Marler Blog - Providing commentary on food poisoning outbreaks & litigation

Or, 33, if you are going to count miscarriages - all included in the 146 the CDC counted.  People should not die from eating cantaloupe.

Sharon Kay Jones, 62, of Castle Rock, died on January 29, 2012 from complications of breast cancer and Listeria. The oldest of 6 children, she was born May 18, 1949 in Denver, CO to Elwood V. and Maxine R. (Provenzano) Johnson. She graduated Aurora Central High School in 1967 and married David A. Jones on November 8, 1969. They have one son, WB “Dub” Jones.

Sharon and family moved to Castle Rock in 1976 where she began working for the Douglas County Treasurer’s Office. She remained there 35 years, 28 as the Chief Deputy Treasurer, and was elected Douglas County Treasurer in 2002. She retired from her second term of elected office in January 2011 and took up a part time job at the Sheriff’s office.

Sharon quickly became known for her friendly, gracious, and warm personality, earning her the unofficial title of County Hugger. She was so good in this role that she enticed hugs from the most irascible personalities, a quality earning her hundreds of friends by the time she retired. Her generous nature and conscientious leadership made her a favorite elected official among her employees, peers, fellow elected officials, state government, and treasurers’ offices across Colorado.

An adventurous soul, Sharon took numerous camping trips and road trips across the United States. She developed a love for hot air balloons and determined that her second career would be as a hot air balloon chaser. Sharon also became a “motorcycle mama”, graduating at the top of her ABATE riding class and then taking cross-country trips on a bigger bike than many men ride. It was a source of great amusement for her son and daughter-in-law to witness public reaction to this short, round, matronly woman putting on her leathers, hopping aboard a large motorcycle and roaring off.

Sharon was known for wearing an angel pin every day, never realizing that many considered her their own personal angel. Before Sharon left this Earth, she composed this message for her friends: “I‘ve been blessed my whole life with so many people that care about and love me. I’ve truly enjoyed spending time with each and every one of you. I appreciate the support you’ve given me and my son and daughter-in-law during these last hard months. Thank you so much.”

She is survived by her son and daughter-in-law WB and Melody Jones, spouse David Jones, five siblings Larry Johnson, Kim Mandos, Janice Cook, Woody Johnson, and Craig Johnson, many nieces and nephews, and an enormous extended family.

Viewing Wednesday, February 1, 2012 at St. Francis of Assisi Roman Catholic Church in Castle Rock, 11:00 a.m. to 8:00 p.m. Funeral services Thursday, February 2 at the church beginning 1:00 p.m., reception following immediately. Interment held at a later date for family and close personal friends.

Non tax-deductible donations may be made in her memory to Womenade of Castle Rock, c/o Donna Scott, 2705 Castle Crest Drive, Castle Rock, CO 80104.

Hannaford’s was implicated in a 19-victim, 7-state outbreak of Salmonella Typhimurium outbreak that was likely the result of “high-risk practices;” so says the USDA’s FSIS.  Hannaford’s stores did not keep grinding records that showed the source of all the trimmings that they used when they ground their beef for resale, and the result is, will we never know the identity of the beef company that sold Hannaford’s the antibiotic-resistant Salmonella-contaminated beef. 

Leslie Bridgers at the Portland Press Herald wrote today:

Officials from the USDA's Food Safety and Inspection Service said Friday that they plan to close the investigation within a week.

The officials said Hannaford's "high-risk practices" for grinding beef were the barrier in their investigation, although those practices did not break any regulatory requirements and are probably used by other meat retailers.

Daniel Engeljohn, assistant administrator of the Food Safety and Inspection Service, said it was not always clear from Hannaford's records when the stores were grinding the trimmings. Investigators found that Hannaford would grind trimmings and tube meat without cleaning the equipment in between, he said, raising the possibility of cross-contamination.

Engeljohn noted that there is a lower sanitary standard for the cuts of meat that are used for trimmings than there is for the ground beef that comes in tubes.

There is no requirement that equipment be cleaned between grinds of meat from different companies, Engeljohn said, but the USDA has told retailers for several years that it recommends it, along with more complete information in grinding logs.

Hannaford's "high-risk practices" aside, it is past time for FSIS to mandate better “regulator requirements” so the source of tainted beef can be found.  As importantly, FSIS consideration must be given to the use of trim (a beef product most likely to be contaminated) as a source of fill for ground beef production.

So, how useful is this information?  This is from an actual case:

At first glance, it appeared that the E. coli O157:H7 infections experienced by two young girls whose parents retained us in 2010 were simply part of a small cluster of cases occurring in two California Counties. Both girls developed hemolytic uremic syndrome (HUS).

As part of the routine case investigation, County A public health investigators learned that in October 2008 the two young girls had eaten at an unnamed restaurant located in County A. In neighboring County B, a man with an E. coli O157:H7 infection reported eating at the same unnamed restaurant located in County B in October 2008.

Genetic testing by pulsed field gel electrophoresis (PFGE) showed that the two young girls and the County B man were sickened with an indistinguishable strain of E. coli O157:H7, designated by PFGE pattern numbers EXHX01.4626/EXHA26.2558. The strain was so unusual that it triggered a cluster investigation. Federal officials at the Centers for Disease Control and Prevention (CDC) assigned Cluster Identification Number 08100NEXH-1mlc to the investigation.

Through OutbreakNet, a national outbreak response unit staffed at the CDC, a fourth case-patient in the cluster was identified - a resident of South Dakota. This patient confirmed the association between illness and eating the same unnamed restaurant in County A in October 2008 while on vacation in County A. The two young girls and the South Dakota woman had symptom onsets within five days of eating at the unnamed restaurant.

Within a matter of days the outbreak grew beyond the confines of California County A and B and South Dakota. Public health laboratories continued to report PFGE matches of the unnamed restaurant strain of E. coli O157:H7. Case-patients were also identified in Illinois, Florida, New Jersey, and Ohio. These individuals reported other unnamed restaurant exposures - none ate at the unnamed California restaurants. This led investigators to suspect a contaminated ingredient was in the marketplace.

Canadian investigators also identified an E. coli O157:H7 outbreak involving 55 persons with at least 13 ill case patients culturing positive for the outbreak strain. The majority of cases were linked to one of two unnamed restaurants. Illnesses occurred in October 2008. Canadian investigators conducted a case-control study, and lettuce was statistically associated with illness. Product traceback showed that two restaurants tied to the outbreak shared a common produce supplier and that an unnamed brand of lettuce was the only lettuce in common to all Canadian restaurants with outbreak cases. The same lettuce was supplied to the unnamed restaurants in California Counties A and B.

Pretty useful information to consumers?

So, to those who thought that the only reason that I was complaining about the CDC's and public healths' non-disclosure of the name of "Mexican-style fast food restaurant chain, Restaurant Chain A" linked to  Outbreak 1 and 2 and more recent Outbreak 3, think again.  I can figure (with the help of Marler Clark lawyers and staff) these outbreaks out, and whom to sue, without the help of my friends at the CDC or local and state health departments.

So, seriously, will someone explain to the public the purpose of announcing a outbreak (the true case study I mention above was never even announced by public health), but not naming the restaurant?

And, for those who think that the CDC's nondiclosure of "Mexican-style fast food restaurant chain, Restaurant Chain A" is that they are bending over to big business, think again, they do it to small - even "raw milk dairy A" - busineses.  See, "Escherichia coli 0157:H7 Infections in Children Associated with Raw Milk and Raw Colostrum From Cows --- California, 2006."

Seriously, which “Mexican-style fast food restaurant chain, Restaurant Chain A” has restaurants in all these states?

As the CDC reported as of January 19, 2012, a total of 68 individuals infected with the outbreak strain of Salmonella Enteritidis have been reported from 10 states. The number of ill persons identified in each state with the outbreak strain was as follows: Texas (43), Oklahoma (16), Kansas (2), Iowa (1), Michigan (1), Missouri (1), Nebraska (1), New Mexico (1), Ohio (1), and Tennessee (1).  Also according to the CDC, collaborative investigative efforts of state, local, and federal public health agencies indicated that eating food from a “Mexican-style fast food restaurant chain, Restaurant Chain A,” was associated with some illnesses.  The mystery restaurant was not named.

Eerily familiar were two Salmonella Outbreaks reported by the CDC on August 1, 2010.  One, a total of 75 individuals infected with a matching strain of Salmonella Hartford were reported from 15 states since April 1, 2010. The number of ill people identified in each state with this strain is as follows: CO (1), FL (1), GA (1), IL (5), IN (11), KY (23), MA (2), MI (3), MT (1), NC (1), NH (1), NY (1), OH (19), PA (1), and WI (4).  The other a total of 80 individuals infected with a matching strain of Salmonella Baildon were reported from 15 states since May 1, 2010. The number of ill people identified in each state with this strain is as follows: CT (1), GA (1), IA (1), IL (20), IN (4), KY (5), MA (1), MI (4), MN (5), NJ (6), NY (2), OH (6), OR (1), WA (1) and WI (22).  According to the CDC, an analysis indicated that eating at a “Mexican-style fast food Restaurant Chain A” was associated with illness.  Within a few days, Taco Bell, a “Mexican-style fast food restaurant” was identified by Food Safety News and others.

So, how long until the “Mexican-style fast food restaurant” is identified?  And, more importantly, why was it not disclosed in the first place?

Dear Texas, Oklahoma, Kansas, Iowa, Michigan, Missouri, Nebraska, New Mexico, Ohio, and Tennessee Departments of Health:

With respect to the recent CDC report involving a Salmonella Outbreak linked to “Mexican-style fast food restaurant chain, Restaurant Chain A” (http://www.cdc.gov/salmonella/restaurant-enteriditis/011912/index.html), can you tell me the identity of the restaurant?  If not, can you explain the Department of Public Health’s rationale for non-disclosure?

I wonder if public health officials would have identified the actual restaurant (McDonalds) in the below 1982 E. coli O157:H7 outbreak if the 1993 Jack in the Box E. coli O157:H7 outbreak would have happened?

Hemorrhagic colitis associated with a rare Escherichia coli serotype.  N Engl J Med. 1983 Mar 24; 308 (12): 681-5. Riley LW, Remis RS, Helgerson SD, McGee HB, Wells JG, Davis BR, Hebert RJ, Olcott ES, Johnson LM, Hargrett NT, Blake PA, Cohen ML.

We investigated two outbreaks of an unusual gastrointestinal illness that affected at least 47 people in Oregon and Michigan in February through March and May through June 1982. The illness was characterized by severe crampy abdominal pain, initially watery diarrhea followed by grossly bloody diarrhea, and little or no fever. It was associated with eating at restaurants belonging to the same fast-food restaurant chain in Oregon (P less than 0.005) and Michigan (P = 0.0005) and with eating any of three sandwiches containing three ingredients in common (beef patty, rehydrated onions, and pickles). Stool cultures did not yield previously recognized pathogens. However, a rare Escherichia coli serotype, O157:H7, that was not invasive or toxigenic by standard tests was isolated from 9 of 12 stools collected within four days of onset of illness in both outbreaks combined, and from a beef patty from a suspected lot of meat in Michigan. The only known previous isolation of this serotype was from a sporadic case of hemorrhagic colitis in 1975. This report describes a clinically distinctive gastrointestinal illness associated with E. coli O157:H7, apparently transmitted by undercooked meat.

Thanks to my good friend David Gumpert over at the Complete Patient for providing me the California Department of Public Health letter to Organic Pastures outlining the likely cause of the 2011 E. coli outbreak linked to Organic Pastures products.  According to David, here are the highlights:

* Out of "a significant number of samples" of manure, water, soil, and swabs of various contact surfaces, ten "from the calf area were positive for E. coli O157:H7 (1 swab, 3 soil, 1 water, and 5 fecal)..."

* Two of the samples--one manure and one water-- "had a PFGE (pulse-field gel electrophoresis) pattern indistinguishable from the outbreak strain."

* The CDPH doesn't speculate about how the E. coli O157:H7 got into the milk from the calf area, except to say, "the fact that E. coli O157:H7 identical to the outbreak strain was recovered from OPDC environment supports the probability that the OPDC raw milk the case patients consumed was similarly contaminated leading to their illnesses."

* The CDPH also "isolated shiga-toxin producing pathogens" from packaged OPDC colostrum collected at the dairy. "The pathogen is very rare and we were unable to serotype it at our laboratory. The isolate has been sent to the U.S. Centers for Disease Control and Prevention for further evaluation." According to the CDC, E. coli O157: H7 is the most common producing E. coli (STEC). Other such E. coli "are not nearly as well understood, partly because outbreaks due to them are rarely identified. As a whole, the non-O157 serogroup is less likely to cause severe illness than E. coli O157; however, some non-O157 STEC serogroups can cause the most severe manifestations of STEC illness."

* The CDPH also said it found "sanitary deficiencies" in the OPDC milk bottling room, milk storage rooms, labeling room, kefir room, and common areas. These included chipping paint, mold-mildew, and rodent droppings.