause, accounting for 54% of outbreaks and 11,879 cases, followed by Salmonella (18% of outbreaks and 3,252 cases). Among the 11 reported deaths, 10 were attributed to bacterial etiologies (six Escherichia coli O157:H7, two Listeria monocytogenes, one Salmonella serotype Enteritidis, and one Clostridium botulinum), and one was attributed to a chemical (mushroom toxin). Among outbreaks caused by a single food vehicle, the most common food commodities to which outbreak-related cases were attributed were poultry (21%), leafy vegetables (17%), and fruits/nuts (16%). Public health professionals can use this information to 1) target control strategies for specific pathogens in particular foods along the farm-to-table continuum and 2) support good food-handling practices among restaurant workers and the public.

State, local, and territorial health departments voluntarily submit reports of FBDOs using a web-based standard form to the electronic Foodborne Outbreak Reporting System (eFORS). An FBDO is defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. Information regarding clinical syndromes, incubation period, and laboratory testing for various etiologic agents is available to guide reporting officials.* Officials report an etiology as either confirmed (at least one etiologic agent found) or suspected (based on clinical and epidemiologic information). Analysis was limited to FBDOs with a single etiology (i.e., suspected or confirmed). Food vehicles are food items linked to illnesses by an outbreak investigation. CDC classifies the foods vehicles implicated in outbreak reports into the following 17 food commodities: fish, crustaceans, mollusks, dairy, eggs, beef, game, pork, poultry, grains/beans, oils/sugars, fruits/nuts, fungi, leafy vegetables, root vegetables, sprouts, and vegetables from a vine or stalk.

During 2006, public health officials reported a total of 1,270 FBDOs from 48 states. A confirmed or suspected single etiologic agent was indentified in 884 (70%) FBDOs (621 confirmed and 263 suspected), accounting for 22,510 (81%) cases. The number of outbreaks reported by each state or territory ranged from zero to 76. The median rate was 0.21 (range: zero to 1.3) per 100,000 population. For seven states (Hawaii, Maine, Minnesota, North Dakota, Oregon, Vermont, and Wisconsin), the rate of reporting was greater than three times the median. Rates of reported outbreaks varied markedly by etiology group. Among the 621 outbreaks (with 18,111 cases) with a confirmed single etiologic agent, 343 (55%) outbreaks and 11,981 (66%) cases were caused by viruses, 217 (35%) outbreaks and 5,781 (32%) cases were caused by bacteria, 52 (8%) outbreaks and 219 (1%) cases were caused by chemical agents, and nine (1%) outbreaks and 29 (1%) cases were caused by parasites. Calicivirus caused 337 (98%) of the confirmed FBDOs attributed to viruses; all calicivirus outbreaks reported in 2006 were attributed to norovirus. Salmonella, the most commonly reported bacterial etiologic agent, caused 112 (52%) of the confirmed FBDOs attributed to bacteria; Salmonella serotype Enteritidis caused the most outbreaks (28 [13%]). Shiga toxin--producing E. coli (STEC) caused 29 (13%) of confirmed FBDOs attributed to bacteria, of which 27 were serogroup O157.

Eleven multistate outbreaks, defined as outbreaks in which exposures occurred in more than one state, were detected; 10 of these were attributed to bacteria. One attributed to chemical agents was transmitted by baked goods contaminated by a floor sealant (11 cases). Four of the bacterial outbreaks were attributed to E. coli O157, of which three were transmitted by leafy vegetables (395 cases) and one was transmitted by beef (44 cases). Four were attributed to Salmonella, of which two were transmitted by tomatoes (307 cases), one by peanut butter (715 cases), and one by fruit salad (41 cases). An outbreak of Vibrio parahaemolyticus infections was transmitted by oysters (177 cases). An outbreak attributed to C. botulinum toxin was transmitted by carrot juice (four cases).

Public health officials identified a food vehicle in 528 (42%) FBDOs, of which 243 (46%) outbreaks with 6,395 (50%) cases were classified as having ingredients belonging to only one of the 17 commodities. Among the 243 outbreaks attributed to a single commodity, the most outbreaks were attributed to fish (47 outbreaks), poultry (35 outbreaks), and beef (25 outbreaks), and the most cases were attributed to poultry (1,355 cases), leafy vegetables (1,081 cases), and fruits/nuts (1,021 cases). Pathogen-commodity pairs responsible for the most outbreak-related cases were Clostridium perfringens in poultry (902 cases), Salmonella in fruits/nuts (776 cases), norovirus in leafy vegetables (657 cases), STEC in leafy vegetables (398 cases), Salmonella in vine-stalk vegetables (331 cases), and V. parahaemolyticus in mollusks (223 cases).

Although the dairy commodity accounted for only 3% of single commodity outbreak-related cases (16 outbreaks and 193 cases), 71% of dairy outbreak cases were attributed to unpasteurized (raw) milk (10 outbreaks and 137 cases). A wide range of bacterial pathogens were associated with unpasteurized milk outbreaks, including Campylobacter (six outbreaks), STEC O157 (two outbreaks), Salmonella (one outbreak), and Listeria (one outbreak), resulting in 11 hospitalizations and one death.

The largest outbreaks with a known etiology and single food commodity were attributed to baked chicken contaminated with C. perfringens (741 cases), peanut butter contaminated with Salmonella (714 cases), and spinach contaminated with E. coli O157 (238 cases). In the spinach outbreak, 31 persons developed hemolytic uremic syndrome, and five died, including a child. The contaminated spinach was traced back to a single farm, where the outbreak strain was isolated from nearby cattle feces and feral swine feces.

Full Report at MMWR.

Outbreak of E. coli O157:H7 Infections in Boulder County & other Denver-area Counties September-October 2008 Linked to Jimmy John's Restaurants

Boulder County Public Health just published this report:

FDA Needs More Resources To Oversee Food Safety According to Marler Clark Client

NPR Joanne Silberner interviewed Peter Hurley, father of three-year-old Jacob Hurley, who was poisoned by Salmonella-tainted peanut butter for Morning Edition, June 10, 2009 · Congress is taking the first step toward major changes in monitoring the safety of the nation's food supply. The broad plan is to give more money and power to an agency that has come under a lot of criticism in recent years — the Food and Drug Administration.

Listen Here.

September 2008 Aunt Mid's Lettuce E. coli O157:H7 Outbreak Linked to Santa Barbara Farms

On September 15, 2008, Ingham County Health Department (ICHD) was notified that nine students of Michigan State University (MSU) were seen in the emergency department over the weekend with gastrointestinal symptoms of abdominal pain, diarrhea, and bloody diarrhea. Lab cultures had confirmed that at least two of them were positive for E. coli O157:H7. The ICHD then launched an investigation with help from the Michigan Department of Community Health (MDCH), and both the United States & Michigan Department of Agriculture (MDA).

Over the ensuing days it became clear that the outbreak was not limited to MSU. While at MSU, the reported number of E. coli O157:H7 cases had risen to 18 (3 confirmed, 15 probable), there were also a reported 12 cases at Lenawee County Jail (5 confirmed, 7 probable). In fact, by September 29, a total of 26 confirmed cases of E. coli O157:H7 with the same genetic fingerprint had been reported to MDCH, from eight Michigan counties. Additionally, nine individuals in Illinois and three from the Province of Ontario had also been identified with the same genetic strain of E. coli O157:H7.

By this point, there was also strong epidemiological evidence linking the outbreak to institutional size, bagged iceberg lettuce. Two separate case-control studies had been conducted by MDCH at MSU and the Illinois Department of Public Health, and both implicated iceberg lettuce as the source of contamination. As a result, the MDA coordinated a traceback investigation of iceberg lettuce and found that the common supplier of all iceberg lettuce to MSU, the Lenawee County Jail, a restaurant in Illinois, as well as other foodservice locations identified by ill individuals, was Fresh-Pak Inc., distributed under the name, “Aunt Mid’s.”

The MDA subsequently conducted product and environmental sample testing at Aunt Mid’s. Though the tests did not find E. coli, testing was on current products, not on products from the outbreak timeframe. Lettuce from the outbreak timeframe was not available for testing during the investigation due to the perishable nature of the product.

Meanwhile, the toll of people affected by the E. coli O157:H7 outbreak had increased. By October 3rd, Michigan had identified 34 cases in nine counties with the same PFGE pattern by two enzymes. This included: nine students from MSU (Ingham County), five inmates at the Lenawee County Jail, three students at the University of Michigan and one in Washtenaw County, five in Macomb County, five in Wayne County, three in Kent County, and one each in St. Clair, Oakland, and Genesee Counties. The onset dates of symptoms of these confirmed genetically linked E. coli O157:H7 patients ranged from September 8 to 19.

The epidemiological investigation by MDA, which had already identified Aunt Mid’s as the common supplier of iceberg lettuce, soon revealed the likely origin of the contamination Using illness dates, ship dates, and delivery dates, the MDA was able to narrow the origin to California. The California Department of Public Health then assisted the investigation by surveying 15 possible supplier farms. By October 10, Michigan and California had both traced the lettuce supplied to the initial cases to Santa Barbara Farms in Santa Barbara, California.

Settlement Reached in hemolytic-uremic syndrome (HUS) Case Linked to Multistate Outbreak of E. coli O157:H7 Infections from November-December 2006

This outbreak was clearly linked to Ready Pac lettuce served in Taco Bell restaurants in the northeastern United States. As of December 14, 2006, Thursday, 71 persons with illness associated with the Taco Bell restaurant outbreak have been reported to CDC from 5 states: New Jersey (33), New York (22), Pennsylvania (13), Delaware (2), and South Carolina (1). States with Taco Bell restaurants where persons confirmed to have the outbreak strain have eaten are New Jersey, New York, Pennsylvania, and Delaware. (The patient from South Carolina ate at a Taco Bell restaurant in Pennsylvania). Other cases of illness are under investigation by state public health officials. Among these 71 ill persons, 53 (75%) were hospitalized and 8 (11%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS). Illness onset dates have ranged from November 20 to December 6.

Cases in 52 of the 71 patients are confirmed, meaning that the patients’ E. coli O157:H7 strains have the outbreak “DNA fingerprint.” E. coli O157 strains are routinely “DNA fingerprinted” at public health laboratories in all states as part of PulseNet (the network of public health laboratories that sub-type bacteria). E. coli O157 strains from other cases are being tested by PulseNet. As a result of testing by PulseNet, cases with the outbreak strain “fingerprint” pattern are being re-classified as confirmed cases, and cases with an unrelated “fingerprint” pattern are being dropped from the outbreak case count.

The Alexandre Eco Farms Dairy Raw Milk Campylobacter Outbreak

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...

Organic Pastures Raw Milk Warnings - Real or Imaginary? Does it Tell You That it Might Contain E. coli, Listeria or Campylobacter?

I spend a lot of time trying to convince companies why it is a bad idea to poison their customers - either suing them through Marler Clark or educating them through Outbreak Inc

Educating consumers is also something we all need to do for ourselves.  We need to pay attention to what we consume.  However, in our search for knowledge about what may be good for us, shouldn't we expect that the manufacturers and sellers of our food be fair and unbiased about the risks of consuming the food they sell us?

Warning Labels - the "Holy Grail" of manufacturers and sellers.  Many manufacturers and sellers think that a warning label saves them from their customer (or the customer's child) from suing them if the product in fact has a defect - in the case of food - a pathogen that can sicken or kill.  But, a warning label is a "double-edged sword."  If you are too honest - "the product may contain E. coli, Listeria or Campylobacter - consume this product and it may kill you" - that might be bad for sales?  Too vague and what do you get?

What do you think about Organic Pastures' warning label?  Real or Imaginary?  Perhaps it is just best to keep the shit out.

California Code of Regulations

Title 17. Public Health
Division 1. State Department of Health Services
Chapter 5. Sanitation (Environmental)
Subchapter 2. Foods and Drugs
Article 3.7. Raw Milk and Raw Milk Products

S 17:11380. Required Health Warning on Labels of Raw Milk and Raw Milk Products.

(a) Raw Milk and raw milk products shall bear the following warning on the principal display panel or panels of the label:

WARNING

Raw (unpasteurized) milk and raw milk dairy products may contain disease-causing micro-organisms. Persons at highest risk of disease from these organisms include newborns and infants; the elderly; pregnant women; those taking corticosteroids, antibiotics or antacids; and those having chronic illnesses or other conditions that weaken their immunity.

'Raw milk product' means any food which contains raw milk, and shall include, but not be limited to, cheese (except when ripened or cured at least 60 days pursuant to sections 37975 and 38001 Food & Agric. of the Food and Agricultural Code), cream, butter and kefir.

Hmm, I wonder if Organic Pasture's Warnings are sufficient?

E. coli Outbreaks, Illnesses, Deaths and Litigation in Ohio Since 1999

KFC E. coli Outbreak – Ohio - 1999

In late July of 1999, Ohio public health officials began receiving reports that patients at local hospitals were suffering from E. coli O157:H7 infections. By August 2, 1999, fifteen cases had been confirmed, and through investigative interviews the Ohio Department of Health learned that eleven of those fifteen people had eaten foods purchased from KFC restaurants in southwestern Ohio counties in the week before becoming ill.

Marler Clark represented a woman who became ill with an E. coli infection and hemolytic uremic syndrome after eating foods purchased from a Cincinnati KFC restaurant. She was hospitalized for nearly a month with acute renal failure and other life-threatening complications and nearly died twice. As a result of her E. coli O157:H7 infection, the woman suffered permanent and irreversible injury to her kidneys, pancreas, heart, lungs, and brain. Her claim was resolved in 2001.

ConAgra Ground Beef E. coli Outbreak – Nationwide (including Ohio) - 2002

On June 30, 2002, the USDA Food Safety and Inspection Service (FSIS) announced the recall of 354,200 pounds of ground beef manufactured at the ConAgra Beef Company plant in Greeley, Colorado. The contaminated ground beef had been produced at the plant on May 31, thirty days prior to the recall, and was distributed nationally to retailers and institutions. On July 19, 2002, FSIS expanded the ConAgra ground beef recall to 18.6 million pounds of ground beef. In the weeks that followed the nationwide recall, more than 45 people in 23 states reported illnesses linked to the contaminated ground beef.

Marler Clark represented 23 victims of the ConAgra E. coli outbreak, which led to at least 46 illnesses and one death. Among the victims was the death of an Ohio childcare worker, a Colorado security officer who was battling forest fires, and young children in Colorado, Nebraska, and South Dakota. Several of them were hospitalized with hemolytic uremic syndrome, a frightening complication of E. coli O157:H7 infection that can lead to kidney failure and neurological impairment. Their claims were resolved in 2004.

Nebraska Beef E. coli Outbreak – Nationwide (including Ohio) - 2008

On August 8, 2008 Nebraska Beef recalled an additional 1.2 million pounds of meat after a cluster of Boston illnesses was traced to Whole Foods, whose processor, Coleman Natural Meats, purchased the meat from Nebraska Beef. As many as 30 illnesses are reported in California, Colorado, Connecticut, Idaho, Illinois, Massachusetts, New Jersey, New Mexico, Ohio, Pennsylvania, Virginia, and Canada.

On August 14, Nebraska Beef added another 160,000 pounds to the recall, bringing the total to 1.36 million pounds. Numerous stores and supermarkets have initiated voluntary recalls. 49 confirmed cases have been linked both epidemiologically and by molecular fingerprinting to the first part of this outbreak, 21 in Michigan and 20 in Ohio, 4 in Georgia, and one each in New York, Kentucky, Indiana, and Utah. Onset of illness in these patients occurred from 5/27/08 to 7/1/08. Twenty-seven ill persons have been hospitalized. One patient has developed a type of kidney failure called hemolytic-uremic syndrome (HUS). Kroger initiated a voluntary recall on June 27, but did not name their meat supplier.

Marler Clark filed the first lawsuit stemming from the outbreak on the morning of June 30. Late that night, the FSIS announced that the tainted meat had been traced back to Nebraska Beef Products, and a recall of 531,707 pounds of ground beef products was initiated. On July 2, the Kroger recall widened to 20 states. On July 3, the Nebraska Beef recall was widened to include 5.3 million pounds.

The E. coli O157:H7 Bacteria and Hemolytic Uremic Syndrome (HUS)

The E. coli O157:H7 Bacteria

E. coli O157:H7 is one of hundreds of strains of the bacterium Escherichia coli. Most strains of E. coli are harmless and live as normal flora in the intestines of healthy humans and animal. The E. coli bacterium is among the most extensively studied microorganism. The combination of letters and numbers in the name of the E. coli O157:H7 refers to the specific markers found on its surface and distinguishes it from other types of E. coli. The testing done to distinguish E. coli O157:H7 from its other E. coli counterparts is called serotyping. Pulsed-field gel electrophoresis (“PFGE”), sometimes also referred to as genetic fingerprinting, is used to compare E. coli O157:H7 isolates to determine if the strains are distinguishable.

E. coli O157:H7 was first recognized as a pathogen in 1982 during an investigation into an outbreak of hemorrhagic colitis associated with consumption of hamburgers from a fast food chain restaurant. Retrospective examination of more than three thousand E. coli cultures obtained between 1973 and 1982 found only one isolation with serotype O157:H7, and that was a case in 1975. In the ten years that followed there were approximately thirty outbreaks recorded in the United States. This number is likely misleading, however, because E. coli O157:H7 infections did not become a reportable disease in any state until 1987 when Washington became the first state to mandate its reporting. As a result, only the most geographically concentrated outbreak would have garnered enough notice to prompt further investigation.

The virulence of E. coli O157:H7 is a result of its ability to produce Shiga-like toxins. It has been theorized that generic E. coli picked up this deadly ability through horizontal transfer of virulence genes from the Shigella bacteria. Genome sequencing of E. coli O157:H7 has since confirmed that gene transfer did in fact occur, and that the evolution of ever more virulent forms of bacteria will likely continue to occur. The CDC has emphasized the prospect of emerging pathogens as a significant public health threat for some time.

Foods of a bovine origin are the most common cause of both outbreaks and sporadic cases of E. coli O157:H7 infections. Surveys performed on feedlots have demonstrated that cattle can be infected with E. coli O157:H7 through close contact, and under muddy conditions. The prevalence of E. coli O157:H7 among cattle in these feed lots can reach 63-100%, especially during the summer. The prevalence of E. coli O157:H7 in the summer, which is when outdoor grilling of hamburgers becomes most common, is a significant public safety risk.

According to a recent study, an “estimated 73,480 illnesses due to E. coli O157:H7 infections occur each year in the United States, leading to an estimated 2,168 hospitalizations and sixty-one deaths annually.” The hemorrhagic colitis caused by E. coli O157:H7 is characterized by severe abdominal cramps, diarrhea that typically turns bloody within twenty-four hours, and sometimes fevers. The typical incubation period—which is to say the time from exposure to the onset of symptoms—in outbreaks is usually reported as three to eight days. Infection can occur in people of all ages but is most common in children. The duration of an uncomplicated illness can range from one to twelve days. In reported outbreaks, the rate of death is 0-2%, with rates running as high as 16-35% in outbreaks involving the elderly, like those at nursing homes.

What makes E. coli O157:H7 truly and decidedly dangerous is its very low infectious dose, and how relatively difficult it is to kill these bacteria. Unlike Salmonella, for example, which usually requires something approximating an “egregious food handling error, E. coli O157:H7 in ground beef that is only slightly undercooked can result in infection.” As few as twenty organisms have been said to be sufficient to infect a person and, as a result, possibly kill them. And unlike generic E. coli, the O157:H7 serotype multiplies at temperatures up to 44 degrees Fahrenheit, survives freezing and thawing, is heat resistant, grows at temperatures up to 111 degrees Fahrenheit, resists drying, and can survive exposure to acidic environments.

And, finally, to make it even more of a dangerous threat, E. coli O157:H7 bacteria are easily transmitted by person-to-person contact. There is also the serious risk of cross-contamination between raw meat and other food items intended to be eaten without cooking. Indeed, a principle and consistent criticism of the USDA E. coli O157:H7 policy is the fact that it has failed to focus on the risks of cross-contamination versus that posed by so-called improper cooking. With this pathogen, there is ultimately no real margin of error, and the cost of error can be death. It is for this precise reason that the USDA has repeatedly rejected calls from the meat industry to hold consumers responsible for E. coli O157:H7 surviving after cooking.

Hemolytic Uremic Syndrome (HUS)

E. coli O157:H7 infections can lead to a severe, life-threatening complication called hemolytic uremic syndrome (“HUS”). HUS accounts for the majority of the acute and chronic illness and death caused by the bacteria. HUS occurs in 2-7% of victims, primarily children, with onset five to ten days after diarrhea begins. It is the most common cause of renal failure in children. Approximately half of the children who suffer HUS require dialysis, and at least 5% of those who survive have long-term renal impairment. The same number suffers severe brain damage. While somewhat rare, serious injury to the pancreas, resulting in death or the development of diabetes can also occur. There is no cure or effective treatment for HUS. And, tragically, as too many parents can attest, children with HUS too often die.

HUS develops when the toxin from the bacteria, known as Shiga-like toxin (“SLT”), enters the circulation through the inflamed bowel wall. SLT, and most likely other chemical mediators, attach to receptors on the inside surface of blood vessel cells (endothelial cells) and initiate a chemical cascade that results in the formation of tiny thrombi (blood clots) within these vessels. Some organs seem more susceptible, perhaps due to the presence of increased numbers of receptors, and include the kidney, pancreas, and brain. By definition, when fully expressed, HUS presents with the triad of hemolytic anemia (destruction of red blood cells), thrombocytopenia (low platelet count), and acute renal failure (loss of kidney function).

As already noted, there is no known therapy to halt the progression of HUS. HUS is a frightening complication that even in the best American centers has a notable mortality rate. Among survivors, at least five percent will suffer end stage renal disease (“ESRD”) with the resultant need for dialysis or transplantation. But, “[b] ecause renal failure can progress slowly over decades, the eventual incidence of ESRD cannot yet be determined.” Other long-term problems include the risk for hypertension, proteinuria (abnormal amounts of protein in the urine that can portend a decline in renal function), and reduced kidney filtration rate. Since the longest available follow-up studies of HUS victims are 25 years, an accurate lifetime prognosis is not really available and remains controversial. All that can be said for certain is that HUS causes permanent injury, and it requires a lifetime of close medical monitoring.

References

Continue Reading...

Settlement in Hemolytic Uremic Syndrome (HUS) Case Linked to 2007 E. coli O157:H7 Outbreak

In the first major hamburger recall since 2002, on June 9, 2007, United Food Group voluntarily expanded its June 3 and 6 recalls to include a total of approximately 5.7 million pounds of both fresh and frozen ground beef products produced between April 6 and April 20 because it was contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service announced.

An investigation carried out by the California Department of Health Services and the Colorado Department of Health, in coordination with the Centers for Disease Control and Prevention, preceded the recall of June 3. Illnesses occurred in Arizona (6), California (3), Colorado (2), Idaho (1), Utah (1) and Wyoming (1). Illness onset dates ranged between April 25 and May 18.

Four of those illnesses were children who developed Hemolytic Uremic Syndrome (HUS).

Their stories, like the stories of other victims of HUS linked to hamburger consumption, began with that all-American past time of eating a hamburger then lead to an acute illness where death was a real possibility. Now, it is a lifetime of risk of kidney failure.

We have been able to settle three of the four HUS cases. It will be interesting to see what a jury says about the other case. See some of the client videos to see what these families have experienced.

Sixteen Years of E. coli O157:H7 Litigation

Since the Jack in the Box E. coli Outbreak of 1993, I have been involved in every E. coli Outbreak and have represented the most seriously injured cases.  There have been far too many deaths.

* AFG / Supervalu E. coli Outbreak - Minnesota
* AgVenture Farms Petting Zoo E. coli O157:H7 Outbreak Litigation - Florida
* Aunt Mid’s Lettuce E. coli outbreak - Michigan, Illinois, and Ontario
* Bauer Meat E. coli Litigation - Georgia
* BJ’s Wholesale Club E. coli Litigation - New York and New Jersey
* Captain’s Galley Seafood Restaurant E. coli Outbreak - North Carolina
* Cargill E. coli Outbreak - Nationwide
* Carneco / Sam’s Club E. coli Outbreak - Wisconsin & Michigan
* CCC Alternative Learning Daycare E. coli Outbreak - Texas
* China Buffet E. coli Outbreak - Minnesota
* ConAgra Ground Beef E. coli Outbreak - Nationwide
* Country Cottage Restaurant E coli O111 Outbreak - Oklahoma
* Crossroads Farm Petting Zoo E. coli Outbreak - North Carolina
* Dee Creek Farm E. coli Outbreak - Washington & Oregon
* Dole Lettuce E. coli Outbreak - Minnesota, Wisconsin, and Oregon
* Dole Spinach E. coli Outbreak - Nationwide
* Emmpak E. coli Outbreak - Wisconsin
* Excel E. coli Outbreak - Georgia
* Finley Elementary School E. coli Outbreak - Washington
* Flanders Provision Co. E. coli Outbreak - Colorado, Nationwide
* Forest Ranch Fire Department Fundraiser E. coli Outbreak - California
* Fresno Meat Market E. coli Outbreak - California
* Gold Coast Produce E. coli Outbreak - California
* Golden Corral E. coli Outbreak - Nebraska
* Habaneros E. coli Outbreak - Missouri
* Interstate Meat E. coli O157:H7 Outbreak - Oregon, Washington & Idaho
* Ixtapa Mexican Restaurant E. coli outbreak - Washington State
* Jack in the Box E. coli Outbreak - Western States
* Jimmy John’s Gourmet Sandwiches E Coli Outbreak - Colorado
* Karl Ehmer Meats E. coli Outbreak – New Jersey
* KFC E. coli Outbreak - Ohio
* Kid’s Korner Daycare E. coli Outbreak - Missouri
* Kindercare E. coli Outbreak - California
* King Garden Restaurant E. coli Outbreak - Ohio
* Lane County Fair E. coli Outbreak - Oregon
* Nebraska Beef E. coli Litigation - Minnesota
* Nebraska Beef E. coli Outbreak - Nationwide
* Odwalla E. coli Outbreak - Western States
* Olive Garden E. coli Outbreak - Oregon
* Organic Pastures E. coli Outbreak - California
* Parsley E. coli Outbreak - Washington & Oregon
* Peninsula Village E. coli Outbreak - Tennessee
* PM Beef Holdings, Lunds & Byerly’s E. coli Outbreak - Minnesota
* R & S Meats E. coli Cases - New York
* Robeson Schools E. coli Outbreak - North Carolina
* Robinswood Pointe Senior Living Facility E. coli Outbreak - Washington
* Rochester Meat Company E. coli Outbreak - Wisconsin, California
* S & S Foods - Goshen Boy Scout Camp E. coli Outbreak - North Carolina
* Sizzler E. coli Outbreak - Wisconsin
* Sodexho Spinach E. coli Outbreak - California
* Spokane Produce E. coli Outbreak - Washington, Oregon, Idaho
* Stop & Shop E. coli Case - New Hampshire
* Taco John’s E. coli Outbreak – Iowa and Minnesota
* Topps and Price Chopper E. coli Case - New York
* Topps Meats E. coli Outbreak - Nationwide
* Totino’s and Jeno’s Pizza E. coli Outbreak
* United Food Group E. coli Outbreak - Western States
* Valley Meats E. coli Outbreak - Ohio, Illinois, Pennsylvania
* Washington County Fair E. coli Outbreak - New York
* Wendy’s E. coli Outbreak - Oregon
* Wendy’s E. coli Outbreak - Utah
* White Water Water Park E. coli Outbreak - Georgia

Royal Institute of Public Health

One of the "good news, bad news" of sleeping few hours at odd times is that jet lag has very little impact on you.  It is 11:36 PM here in "jolly olde England" and 3:26 PM in Seattle,  Folks at the office are about to head to the Starbucks (they are on every block here in London).  Me, I made a few last minute changes to my PowerPoint for the morning.

CDC Reports Outbreak of Salmonella Serotype Saintpaul Infections Associated with Eating Alfalfa Sprouts

From the MMWR Today - Since February 1, a total of 228 cases have been reported from 13 states: Nebraska (110 cases), Iowa (35), South Dakota (35), Michigan (18), Kansas (eight), Pennsylvania (seven), Minnesota (five), Ohio (three), Illinois (two), West Virginia (two), Florida (one), North Carolina (one), and Utah (one) (Figure 2). Patients range in age from <1 year to 85 years (median: 29 years); 69% are female. Among patients with available information, 4% reported being hospitalized. No deaths have been reported.

On February 24, 2009, the Nebraska Department of Health and Human Services identified six isolates of Salmonella serotype Saintpaul with collection dates from February 7--14. Salmonella Saintpaul is not a commonly detected serotype; during 2008, only three Salmonella Saintpaul isolates were identified in Nebraska. This report summarizes the preliminary results of the investigation of this outbreak, which has identified 228 cases in 13 states and implicated the source as alfalfa sprouts produced at multiple facilities using seeds that likely originated from a common grower. On April 26, the Food and Drug Administration (FDA) and CDC recommended that consumers not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts, until further notice. On May 1, FDA alerted sprout growers and retailers that a seed supplier was withdrawing voluntarily from the market all lots of alfalfa seeds with a specific three-digit prefix.

For this investigation, a case was defined as illness in a person whose stool culture on or after February 1, 2009, yielded Salmonella Saintpaul with the outbreak strain pulsed-field gel electrophoresis (PFGE) patterns (XbaI JN6X01.0072, JN6X01.0252, JN6X01.0340, JN6X01.0709, JN6X01.0712, JN6X01.0718, or JN6X01.0719). During January 1, 2008 to January 31, 2009, only four cases of the outbreak strain of Salmonella Saintpaul were identified by PulseNet.

By March 19, a total of 186 cases had been identified in Illinois, Iowa, Kansas, Minnesota, Nebraska, and South Dakota. Of the 156 patients with completed interviews, 114 (73%) reported alfalfa sprout consumption.

In mid-April, 42 additional case-patients with onset of illness beginning after March 15 were identified from Florida, Iowa, North Carolina, Michigan, Minnesota, Nebraska, Ohio, Pennsylvania, Utah, and West Virginia. At least 20 of these case-patients reported recently eating sprouts. Alfalfa sprouts eaten by these case-patients were traced back to growing facilities in Michigan, Minnesota, and Pennsylvania that received seed lots identified with prefix 032 from Caudill Seed Company. Alfalfa sprout irrigation water collected on March 10 from a growing facility in Wisconsin grew Salmonella Saintpaul indistinguishable from the outbreak strain. These sprouts also were grown from a seed lot identified with prefix 032 received from Caudill Seed Company. No human illnesses have been linked to the Wisconsin facility. Preliminary findings indicate that the implicated seed lots were sold in many states and might account for a large proportion of the alfalfa seeds that were being used by sprout growers during this outbreak.

We presently have nearly a dozen clients from several states.  Four Lawsuits have been filed.

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.

Salmonella Sprout Lawsuit Linked to Sprouts and Seeds

Today we amended our complaint on behalf of “Daniel Krim, 49, [who] became ill after eating alfalfa sprouts on a turkey sandwich he purchased from a La Vista restaurant in late February. His flu-like symptoms worsened, forcing him to go to the emergency room at Midlands Hospital in Papillion. Days later, his doctor confirmed he had been infected with the Salmonella St. Paul strain, according to his lawsuit, filed last week in Sarpy County District Court.”

According to Leia Baez of the Omaha World-Herald, “Krim is suing CW Sprouts, Inc., whose SunSprouts products were linked to the outbreak in Nebraska, Iowa, Kansas, Colorado and South Dakota. He also is suing Caudill Seed and Warehouse Co. of Louisville, Ky., the company that manufactured and sold alfalfa sprout seeds to CW Sprouts."

Dr. Richard Besser (acting head of CDC), Swine Flu (H1N1), E. coli O157:H7, Apple Cider and Bill Marler have what in Common?

OK, it is 2:00 AM and the power is out after a wind a rain and storm on Bainbridge Island. Fortunately, my laptop has batteries and I have a wireless card. I am also wondering where my passport is since I leave for Canada in 12 hours. But, hopefully the morning will find it – somewhere.

So, I was reading up on the recent pronouncements about Swine Flu (politically correct H1N1 virus) and kept bumping into Dr. Richard Besser, acting head of CDC. Doing a little research on him at 2:00 AM uncovered this article about his research into an E. coli O157:H7 outbreak linked to unpasteurized apple juice, two years before the outbreak of E. coli O157:H7 linked to Jack in the Box restaurants. There began my connection.

Back to unpasteurized juice – Interesting to note that the CONCLUSIONS below show how we learn – a bit slowly – to protect ourselves from the next outbreak by actually investigating and learning from past outbreaks. Goes to show why surveillance of foodborne illness outbreaks is so important in preventing the next one. Now, if only we can do the same with the Flu.

An outbreak of diarrhea and hemolytic uremic syndrome from Escherichia coli O157:H7 in fresh-pressed apple cider.  Besser RE, Lett SM, Weber JT, Doyle MP, Barrett TJ, Wells JG, Griffin PM.

Escherichia coli O157:H7 causes hemorrhagic colitis and the hemolytic uremic syndrome. In the fall of 1991, an outbreak of E coli O157:H7 infections in southeastern Massachusetts provided an opportunity to identify transmission by a seemingly unlikely vehicle.  Case-control study to determine the vehicle of infection. New England cider producers were surveyed to assess production practices and determined the survival time of E coli O157:H7 organisms in apple cider.  Illness was significantly associated with drinking one brand of apple cider. Thirteen (72%) of 18 patients but only 16 (33%) of 49 controls reported drinking apple cider in the week before illness began (odds ratio [OR], 8.3; 95% confidence interval [CI], 1.8 to 39.7). Among those who drank cider, 12 (92%) of 13 patients compared with two (13%) of 16 controls drank cider from cider mill A (lower 95% CI, 2.9; P < .01). This mill pressed cider in a manner similar to that used by other small cider producers: apples were not washed, cider was not pasteurized, and no preservatives were added. In the laboratory, E coli O157:H7 organisms survived for 20 days in unpreserved refrigerated apple cider. Addition of sodium benzoate 0.1% reduced survival to less than 7 days.

CONCLUSIONS--Fresh-pressed, unpreserved apple cider can transmit E coli O157:H7 organisms, which cause severe infections. Risk of transmission can be reduced by washing and brushing apples before pressing, and preserving cider with sodium benzoate.  Consumers can reduce their risk by only drinking cider made from apples that have been washed and brushed.

An outbreak of Escherichia coli O157:H7 infections and haemolytic uraemic syndrome associated with consumption of unpasteurized apple cider.  Hilborn ED, Mshar PA, Fiorentino TR, Dembek ZF, Barrett TJ, Howard RT, Cartter ML.

During October 1996, an outbreak of Escherichia coli O157:H7 infections among Connecticut residents occurred. An epidemiologic investigation included enhanced surveillance and a case-control study. Clinical isolates of Escherichia coli O157:H7 were typed by pulsed-field gel electrophoresis (PFGE). Implicated cider samples were analysed by culture and polymerase chain reaction (PCR). Consumption of implicated cider was associated with illness; (matched odds ratio = undefined, 95 % confidence interval = 3.5-infinity). Ultimately, a total of 14 outbreak-associated patients were identified. All isolates analysed by PFGE yielded the outbreak-associated subtype. Escherichia coli O157:H7 was not cultured from three cider samples; PCR analysis detected DNA fragments consistent with Escherichia coli O157:H7 in one. This outbreak was associated with drinking one brand of unpasteurized apple cider. PFGE subtyping supported the epidemiologic association. PCR analysis detected microbial contaminants in the absence of live organisms.

CONCLUSIONS - Washing and brushing apples did not prevent cider contamination.

An outbreak of Escherichia coli O157:H7 infection from unpasteurized commercial apple juice.  Cody SH, Glynn MK, Farrar JA, Cairns KL, Griffin PM, Kobayashi J, Fyfe M, Hoffman R, King AS, Lewis JH, Swaminathan B, Bryant RG, Vugia DJ.

Escherichia coli O157:H7 infections have traditionally been associated with animal products, but outbreaks associated with produce have been reported with increasing frequency. In fall 1996, a small cluster of E. coli O157:H7 infections was epidemiologically linked to a particular brand (brand A) of unpasteurized apple juice.  To define the extent of the outbreak, confirm the source, and determine how the apple juice became contaminated.  Descriptive epidemiologic study and traceback investigation.  Western United States and British Columbia, Canada.  Patients with E. coli O157:H7 infection who were exposed to brand A apple juice.  Clinical outcome and juice exposure histories of case-patients, pulsed-field gel electrophoresis of case and juice isolates, and juice production practices.  Seventy persons with E. coli O157:H7 infection and exposure to brand A unpasteurized apple juice were identified. Of these persons, 25 (36%) were hospitalized, 14 (20%) developed the hemolytic uremic syndrome, and 1 (1%) died. Recalled apple juice that was produced on 7 October 1996 grew E. coli O157:H7 with a pulsed-field gel electrophoresis pattern indistinguishable from that of case isolates. Apple juice produced on 7 October 1996 accounted for almost all of the cases, and the source of contamination was suspected to be incoming apples. Three lots of apples could explain contamination of the juice: Two lots originated from an orchard frequented by deer that were subsequently shown to carry E. coli O157:H7, and one lot contained decayed apples that had been waxed.

CONCLUSIONS - Standard procedures at a state-of-the-art plant that produced unpasteurized juices were inadequate to eliminate contamination with E. coli O157:H7.  This outbreak demonstrated that unpasteurized juices must be considered a potentially hazardous food and led to widespread changes in the fresh juice industry.

My connection, I represented most of the hemolytic uremic syndrome cases in the Jack in the Box E. coli Outbreak and the "Commercial" (a.k.a Odwalla) E. coli Outbreak.  Well, I wish Dr. Besser well and I hope I find my passport.

Cinco de Mayo - Lou Dobbs favorite Holiday? Foodborne Illness Outbreaks Linked to Mexican-Styled Restaurants and Products

My guess is that Cinco de Mayo is Lou Dobbs favorite holiday.  I know, he seems to make such a big deal about those damn "illegal immigrants," but he knows that you can count on one hand how many foodborne illness outbreaks have been caused by imported Mexican, or for that matter any imported foreign food product.  The bottom line is that US Corporations do a wonderful job of poisoning our own citizens. 

However, in the flavor of the day, here is a list of foodborne illness outbreaks linked to Mexican food - most which was prepared and served in the USA.

Multistate Outbreak of E. coli O157 Infections linked to Taco Bell - Eastcoast

This outbreak was clearly linked to Taco Bell restaurants in the northeastern United States. As of 12 PM (ET) December 14, 2006, Thursday, 71 persons with illness associated with the Taco Bell restaurant outbreak have been reported to CDC from 5 states: New Jersey (33), New York (22), Pennsylvania (13), Delaware (2), and South Carolina (1). States with Taco Bell restaurants where persons confirmed to have the outbreak strain have eaten are New Jersey, New York, Pennsylvania, and Delaware. (The patient from South Carolina ate at a Taco Bell restaurant in Pennsylvania). Other cases of illness are under investigation by state public health officials. Among these 71 ill persons, 53 (75%) were hospitalized and 8 (11%) developed a type of kidney failure called hemolytic-uremic syndrome (HUS). Illness onset dates have ranged from November 20 to December 6.  California Lettuce.

Habaneros E. coli Outbreak – Missouri

In late August of 2003, staff in the Communicable Disease (CD) section at the St. Clair County Health Department (SCCHD) conducted a foodborne outbreak investigation and found that of 64 persons, including seven employees, who had eaten at Habaneros between August 15, 2003 and September 5, 2003, thirty (47%) reported having diarrheal symptoms; ten sought medical care.  An extensive food consumption history was obtained from each person interviewed, but no specific food-item was statistically associated with illness.  Five individuals were laboratory-confirmed with E. coli O157:H7. All five ate at Habaneros on either August 23 or August 24.   Pulsed field gel electrophoresis (PFGE) analysis of the five isolates obtained from culture-confirmed patients revealed that all five had an indistinguishable PFGE pattern, indicating that they were infected with the same strain of E. coli O157:H7.  On September 18, IDPH received a report that E. coli O157:H7 had been cultured from a sample of pico de gallo obtained from Habaneros.

Taco John’s E. coli Outbreak – Iowa and Minnesota

In December 2006, Iowa and Minnesota health officials investigated an E. coli O157:H7 outbreak among patrons at Taco John’s restaurants in Ceder Falls, Iowa, and Albert Lea and Austin, Minnesota.  As of December 13, 2006, the Iowa Department of Health had confirmed that at least 50 Iowans had become ill with E. coli infections after eating at Taco John’s, and the Minnesota Department of Health had confirmed that at least 27 Minnesotans were part of the outbreak.  Lettuce was grown in California

Chi-Chi’s Hepatitis A Outbreak – Pennsylvania

In late October of 2003, Pennsylvania health officials learned of a potential hepatitis A outbreak from emergency room doctors treating patients in Beaver County.  The Beaver County Health Department (BCHD) and Pennsylvania Department of Health (PDOH) began investigating the apparent outbreak, and learned through interviews that all case patients had eaten at the Chi Chi’s restaurant at the Beaver Valley Mall in the weeks before becoming ill. PDOH, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), conducted an epidemiological study of the outbreak, and determined that green onions imported from Mexico were the source of the outbreak.  The FDA issued a statement dated December 9, 2003, affirming that this outbreak was associated with eating raw or undercooked green onions.

Ultimately, over 650 confirmed cases of hepatitis A, both primary and secondary, were linked to consumption of green onions at the Beaver Valley Mall Chi-Chi’s.  The victims included at least 13 employees of the restaurant, and numerous residents of six other states.  Four people died as a consequence of their hepatitis A illness.  In addition, more than 9,000 people who had eaten at the restaurant during the period of potential exposure, or who had been exposed to ill Chi-Chi’s customers, obtained immune globulin shots to prevent hepatitis A infection.

Chili’s Salmonella Outbreak – Illinois

In late June of 2003, the Lake County Health Department (LCHD) was contacted by health care providers who had treated patients for Salmonellosis, and customers who had experienced a diarrheal illness after eating at the Vernon Hills, Illinois, Chili’s Grill & Bar.  LCHD sent investigators to inspect the restaurant for food safety violations. During the inspection, investigators discovered:

- The restaurant’s dishwashing machine was broken and corroded; the tube that fed chlorine into the machine was plugged, preventing proper sanitization of dishes.  Employees told investigators that the machine had not worked properly for at least a week;
- Food was not stored at proper temperatures in the cooler;
- Three employees and a manager had called in sick that day with flu-like symptoms.

LCHD continued to receive reports of Salmonella infection from local hospitals and restaurant patrons throughout the next several days.  During the course of investigating the outbreak, investigators discovered that thirteen employees had been allowed to work despite suffering from diarrhea and other symptoms, and learned that Chili’s had operated despite having no water for part of one day, and no hot water for at least one full day.   Food safety regulations require that hot water be available at all times during a restaurant’s operation.

In mid-July, LCHD concluded its investigation, and reported that over 300 individuals had been sickened as a result of consuming contaminated food at a Chili’s.  Of those, 141 customers and 28 employees had tested positive for Salmonella, while 105 other infected individuals met the LCHD’s definition of a probable case.  LCHD issued a preliminary report that concluded the outbreak was caused by infected employees who contaminated food with Salmonella as a result of poor sanitary practices and improper food-handling.

Viva Cantaloupe Salmonella Outbreak – Nationwide

On May 25, 2001 the FDA issued a press release warning consumers that Viva brand imported cantaloupe had been identified as the source of a Salmonella poona outbreak.  FDA stated that the cantaloupe had been sold by S.P.R. De R.I. Legumbrera San Luis and S.P.R. De R.I. Los Arroyoas of Mexico and imported by Shipley Sales Service of Nogales, Arizona.  Illnesses associated with the consumption of the contaminated cantaloupe had been identified in Arizona, California, Connecticut, Georgia, Hawaii, Massachusetts, Minnesota, Missouri, New Mexico, Nevada, New York, Oregon, Tennessee, and Washington State.  The cantaloupe was sold in retail stores and restaurants and possibly served in health care facilities.  FDA detained all cantaloupe imported by Shipley Sales Service and took steps to prevent the importation of any additional contaminated cantaloupe.   FDA outbreak investigators determined that 50 residents of California (28), Washington (8), Nevada (7), Arizona (6), and Oregon (1) had become ill with a genetically indistinguishable strain of Salmonella poona during the outbreak.  Nine patients were hospitalized and two died.

Senor Felix 5-Layer Dip Shigella Outbreak - Western States

On January 5, 2000, Public Health – Seattle & King County issued a notice to Washington residents that three people had been confirmed ill with Shigella infections after eating five-layer dip manufactured by Senor Felix Gourmet Mexican Foods and sold under several brand names.   Two other cases were pending confirmation in Washington, and more illnesses had been reported in California and Oregon.  The Food and Drug Administration (FDA) issued a nationwide warning regarding the contaminated dip on January 27, 2000, and announced that 49 cases of Shigellosis associated with the consumption of Senor Felix dips had been reported in California, Oregon, and Washington; five patients had been hospitalized.  Health officials ultimately identified 406 people with Shigella infections who had eaten the dip in the week prior to illness.  Cases were reported in ten states. An environmental investigation of the processing facility revealed numerous problems with manufacturing practices and quality control at the Senor Felix facility.

Viva Mexico Shigella Outbreak – California

In October of 2000, the California Department of Health Services (CDHS) was notified that several Redwood City, California, residents had become ill with confirmed Shigella infections.   San Mateo County Communicable Disease Control staff conducted a case-control study, and learned that there was a statistically significant association between consuming the salsa prepared at Viva Mexico and illness. CDHS conducted an environmental assessment of the restaurant on October 24, noting multiple food code violations, and San Mateo County sanitarians closed the restaurant.  Violations cited included:

- No soap in the women’s restroom;
- No sanitizer on the premises;
- On site thermometer was reading temperatures 10°F off;
- Improper cooling of foods – meat, poultry, and beans – with core temperatures from 50-70°F after 18 hours of cooling;
- Cross contamination of foods – meat residue on knives used to cut produce.

When the outbreak investigation was complete, CDHS had identified 221 people who had eaten at Viva Mexico between October 19 and October 24 and had become ill with Shigella infections.   Seventy people were culture-confirmed with Shigella, and one person died as a result of her illness.

Settlements in E. coli O157:H7 Cases

On October 22, The General Communicable Disease Control Branch (GCDC) of North Carolina was contacted by a guest and family member of the bride to report an outbreak of gastroenteritis caused by E. coli O157:H7, associated with a catered wedding reception held in Raleigh on October 13, 2007. GCDC reported the call to Communicable Disease nurse staff at the Wake County Human Services Department (WCHS) and offered to assist with their investigation.

The wedding reception was held at the Exploris Museum in Raleigh and was catered by Triangle Catering. 110 wedding guests were invited to attend, and staff who worked the even were allowed to consume leftover food items.

27 people report a diarrheal illness with onset between October 13-24, 2007. Two people were hospitalized. One patient in New York reportedly has acute renal failure, and is considered an HUS case by the State of New York.  The State of North Carolina Health Department concluded that:

"It does seem more likely than not the outbreak occurred because of exposures to food items served at the wedding reception that were contaminated with E. coli O157:H7. "

All cases were recently settled.

Hepatitis A Lawsuits Settled

In late April 2008, San Diego County health officials announced that a number of Hepatitis A (HAV) infections had been traced to a Chipotle Grill restaurant in La Mesa, California, near San Diego. Officials advised customers who had eaten at the restaurant between March 1 and April 22 that they might be at risk for infection. As of early May, more than twenty people who ate at the La Mesa restaurant have tested positive for HAV infection. Several of those victims contacted Marler Clark for assistance with their cases.  All claims have been settled.

Hepatitis A is a food borne virus that can be passed by infected food handlers to consumers. The virus attacks the liver, and symptoms can include nausea, vomiting, abdominal cramps, dark urine, fever, chills, fatigue, body aches, loss of appetite, and later on, jaundice. In extreme cases, liver failure can result. The virus has a long incubation period, and symptoms may not appear for fifteen to fifty days.

"Market Withdraw" of Italian Alfalfa Seeds Distributed by Caudill Seed Company Linked to Salmonella Sprouts Outbreak

I think a "Market Withdraw" is like being "a little pregnant."  But, it is not a Recall - or, is it?

The FDA just reported that preliminary epidemiology regarding the ongoing outbreak of illness from Salmonella Saintpaul in people who had eaten alfalfa sprouts was shared with the supplier of the seeds associated with illness. Based on this information the seed supplier made the decision to voluntarily withdraw from the market all of the alfalfa seeds bearing six digit lot numbers that start with “032.”

All seeds involved in this market withdrawal came from Italy. The seeds are in 50-pound white bags that are either paper or woven from a synthetic material, and the lot numbers in question begin with “032,” followed by a hyphen and three more digits. The bags carry a computer-generated white or yellow label, on which is printed “Distributed by Caudill Seed Company., 1402 W. Main St., Louisville KY 40203” and the lot number.

FDA has no evidence that alfalfa seeds from other lots, or sprouts grown from them, are affected by this market withdrawal. Retailers, restaurateurs, and personnel at other food-service facilities should ask their suppliers to verify that the alfalfa sprouts or seeds being provided do not come from an affected lot before buying or serving them. Suppliers who can verify that their products were not sourced from the affected lots may wish to notify their customers; likewise, retailers, restaurateurs, and food-service facilities who have verified the sources of their alfalfa products may wish to notify their customers.

Seeds from the affected lots, lot numbers beginning with 032, and sprouts grown from them, should be safely discarded, as should other products that contain the sprouts, such as sprout blends. Growers who have used seeds from the potentially contaminated lots should clean all equipment and other surfaces that came into contact with them. They should also safely discard any water that came into contact with the sprouts, and disinfect receptacles or equipment that came into contact with the water.

We have already filed three lawsuits against the sprouters.  It looks like soon they will have company in the litigation.

Investigation of an Outbreak of Salmonella Saintpaul Infections Linked to Raw Alfalfa Sprouts - Whose Seeds are They? Why No Recall Of Seeds?

The CDC reports that since mid-March, 35 persons infected with the outbreak strain of Salmonella Saintpaul have been reported from 7 states. The number of ill persons identified in each state is as follows: Michigan (17), Minnesota (4), Ohio (3), Pennsylvania (6), South Dakota (2), Utah (1), and West Virginia (2). Cases are still being reported, and possible cases are in various stages of laboratory testing, so illnesses may be reported from other states. No deaths have been reported.  State and local authorities, CDC, and FDA have linked this outbreak to eating alfalfa sprouts. Most of those who became ill reported eating raw alfalfa sprouts. Some reported eating sprouts at restaurants; others purchased sprouts at the retail level.

The initial investigation has traced the contaminated raw alfalfa sprouts to multiple sprout growers in multiple states. This suggests a problem with the seeds used, as well as the possible failure of the sprout growers involved to appropriately and consistently follow the FDA Sprout Guidance issued in 1999.  The guidance recommends an effective seed disinfection treatment immediately before the start of sprouting (such as treating seeds in a 20,000 parts per million calcium hypochlorite solution with agitation for 15 minutes) and regularly testing the water used for every batch of sprouts for Salmonella and E coli O157:H7.

This outbreak appears to be an extension of an earlier outbreak in 2009. In February and March, an outbreak of Salmonella Saintpaul infections occurred in Nebraska, South Dakota, Iowa, Kansas, and Minnesota. This outbreak was linked to raw alfalfa sprouts produced at a single facility, and the outbreak strain was indistinguishable from that of the more recently reported cases. CDC is also currently working with public health officials in several states and FDA to investigate an outbreak of Listeria monocytogenes infections linked with eating alfalfa sprouts.

So, where did the seeds come from, and why not a recall of seeds?

E. coli O157:H7 Litigation Linked to Hamburger Settled

In June of 2007, United Food Group, LLC (UFG) recalled 5.7 million pounds of ground beef products after a joint investigation into an E. coli O157:H7 outbreak by Colorado and California health officials in conjunction with the Centers for Disease Control and Prevention (CDC) led to the conclusion that UFG ground beef was the source of the outbreak.  The California Department of Health Services, Colorado Department of Health, and CDC reported 14 illnesses associated with the outbreak: 6 in Arizona, 3 in California, 2 in Colorado, 1 in Idaho, 1 in Utah, and 1 in Wyoming.

Marler Clark filed suit against United Food Group (UFG) on June 14, 2007 on behalf of a four-year-old California child who became ill with E. coli O157:H7 and hemolytic uremic syndrome (HUS) after eating UFG ground beef. The firm represented several other families who were impacted by the UFG ground beef E. coli O157:H7 outbreak and recall, including three others who developed HUS.  In total, Marler Clark represented nine cases. To date, eight have been settled.

FDA Botulism Report - Castleberry's Canned Chili

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.   Report below (click to download):

The Last of the Salmonella Serotype I 4,5,12:i:-* Pot Pie Cases Settled

In 2007 Public health officials from several states collaborated to determine the source of the outbreak, and the Centers for Disease Control and Prevention (CDC) officially announced that a Salmonella serotype I 4,5,12:i:-* outbreak had been traced to the consumption of ConAgra pot pies on October 9th. At the time, ConAgra did not initiate a recall.

The CDC report summarized the results of the investigation, which determined that 401 cases of salmonellosis occurred in 41 states during 2007, with 32% of ill persons hospitalized. In October 2007 the illnesses were finally associated with consumption of Banquet® brand frozen, not-ready-to-eat pot pies. Further investigation determined that 77% of patients who ate these pies cooked them in microwave ovens and that consumer confusion regarding microwaving instructions might have resulted in a failure to cook the product properly.

Petting Zoos - Still Dangerous - E. coli O157:H7

I was reading the CDC’s MMWR article – “Outbreak of Shiga Toxin--Producing Escherichia coli O157 Infection Associated with a Day Camp Petting Zoo --- Pinellas County, Florida, May--June 2007” and it struck me how humans seem nearly incapable of learning for the past. We have been tracking this ongoing problem for years now and built www.fair-safety.com as a resource for the Fair and Petting Zoo Industry. But, they seem to be slow learners.

According to the CDC, during 1991--2005, the CDC received reports of 32 outbreaks of E. coli O157:H7 that were associated with animals in public settings. Among these, venues in certain outbreaks were not in compliance with NASPHV guidelines, with reported inadequate handwashing facilities, permitted consumption of food or drink in animal areas, unsupervised handwashing, and no signage. During 2006--2008, five E. coli O157:H7 outbreaks related to animal settings were reported (CDC, unpublished data, 2009). NASPHV guidelines include recommendations on handwashing, venue design, animal care and management, risk communication, and oversight needed for animals in public settings.

The article was reported by: KA Alelis, MPH, PE Borkowski, Pinellas County Health Dept; P Fiorella, PhD, J Nasir, J Middaugh, MD, C Blackmore, DVM, Florida Dept of Health. J Keen, DVM, US Dept of Agriculture and Univ of Nebraska. This report is based, in part, on contributions by C Minor, Florida Dept of Health; T Holt, DVM, W Jeter, DVM, J Crews, DVM, and J Carter, Florida Dept of Agriculture and Consumer Svcs.

References

1. CDC. Compendium of measures to prevent disease associated with animals in public settings, 2007: National Association of State Public Health Veterinarians, Inc. (NASPHV). MMWR 2007;56(No. RR-5).
2. Mead PS, Slutsker L, Dietz V, et al. Food-related illness and death in the United States. Emerg Infect Dis 1999;5:607--25.
3. Su C, Brandt LJ. Escherichia coli O157:H7 infection in humans. Ann Intern Med 1995;123:698--714.
4. Keen JE, Elder RO. Isolation of Shiga-toxigenic Escherichia coli O157 from the surfaces and the oral cavity of finished beef feedlot cattle. J Am Vet Med Assoc 2002;220:756--63.
5. CDC. Outbreaks of Escherichia coli O157:H7 associated with petting zoos---North Carolina, Florida, and Arizona, 2004 and 2005. MMWR 2005;54:1277--80.
6. Steinmuller N, Demma L, Bender JB, Eidson M, Angulo FJ. Outbreaks of enteric disease associated with animal contact: not just a foodborne problem anymore. Clin Infect Dis 2006;43:1596--602.
7. CDC. Outbreaks of Escherichia coli O157:H7 infections among children associated with farm visits---Pennsylvania and Washington, 2000. MMWR 2001;50:293--7.
8. Crump JA, Sulka AC, Langer AJ, et al. An outbreak of Escherichia coli O157:H7 infections among visitors to a dairy farm. N Engl J Med 2002;347:555--60.

We still have pending litigation against the State of North Carolina steming from a petting zoo E. coli O157:H7 outbreak in 2004 were several children suffered acute kidney failure caused by Hemolytic Uremic Syndrome.

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."

Salmonella Lawsuit to be Filed Amid Continuing Outbreak Linked to Sprouts

We will be filing yet another lawsuit stemming from a multi-state outbreak of Salmonella-tainted sprouts was filed today in the Tenth District Court for Sarpy County, Nebraska. Bellevue resident Daniel Krim, one of 121 people sickened in the February-March 2009 outbreak.

The lawsuit was filed against CW sprouts, the Nebraska firm whose Sunsprout brand of raw sprouts was distributed to retail customers, including grocery stores and restaurants. Also named in the lawsuit is John Doe Corporation, the yet-to-be identified company that cultivated and distributed the seeds used to grow the tainted sprouts.

Daniel Krim purchased a sandwich containing the defendant’s sprouts at a LaVista Jimmy John’s restaurant in February, and fell ill the next day with flu-like symptoms including fever, nausea, abdominal cramps, and diarrhea. His symptoms continued to worsen, causing him to seek emergency medical care. He was treated for dehydration and gave a stool sample that later revealed that he was infected with the outbreak strain of Salmonella saintpaul. Mr. Krim missed more than a week of work due to his illness, and lost over ten pounds.

The CDC has opened an investigation into a new Salmonella saintpaul outbreak tied to sprouts, which to date has sickened 35 people in six states: Michigan, Minnesota, Ohio, Pennsylvania, South Dakota, Utah, and West Virginia. According to preliminary testing, the new outbreak appears to be an extension of the February-March outbreak in Nebraska, Iowa, South Dakota, Minnesota, and Kansas that sickened Daniel Krim.

CDC - Investigation of an Outbreak of 35 Salmonella Saintpaul Infections Linked to Raw Alfalfa Sprouts in Michigan (17), Minnesota (4), Ohio (3), Pennsylvania (6), South Dakota (2), Utah (1) - Manufacturers, Suppliers, Restaurants, Grocery Stores Unnamed

CDC is collaborating with public health officials in many states and the United States Food and Drug Administration (FDA) to investigate a multistate outbreak of human infections due to Salmonella serotype Saintpaul.

Since mid-March, 35 persons infected with the outbreak strain of Salmonella Saintpaul have been reported from 7 states. The number of ill persons identified in each state is as follows: Michigan (17), Minnesota (4), Ohio (3), Pennsylvania (6), South Dakota (2), Utah (1), and West Virginia (2). Cases are still being reported, and possible cases are in various stages of laboratory testing, so illnesses may be reported from other states. No deaths have been reported

State and local authorities, CDC, and FDA have linked this outbreak to eating alfalfa sprouts. Most of those who became ill reported eating raw alfalfa sprouts. Some reported eating sprouts at restaurants; others purchased sprouts at the retail level.

The initial investigation has traced the contaminated raw alfalfa sprouts to multiple sprout growers in multiple states. This suggests a problem with the seeds used, as well as the possible failure of the sprout growers involved to appropriately and consistently follow the FDA Sprout Guidance issued in 1999 http://www.cfsan.fda.gov/~dms/sprougd1.html. The guidance recommends an effective seed disinfection treatment immediately before the start of sprouting (such as treating seeds in a 20,000 parts per million calcium hypochlorite solution with agitation for 15 minutes) and regularly testing the water used for every batch of sprouts for Salmonella and E coli O157:H7.

This outbreak appears to be an extension of an earlier outbreak in 2009. In February and March, an outbreak of Salmonella Saintpaul infections occurred in Nebraska, South Dakota, Iowa, Kansas, and Minnesota. This outbreak was linked to raw alfalfa sprouts produced at a single facility, and the outbreak strain was indistinguishable from that of the more recently reported cases. CDC is also currently working with public health officials in several states and FDA to investigate an outbreak of Listeria monocytogenes infections linked with eating alfalfa sprouts.

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12–72 hours after infection. Infection is usually diagnosed by culture of a stool sample. The illness usually lasts 4 to 7 days. Although most people recover without treatment, severe infections may occur. Infants, elderly persons, and those with impaired immune systems are more likely than others to develop severe illness. When severe infection occurs, Salmonella may spread from the intestines to the bloodstream and then to other body sites and can cause death unless the person is treated promptly with antibiotics.

Advice for consumers

* Do not eat raw alfalfa sprouts, including sprout blends containing alfalfa sprouts, until further notice. This warning is only for alfalfa sprouts, not other types of sprouts .
* Persons who think they may have become ill from eating raw alfalfa sprouts are advised to consult their health care providers.

REMINDER for high risk populations: CDC and FDA recommend at all times that persons at high risk for complications from Salmonella infection, such as the elderly, young children, and those with compromised immune systems, not eat raw sprouts. For such persons who continue to eat sprouts, FDA recommends cooking them (U.S. Food and Drug Administration, 2002 consumer advisory, available at http://www.cfsan.fda.gov/~lrd/tpsprout.html).

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.

DO NOT EAT SPROUTS - FDA Tells Consumers on a Sunday Afternoon - Michigan, Minnesota, Pennsylvania, South Dakota, Utah, and West Virginia Implicated

The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention announced today not to eat raw alfalfa sprouts, saying they may be contaminated with Salmonella.

The contamination appears to be in seeds so washing the sprouts may not help, the FDA said in a statement.  "Other types of sprouts have not been implicated at this time," the agency said.

"FDA will work with the alfalfa sprout industry to help identify which seeds and alfalfa sprouts are not connected with this contamination, so that this advisory can be changed as quickly as possible."  The FDA said 31 Salmonella Saintpaul infections have been seen in Michigan, Minnesota, Pennsylvania, South Dakota, Utah, and West Virginia.

"Some reported eating raw sprouts at restaurants; others reported purchasing the raw sprouts at the retail level," the FDA said.  "This outbreak appears to be an extension of an earlier outbreak in 2009. In February and March, an outbreak of Salmonella Saintpaul infections occurred in Nebraska, South Dakota, Iowa, Kansas, and Minnesota," the FDA added.

Thirty-Three Sprout Linked Outbreaks Since 1990 Sicked 2,166

Ben Chapman, over at Bites, published a very complete list of Sprout Outbreaks Since 1990.

Since 1990, raw or slightly cooked sprouts have caused an estimated 2,166 illnesses, through 33 outbreaks (actually - 37 outbreaks, 2,273 illnesses). The U.S. Food and Drug Administration estimates that sprout-link outbreaks account for 40 per cent of all food-borne illness associated with produce.

Year      Type      Pathogen      Cases      Location

Continue Reading...

The Fight for Safe Food - The Facts, Quotes and Opinions of 16 Years of Fighting for Consumers

As one reporter I spoke to last week noted:

The Facts:

The law firm of Marler and Clark has represented victims from every major food borne illness since 1993. Marler has fought for the rights of victims of food-borne illnesses for more than 16 years now and says in that time he has seen no laws tightened to protect consumers.

My Quotes:

Lawyer says Plainview plant may not be at fault

"What some people don’t understand is the ripple effect this kind of thing can cause," Marler said. "Some 50-60 people here lose their jobs, the corporation goes bankrupt, there are other companies that go bankrupt due to the cost of the product recall, more people lose their jobs . . . . You add it up and that is some major money being lost, not to mention the human cost of people getting sick and dying."

Peanut Victims' Lawyers Visit Blakely Plant

"It really is a failure of not only this company, but also of government oversight,” said Bill Marler. “It's a failure of the peanut association to pay attention to all of its members and a failure on the part of consumers to hold their government accountable."

"125 people are out of a job, that the peanut industry is losing half a billion dollars from just one company when the last time the FDA was here was in 2001. I think most tax payers would think spending more on the FDA could have saved a lot of problems, 9 people wouldn't have died, 700 people wouldn't have been sickened and 125 people wouldn't be out of a job," Marler says.

"It's interesting that the president seems to be interested, he talked about his daughter eating peanut butter and hopefully that will loosen up money."

My Opinion:

I was able to tour the Peanut Corporation of America plants in Blakely, Georgia and Plainview, Texas this week. I saw mice, cockroaches, and leaking roofs – all bad signs in a food production plant. But those weren’t the only bad signs. I also saw two small towns, already struggling in this economy, that have lost steady incomes for the more than 100 people who used to work at the plants; incomes their families – and the towns – depended on. I saw seemingly endless fields lying fallow that should be full of peanuts, crops that would have supported unknown numbers of farmers and other businesses all along the line of distribution, and the communities they live in.

It’s my job to focus on the people who were sickened in this outbreak – the 691 (confirmed) ill, the 160 hospitalized, and the nine families who lost loved ones. But the victims of this outbreak are everywhere. Certainly in these two towns, which have lost valuable jobs, perhaps forever. But with more than 4,800 products recalled, millions of dollars in costs all have the same ripple-out effect – the businesses suffer, then the employees suffer, then the communities suffer. We all feel the effects. And. It. Has. To. Stop.

It’s ridiculous to point at the Peanut Corporation of America and say, “it was all their fault”, and go back to business as usual. Oh, PCA carries plenty of blame; I’ll be the first to say. They ran a shoddy factory and made inexcusable decisions which caused incalculable loss and suffering. And they will pay for it. But they are not alone in this. Bad actors can only flourish in a broken system, where the loopholes are truck-sized and regulation thin. We went through this two years ago with the Peter Pan/Great Value peanut butter outbreak, and we all thought it would never happen again at that scale – and we were wrong. It will happen again - and again - unless industry, government, and business interests grow collective backbones and put an end to it.

Larry King and Stewart Parnell have what in common?

Press coverage for Georgia Trip:

Lawyer To Tour Georgia Plant Linked To Salmonella

News Now Update: Tour of Salmonella Tainted Peanut Plant

Peanut Victims' Lawyers Visit Blakely Plant

PCA plant conditions 'disturbing'

Attorney: Mice, leaky roof found at Georgia nut plant

I finally made it into the Blakely, Georgia Peanut Corporation of America plant.  Despite being scrubbed a bit in the last few months, we still found mice and cockroaches in the plant with several spots where the roof had been clearly leaking.  Really little question that any company purchasing product from this plant should have been on notice of the risks had they ever taken the time for a quick visit.  There was no lights nor air-conditioning in the plant (someone did not pay the bills I guess).  I did find the below letter sitting in the fax machine in the office.  Guess it came just before "the lights went out in Georgia."  As Mr. King's request I have taken the letter off line.

After being in Plainview and Blakely, where over 100 people lost their jobs, after seeing untilled peanut fields as I drove across South Georgia, I wonder were the hell the Peanut Association and the Georgia Department of Agriculture was in the years after the 2007 ConAgra Peter Pan Peanut Butter outbreak?  What more could have been done to prevent 700 illnessses and nine deaths?  What more could have been done to prevent over $1B in losses by business?  Perhaps Stewart Parnell woud have told Larry King?

Busy Day in the Salmonella Peanut World

90% of the peanut business is mental - the other half is hard work!

So, said the white board in the manager's office in the Plainview, Texas Peanut Corporation of America Plant that I visited today.

I guess that did not translate into dealing with leaking roofs, mice and cockroaches.

Plainview Texas - Former Home of Peanut Corporation of America Salmonella Plant

Well, made it from Seattle to Dallas to Lubbock to Plainview today. Had a great steak dinner at the “Rockin’ R Steak House.” They did not have a beer or wine list because they share a back door with their neighbor, the Baptist Church.  We parked across the street and had little fear of being hit by a car (or anything else) as we crossed the street.

According to Wikipedia, Plainview is located at 34°11′28″N 101°43′8″W / 34.19111°N 101.71889°W / 34.19111; -101.71889 (34.191204, -101.718806), a.k.a “out in the middle of nowhere.” From the 2000 census, there were 22,336 people, 7,626 households, and 5,666 families residing in the city. On February 11, 2009, the Texas Department of State Health Services ordered the cessation of operations and full recall of all products produced by a Plainview-based peanut processing facility owned by Peanut Corporation of America, following the discovery of "dead rodents, rodent excrement and bird feathers in the plant," and revelations that the plant had operated without state licensure or inspection. Notable natives:

* Lawrence McCutcheon, running back for the Los Angeles Rams from 1972-1979, the Denver Broncos & Seattle Seahawks in 1980 and the Buffalo Bills in 1981, was born in Plainview and played football for the Plainview Bulldogs.
* Singer, actor, and sausage entrepreneur Jimmy Dean, known for his sketches with Jim Henson's Muppet Rowlf the Dog, was born in Plainview.
* James H. Clark, technology entrepreneur and founder of Netscape and other companies, was born in Plainview.
* Dave Williamson, drummer for Scurge Records artist The Lifeless Design, is from Plainview.
* The general dentist Felix Conkling Crawford (1938-2007) practiced in Plainview and was a leading figure in both the Texas Dental Association and the American Dental Association. He was also a lobbyist for the ADA.
* Lindy Williams, the lead singer of Boxing Edna and owner of RaceDayOutfitters.com, is from Plainview.
* Horse trainer Carl Nafzger, who has won the Kentucky Derby twice, in 1990 with Unbridled and in 2007 with Street Sense, was born in Plainview. He also won the 1990 Breeder's Cup Classic with Unbridled.
* Former Hale County Judge Bill Hollars, sometimes called "Hang 'em High" Hollars.

Off to see the Peanut Corporation of America plant in the morning.

Marler Clark Files Peanut Butter Salmonella Lawsuit For Family of Minnesota Man - Korean War Veteran Felled by Contaminated Peanut Butter

Clifford Tousignant, father, grandfather and decorated veteran of the Korean War, died in January, 2009, after eating Salmonella-contaminated peanut butter served in the nursing home where he lived in Brainard, MN. His family is filing suit against Kanan Enterprises, the makers of King Nut peanut butter. The complaint was filed Monday in US District Court, District of Minnesota.

“The tragedy of a lost family member is the worst and clearest example of why we need to reform our food safety system,” said Bill Marler, the family’s attorney. “This family lost precious years with their patriarch, because tainted food was shipped to our most vulnerable populations: the elderly, the sick, and children.”

King Nut peanut butter was distributed in 5-pound containers to nursing homes, schools, and hospitals. King Nut used peanut products manufactured by Peanut Corporation of America, whose Salmonella-contaminated products sickened almost seven hundred people and caused the deaths of nine, including Mr. Tousignant. Containers of King Nut tested positive for the strain of Salmonella associated with the nationwide outbreak.

Clifford Tousignant (video link) fell ill in late December 2008, after eating King Nut peanut butter served at the Woodland Good Samaritan Village nursing home. He had profuse diarrhea, which caused him to be hospitalized on New Year’s Eve. He remained in the hospital until January 4, 2009, and while there, tested positive for Salmonella. He returned to the nursing home, but continued to suffer diarrhea and had difficulty eating. He was rushed back to the hospital on January 11, but passed away on January 12 from sepsis following his Salmonella infection.

Marler Clark represents more than eighty victims of the Peanut Corporation of America Salmonella outbreak. The firm also represented the majority of victims of the ConAgra (Peter Pan/Great Value) peanut butter outbreak of 2006-2007.

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. 

Raw Milk Outbreaks - 2009 Update

Thanks to my friends at Kansas State - click below:

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. 

 

Raw Milk, Campylobacter jejuni, President Roosevelt and Guillain-Barré Syndrome - Six Degrees of Separation?

I spent part of the day working on the sad case of a Crescent City, California woman, Mrs. Tardiff, who contracted Campylobacter jejuni from consuming raw milk purchased at Alexandre Family EcoDairy Farms.  The farms stopped the sale of raw milk.  The Del Norte County Department of Public Health eventually linked at least 16 people who contracted Campylobacter jejuni.  Mrs. Tardiff suffered Guillain-Barré (ghee-yan bah-ray) syndrome (GBS) and remained in the hospital in intensive care, partially paralyzed (actually on a ventilator), for several months.  She is still partially paralyzed and is now undergoing intensive rehabilitation.

GBS is a disorder in which the body’s immune system attacks part of the peripheral nervous system. The peripheral nervous system includes the cranial nerves (except the optic [eye] nerve), the spinal nerves, and the autonomic nervous system that governs involuntary actions.  The central nervous system is the spinal cord and brain. GBS often occurs a few days or weeks after a person has had symptoms of a respiratory or gastrointestinal viral or bacterial infection; in fact, two-thirds of affected individuals have had a preceding infection.  Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, and Mycoplasma pneumoniae are commonly identified antecedent pathogens.

Interestingly, a friend suggested an article that GBS might well have been the cause of President Franklin Delano Roosevelt’s paralysis (no indication raw milk was involved).  Here is the abstract from Goldman AS, Schmalstieg EJ, Freeman DH Jr, Goldman DA, Schmalstieg FC Jr., J Med Biogr. 2003 Nov; 11(4): 232-40.  What was the cause of Franklin Delano Roosevelt's paralytic illness?

In 1921, when he was 39 years of age, Franklin Delano Roosevelt contracted an illness characterized by: fever; protracted symmetric, ascending paralysis; facial paralysis; bladder and bowel dysfunction; numbness; and dysaesthesia.  The symptoms gradually resolved except for paralysis of the lower extremities.  The diagnosis at the onset of the illness and thereafter was paralytic poliomyelitis.  Yet his age and many features of the illness are more consistent with a diagnosis of Guillain-Barré syndrome, an autoimmune polyneuritis.  The likelihoods (posterior probabilities) of poliomyelitis and Guillain-Barré syndrome were investigated by Bayesian analysis.  Posterior probabilities were calculated by multiplying the prior probability (disease incidence in Roosevelt's age group) by the symptom probability (likelihood of a symptom occurring in a disease).  Six of eight posterior probabilities strongly favored Guillain-Barré syndrome.

Got Milk?  Raw?

Great Email to Get on Easter Sunday - Little Brother Peanut Vents

So, I get home from visiting my parents for Easter and I get this email from hugh.parnell@yahoo.com. The email came from Lynchburg Virginia - home of Falwell Ministries, Liberty University, Stewart Parnell and the Peanut Corporation of America:

You have got to be a money crazy son of a bitch, with a big mouth. People like you arn't (sic) interested in the problem. You are only trying to feather your own nest. I hope that some day that I can meet you. You have to be a real ass hole.... Hugh Parnell

I “googled” Hugh Parnell. My guess is this nice email came from Hugh Parnell Jr. (Stewart’s little brother). He was quoted in the Washington Post at the time that his brother’s business was linked to 700 illnesses and nine deaths:

Hugh Parnell Jr. said he has not worked for PCA for 10 years but continues to do business with the company as a peanut broker. He defended his brother as someone who "would never try to hurt anybody."

"It'd be like General Motors selling a car with no brakes," he said. "How are you going to benefit from that? You'd just hurt your company."

"He didn't want this," said Hugh Parnell Jr. "It's a nightmare."

A few weeks ago, I got an email from Hugh’s and Stewart’s mother. I posted her emails here – “It is good to be hated by some people.”  Seems like a lovely family.  Perhaps little brother should read the emails that the FBI seized in their ongoing criminal investigation of big brother.

Well, off to hunt Easter Eggs in the rain and snow.

Off to Texas and Georgia in a Week to Tour the Peanut Corporation of America Salmonella Manufacturing Plants

Georgia

Texas

Peanut Corporation of America (PCA) - The Ultimate Humiliation - "None of its Salmonella is in My Product."

The picture speaks for itself.  I am not sure I ever recall a case where a product specifically said that it did not contain another company's product.  A friend did just send me the following photo stemming from the 2006 spinach E. coli outbreak:

With all The Raw Milk Recalls and Outbreaks Lately, I Really Need to Update My Charts

Prompted by a post by the "Raw Milk Apologist," The Complete Patient - "When It Comes to Discussing Raw Milk Safety, It Helps to Appreciate the Behind-the-Scenes Agendas at Hand," I felt the need to give a bit of a counter-point to "the raw milk kills all ills" propaganda the spews from his keyboard.  Here are some hard facts - and recalls and illnesses related to raw milk:

Campylobacter Recall, California (Organic Pastures)

Campylobacter Outbreak, Colorado (Investigation ongoing)

Campylobacter Outbreak, Ferndale, Washington

Campylobacter Recall, Pennsylvania (Dean Farms)

Campylobacter Recall, Pennsylvania (Headricks dairy)

Listeria Outbreak, Washington

My friends at Barfblog (aptly named) produced this list of Raw Milk Outbreaks and Recalls - hopefully the above updates it.

The Oklahoma State Department of Health (OSDH) Issues Final Report on E. coli 0111 Outbreak Linked to Food Served at Country Cottage Restaurant in Locust Grove

Outbreak Statistics At a Glance

Source of Outbreak: Country Cottage Restaurant, Locust Grove, OK

Outbreak Organism: E. coli 0111:NM

Vehicle of Contamination: Unknown

Method of Spread: Foodborne transmission

Confirmed Outbreak Period: Aug. 15-24, 2008

Cases: 341

Hospitalizations: 70

Deaths: 1

The Oklahoma State Department of Health (OSDH) released its final report today on the investigation of the largest E. coli O111 outbreak ever documented in the United States. The outbreak, which occurred in late August 2008 in northeastern Oklahoma, sickened 341 people and resulted in one death.

The report detailed the agency’s extensive epidemiological investigation into the outbreak that included laboratory testing, personal interviews, and an in-depth environmental investigation. While the source of the outbreak – the Country Cottage restaurant in Locust Grove, OK, – was quickly identified, the vehicle for contamination was never found.

Laboratory analyses of specimens provided by those who became sick allowed the OSDH and the federal Centers for Disease Control and Prevention (CDC) to pinpoint E. coli 0111 as the bacterial organism responsible for persons’ illnesses. However, microbiological testing of food products and food preparation and serving surfaces in the restaurant, as well as testing symptomatic restaurant employees, samples from a private water well located on the property, water filters, and the Locust Grove municipal water supply, found no E. coli 0111. The OSDH released multiple situational updates during the investigation that reported no E. coli 0111 had been identified in its extensive testing process. Because the disease-causing organism was not found, the OSDH was unable to eliminate from consideration any of the potential vehicles for transmission of the bacteria into the restaurant, including well water. Even so, analysis of data collected during the investigation suggests there was ongoing foodborne transmission of E. coli O111 to restaurant customers from Aug. 15-24, 2008.

“What is important to remember is that when responding to an infectious disease outbreak, our primary objective is to rapidly identify the source of the infection to contain the outbreak and prevent any further spread,” said State Epidemiologist Dr. Kristy Bradley. “Within 48 hours of being notified of increased cases of persons with bloody diarrhea being admitted to Tulsa area hospitals, we identified the Country Cottagerestaurant as the common source of transmission. The restaurant closed voluntarily and the outbreak was contained.”

According to the CDC, only 10 outbreaks involving E. coli 0111 had been reported nationally prior to Oklahoma’s outbreak. The bacteria are from the family of Shiga toxin-producing E. coli bacteria, or STEC. Persons who ingest STEC may have a diarrheal illness ranging from very mild and non-bloody to severe with very bloody stools. The infectious dose is very small and STEC are often spread by ingesting food items contaminated with fecal matter that are not subsequently cooked. Person-to-person transmission, direct animal contact, and waterborne transmission, either from contaminated drinking water or recreational water, are other exposure routes.

State health officials said as of March 16, 2009, OSDH personnel have reported 6,481 hours of total accrued time and effort dedicated to the E. coli O111 outbreak investigation. This does not take into account the time and effort provided by Tulsa Health Department personnel, student volunteers, or medical staff at various hospitals and clinics who provided surveillance information.

WOW! Peanut Corporation of America Texas Plant Fined $14.6 Million Due to Salmonella Contamination

According to press reports, the Texas Department of State Health Services has levied a $14.6 million fine against the Texas plant owned by a peanut company at the heart of a national salmonella outbreak.  The Texas Department of State Health Services said Thursday it was fining Plainview Peanut Co. LLC over alleged violations that include unsanitary conditions, product contamination, illnesses linked to peanuts from the plant and operating without a food manufacturers' license.  The Plainview plant has been closed since Feb. 9. The plant's owner, Peanut Corp. of America, is blamed for an outbreak that has sickened nearly 700 people and is said to be the cause of at least nine deaths.

I look forward to seeing the insides of both the Texas and Georgia plants in the coming weeks.

Salmonella Peanuts - FDA Serves Warrant for Inspection of Westco Fruit and Nuts Inc. - Is this the future if Recalls are Not Voluntary?

For the last few weeks the FDA and Westco Fruit and Nuts Inc. (Westco/Westcott), have been "negotiating" on whether a recall would be issued of Westco/Westcott peanut products.  Today the FDA dropped the hammer down.  From the FDA Website:

At the request of the U.S. Food and Drug Administration, U.S. Marshals today executed an inspection warrant at Westco Fruit and Nuts Inc. (Westco/Westcott), an Irvington, N.J.-based company. Westco/Westcott did not provide access to distribution documents and declined to recall products after an FDA request. Regulated companies are required by law to grant FDA entry for inspection, as well as provide access to distribution records. The FDA does not have authority to compel companies to recall food products, such as peanuts.  The company, which produces and distributes peanuts and peanut products, received peanuts and peanut product from the Peanut Corporation of America (PCA), a Georgia company that recalled products in January due to concerns of Salmonella contamination.  Despite PCA's effort to remove the affected product from the market and FDA's intervention, Westco/Westcott has refused to recall its products.

"FDA's enforcement action against Westco Fruit and Nuts is an appropriate step toward removing potentially harmful products from the marketplace, especially when, as in this case, a company is unwilling to share information FDA needs to ensure food safety," said Michael Chappell, the FDA's acting associate commissioner for regulatory affairs. "The FDA uses all appropriate legal means necessary to obtain information and fully investigate firms or individuals who put the health of consumers at risk."  On March 23, 2009, the FDA formally requested Westco/Westcott to initiate a recall of all of its products containing peanuts from PCA because such products may be contaminated with Salmonella. On March 26, 2009, the FDA also issued a formal notice to Westco/Westcott requesting access to certain records concerning the distribution of PCA peanut containing products. The company declined both requests.

Investigations by the FDA and the Centers for Disease Control and Prevention identified products from PCA's Blakely, Ga., facility as a source of the current Salmonella Typhimurium outbreak. These efforts led to PCA's recall of peanuts and peanut-derived products.  Between Nov. 19, 2008, and Dec. 30, 2008, Westco/Westcott received three shipments of Oil Roasted Salted Redskin Jumbo Peanuts from PCA's Georgia facility.  Westco/Westcott sold these peanuts in various size/packaging configurations and also used them as an ingredient in a variety of mixed nut products and trail mix produced between Nov. 19, 2008, and early February 2009.  On Feb. 9, 2009, New Jersey officials executed an embargo action at Westco/Westcott's distribution facility to prevent the company from further distributing potentially contaminated peanuts or peanut-derived products in the company's inventory.

Last week ABC reported:

A federal official said Moradi [Westco/Westcott] "ran away and hid" when government inspectors showed up at his plant. Moradi acknowledged hiding from FDA inspectors but said it was because they had repeatedly visited him and staked out his plant, and he was frightened.

"I was intimidated," Moradi said. "I was scared of them."

Moradi described Westco as "a tiny little business" with annual sales of a little more than $1 million.

"These people are basically doing it to cover their a**. FDA is doing this to cover their a**," he said. "For seven years, they did not do inspections [at the PCA plant in Georgia] and now at the cost of a tiny little small business they are coming, and they are forcing me and they have no proof. "

The real question is whether if FDA had recall authority if companies would fight the recall and drag out the battle like Westco/Westcott has done?  The reality is that the "voluntary" recall system has worked quite well over the years.  There have been only a handful of folks like Westco/Westcott who refuse to put public health before profits.

Second Lawsuit Filed in Sprouts Salmonella Outbreak

A second lawsuit was filed today against CW Sprouts, the company tied to the recent Salmonella outbreak associated with alfalfa sprouts. The suit, which was filed in the Tenth District Court of Nebraska, Douglas County, is on behalf of Omaha resident Amanda Monastersky. The Ausman Law Firm, an Omaha area firm, is also representing the plaintiff.

Ms. Monastersky severe gastrointestinal illness lasted for several weeks. Ultimately, health officials determined that Ms. Monastersky was one of more than 120 people infected with Salmonella Saintpaul in Nebraska, Iowa, South Dakota, and Kansas in February and March of 2009. Health officials linked the outbreak to sprouts produced by CW Sprouts and distributed under the name SunSprouts. CW Sprouts has recalled the implicated product.

Settlements in Hemolytic Uremic Syndrome (HUS) Cases Linked to 2007 E. coli O157:H7 Outbreak

In the first major hamburger recall since 2002, on June 9, 2007, United Food Group voluntarily expanded its June 3 and 6 recalls to include a total of approximately 5.7 million pounds of both fresh and frozen ground beef products produced between April 6 and April 20 because it was contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service announced.

An investigation carried out by the California Department of Health Services and the Colorado Department of Health, in coordination with the Centers for Disease Control and Prevention, preceded the recall of June 3. Illnesses occurred in Arizona (6), California (3), Colorado (2), Idaho (1), Utah (1) and Wyoming (1). Illness onset dates ranged between April 25 and May 18.

Four of those illnesses were children who developed Hemolytic Uremic Syndrome (HUS). Their stories, like the stories of other victims of HUS linked to hamburger consumption, began with that all-American past time of eating a hamburger then lead to an acute illness where death was a real possibility. Now, it is a lifetime of risk of kidney failure.

We have been able to settle two of the four HUS cases.  It will be interesting to see what juries say about the other two cases.

Salmonella Pistachios, Pepper, Peanuts, Sprouts, Eggs and Mayonnaise in Last Three Months

As a friend recently said: "You could almost make a sandwich."  A nasty one at that.

Outbreak of E. coli O157 Associated with Raw Milk Consumption purchased at Whole Foods - Connecticut, 2008

For those thinking about drinking raw milk or having your children drink it - read these pages (click below to download PDF):

First Lawsuit in Salmonella-Tainted Sprout Outbreak Filed by Marler Clark

The first lawsuit (complaint) stemming from a multi-state outbreak of Salmonella Saintpaul was filed today against CW sprouts in the Tenth District Court of Nebraska, Douglas County. The complaint was filed on behalf of Omaha resident Stephen Beumler, who is represented by Seattle foodborne illness law firm Marler Clark and by the Ausman Law firm of Omaha.

Stephen Beumler purchased a sandwich from the Council Bluffs Jimmy John’s restaurant on March 1, 2009. The sandwich contained alfalfa sprouts provided to the restaurant by CW Sprouts. Mr. Beumler began to feel ill that night, with nausea, cramping, and diarrhea. Believing he had the flu, Mr. Beumler rested and drank fluids, but his symptoms worsened to include muscle aches and intense fatigue. On Tuesday March 3 he was unable to go to work and his wife—a nurse—began to suspect that the illness was not flu. Mr. Beumler visited his doctor on Wednesday, and the samples he gave that day confirmed that he had been infected with the outbreak strain of Salmonella Saintpaul. Mr. Beumler required an additional five days of recovery before he was able to return to work.

The outbreak began in February 2009, as cases of Salmonella Saintpaul began to appear in Nebraska. By March, cases with the same genetic fingerprint were identified in South Dakota, Iowa, Colorado, and Kansas. By interviewing the more than 120 people sickened in the outbreak, health authorities were able to link the illnesses to sprouts produced by CW Sprouts and distributed to retail outlets such as grocery stores and restaurants under the brand name Sunsprouts.

The warm, moist environment used to grow sprouts is ideal for bacteria growth, and sprouts can play host to a number of different strains of Salmonella, as well as E. coli O157:H7. Bacteria on or in sprouts is difficult to detect, and most people do not wash or cook sprouts, which might kill or remove infectious bacteria.

In 1999, the FDA announced new guidelines for the growing of sprouts, including using calcium hypochlorite treatment on seeds. This treatment exposes seeds to high levels of chlorine, killing bacteria, but leaving seeds unharmed. Since its introduction, manufacturers who consistently use this seed disinfectant treatment have not been implicated in foodborne illness outbreaks; however not all producers have adopted the technique.

FDA - Peanut Butter and other Peanut Containing Products Recall List - Now 3868 products on list

I had not checked the list of recalled peanut butter containing products for a few day and now it is 3868 different products manufactured by over 200 different companies.  All caused by one company that produced about 2.5% of peanut butter products in the USA.  The CDC has not updated its site and still has 691 ill with 9 deaths as its official count.  According to the FDA, the information is current as of 12 PM March 28, 2009
.  Click on picture to go to FDA's searchable site.


Peanut Butter Provocateur

Seattle Metropolitan Magazine writer Jill Watanabe and I spoke a few weeks ago.  Here is her take on the Peanut Butter Mess:

Peanut butter, meet food fighter. Seattle attorney Bill Marler just dipped his knife into your jar and, well, your salmonella secret is over.

Marler broke the story on Peanut Corporation of America’s not-so-smooth business practices in late January. On his blog, he posted a leaked copy of an FDA report confirming that the peanut processor had knowingly shipped salmonella-tainted products from its plant in Blakely, Georgia. The media quickly went nuts spreading the news, and calls from salmonella-sickened victims began rolling in. Nearly four months later, Marler’s firm is in contact with more than 50 potential clients seeking lawsuits against PCA and its CEO, Stewart Parnell.

Marler’s work doesn’t stop—nor did it start—at Big Peanut. He’s already the nation’s foremost food borne-illness litigator. His vast enemy list includes Chili’s, Dole, KFC, Sizzler, and Wendy’s, and he’s won more than $300 million for his food-poisoned clients. Now Marler’s career may take another path, as he awaits a decision on his bid to become under secretary of the FDA’s Food Safety and Inspection Service agency. “After Obama got elected, I wrote an open letter [to the new under secretary of FSIS] and posted it on my blog,” he explains. “Then I started getting calls from people in and out of government, saying ‘You have to fill out these forms.’” But Marler knows the government might be wary of “letting a trial lawyer in,” and hopes the sentiment doesn’t stick to the roof of the selection committee’s mouth.

Blakely Going "Nuts" - Perhaps Not "Nuts" - Just No Damn Brains

I was reading the Albany, Georgia Herald when I came across Jennifer Maddox Park’s piece “Blakely Going Nuts.” At first I thought the town was so damn sorry and embarrassed for being the location of the peanut butter plant that has sickened nearly 700, hospitalized 150 and killed 9, that they were going to have some type of memorial to the victims – perhaps raise money for medical bills and lost wages? But, alas, not a damn chance. Remember, many who lived in the Blakely knew that the Peanut Corporation of America plant was rat and bird infested and some even knew that it was shipping Salmonella-tainted product.

Here, according to my new friend Jennifer, is what is actually happening – “Included in the event will be live music, free peanut snacks including grilled peanut butter and jelly sandwiches, an obstacle course, educational exhibits and a peanut recipe contest.” And there are the lovely, caring quotes by politicians and folks from the Chamber of Commerce:

“In the midst of negative exposure surrounding the recent salmonella outbreak, representatives from the peanut industry are out to educate the public on the positive impact they can have.”

“We are enthused at how the peanut industry has come together. It’s going to be a great day.”

“We are sending the message that we are proactive in saving the industry. At a time like this, it is important to have an umbrella to bring everyone in the industry together. It’s about community support; it’s just going to be a good day.”

“The peanut industry is a critical component of the economy not only in Blakely but also across our entire state. The festival this weekend will provide some momentum to keep the industry, which supports nearly 50,000 jobs in our state, vibrant and thriving.”

“I think it’s a wonderful thing that the peanut industry has come together,” he said. “The festival is an expression of the fact we know the peanut industry is a great industry. One bad actor is not going to kill it; we are going to prosper. (The event) goes right along with the optimistic spirit over the past couple of years.”

“It shows how strong the community is here. It should be big; hopefully it will be a good day. This can be a fun day given economic times.”

“Our purpose is to show peanut butter is trustworthy. We don’t want to focus on the bad; we want to focus on the good.”

Perhaps I should show up with nine crosses? Or, a bag of hospital bills? Yes, I understand the need to make a buck, but for god’s sake, wait at least until the bodies are cold and the survivor's bills are paid.  Pathetic.

The Salmonella Outbreak: The Role of Industry in Protecting the Nation's Food Supply

I was stunned by the testimony but sickened by the exhibits watching the video of the Subcommittee on Oversight and Investigations hearing titled, “The Salmonella Outbreak: The Role of Industry in Protecting the Nation’s Food Supply” held at 10:00 a.m. this morning, Thursday, March 19, 2009, in 2123 Rayburn House Office Building. This hearing examined the actions and obligations of manufacturers and retailers that purchased tainted peanut products from the Peanut Corporation of America (PCA).  All the video, statements and exhibits can be found here.  Here are some of the more shocking revelations.  Email from Stewart Parnell upon learning of the outbreak:

And, the factory residents:

Energy and Commerce Subcommittee Hearing on "The Salmonella Outbreak: The Role of Industry in Protecting the Nation's Food Supply"

The Subcommittee on Oversight and Investigations will hold a hearing titled, “The Salmonella Outbreak: The Role of Industry in Protecting the Nation’s Food Supply” at 10:00 a.m. Eastern on Thursday, March 19, 2009, in 2123 Rayburn House Office Building. This hearing will examine the actions and obligations of manufacturers and retailers that purchased tainted peanut products from the Peanut Corporation of America (PCA).  Do not forget to tune into the Podcast.

Witness List

* Martin Kanan, President and Chief Executive Officer, King Nut Company
* David Mackay, Chief Executive Officer, Kellogg Company
* Heather Isely, Co-Owner, Vitamin Cottage Natural Food Markets, Inc.

Interestingly, Kellogg Co. chief executive David Mackay provided his prepared remarks to the AP before the hearing.  In it he wants food safety placed under a new leader in the Health and Human Services Department. He also called for new requirements that all food companies have written safety plans, annual federal inspections of facilities that make high-risk foods, and other reforms.

Mackay's strong endorsement of major changes could boost President Barack Obama's efforts to overhaul the system. Last week Obama launched a special review of food safety programs, which are split among several departments and agencies, and rely in some cases on decades-old laws. Critics say more funding is needed for inspections and basic research.

"The recent outbreak illustrated that the U.S. food safety system must be strengthened," Mackay said in prepared remarks for a hearing Thursday. "We believe the key is to focus on prevention, so that potential sources of contamination are identified and properly addressed before they become actual food safety problems."

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:

Can I Sue Miley Cyrus If Her Snacks Make Me Sick?

I actually spoke to "E Online" today regarding the recall of Hannah Montana granola bars.  "E" wanted to know if someone could sue Miley Cyrus (aka Hannah Montana).  As I said:

Do you live in China? That would help, says attorney Bill Marler, who represents victims in food-poisoning cases.

"China has recently passed a law saying someone who becomes sickened from a product can sue someone who puts their name on the product or is part of the campaign for the product," Marler tells me.

But in the U.S., Marler says, we have no such laws. "Your only recourse is against the people who made the granola bar," Marler says, "and the company in Georgia that produced the peanuts."

691 Salmonella Typhimurium Peanut Product Illnesses in 46 States

The CDC reports today that 691 persons infected with the outbreak strain of Salmonella Typhimurium have been reported from 46 states. The number of ill persons identified in each state is as follows: Alabama (2), Arizona (14), Arkansas (6), California (76), Colorado (18), Connecticut (11), Florida (1), Georgia (6), Hawaii (6), Idaho (17), Illinois (11), Indiana (10), Iowa (3), Kansas (2), Kentucky (3), Louisiana (1), Maine (5), Maryland (10), Massachusetts (48), Michigan (38), Minnesota (43), Missouri (15), Mississippi (7), Montana (2), Nebraska (1), New Hampshire (13), New Jersey (24), New York (34), Nevada (7), North Carolina (6), North Dakota (17), Ohio (100), Oklahoma (4), Oregon (13), Pennsylvania (19), Rhode Island (5), South Dakota (4), Tennessee (14), Texas (10), Utah (7), Vermont (4), Virginia (21), Washington (24), West Virginia (2), Wisconsin (5), and Wyoming (2). Additionally, one ill person was reported from Canada.  Interesting - No cases in Alaska, South Carolina, Delaware or New Mexico.

Among the persons with confirmed, reported dates available, illnesses began between September 1, 2008 and February 24, 2009. Patients range in age from <1 to 98 years. The median age of patients is 16 years which means that half of ill persons are younger than 16 years. 21% are age <5 years, 17% are >59 years. 48% of patients are female. Among persons with available information, 23% reported being hospitalized. Infection may have contributed to nine deaths: Idaho (1), Minnesota (3), North Carolina (1), Ohio (2), and Virginia (2).

The FDA lists at least 3488 different peanut-containing products being recalled.

This Post is for Dads - Like Barack Obama and Tom Vilsack

So, I know how (imagine how) the President spent his day – security briefings and then trying to fix the banking, health care, automobile, employment and environment messes.  Other Dads?  Doing their day jobs – blue collar, white collar, service or manufacturing – all putting in a day’s work.  Me, I spent the day – again away from my kids – this time with yet another family of a client needlessly, horribly, and for their child, her life devastated because she ate a hamburger contaminated with E. coli O157:H7.  A product inspected by the USDA/FSIS.

Then I got this test message from my thirteen-year-old daughter:

“Hey Dad, have you gotten any Hannah Montana Granola Bar Clients?”

Seriously, the recent peanut butter Salmonella outbreak has touched Hannah Montana peanut granola bars for God’s sake.

You must admit, I am unique. How many fathers – including the President or the Secretary of Agriculture – sadly get a message like that?

So, the details: The U.S. Food and Drug Administration (FDA) has updated its list of recalled products.

Disney Hannah Montana - Peanut Chocolate Granola Bar
Boxes of 6 or 18 bars, 22 g each - 0 53847 20587 9 * - 0 53847 24451 9 * - 0 53847 20610 4 * - 1H001 through 3H365 - 1J001 through 3J365 - 1K001 through 3K029.

Sorry Hannah. However, you should be thankful you do not live in China. In one of its recent regulations, individuals who recommend food in advertisements are legally liable for damages if the product is later found to be unsafe. Celebrities are widely believed to be directly targeted by the provision.