According to heath officials in the US and Canada, the 31 cases share a related whole genome sequencing (WGS), but US investigators “did not identify a specific food item, grocery store, food processor, or restaurant chain as the source of infections.”  However, Canadian investigators found their cases to be linked to “Rosemount brand cooked diced chicken meat.”  What is perplexing is that our FSIS reported, “that multiple samples of product produced by Tip Top Poultry, Inc. confirmed positive for the presence of Listeria monocytogenes after being tested in Canada.”  

No connection between the 24 sick, with 2 deaths in the US and Tip Top Poultry?  Really?

CDC, several states, and federal partners investigated a multistate outbreak of Listeria monocytogenes infections. The outbreak investigation is over and did not identify a specific food item, grocery store, food processor, or restaurant chain as the source of infections.

Public health investigators used the PulseNet system to identify illnesses that may have been part of this outbreak. PulseNet is the national subtyping network of public health and food regulatory agency laboratories coordinated by CDC. DNA fingerprinting is performed on Listeria bacteria isolated from ill people by using a standardized laboratory and data analysis method called whole genome sequencing (WGS). CDC PulseNet manages a national database of these sequences that are used to identify possible outbreaks. WGS gives investigators detailed information about the bacteria causing illness. In this investigation, WGS showed that bacteria isolated from ill people were closely related genetically. This means that people in this outbreak were more likely to share a common source of infection.

As of November 7, 2019, a total of 24 people infected with the outbreak strain of Listeria monocytogenes were reported from 13 states.

Listeria specimens were collected from ill people from July 20, 2017, to August 1, 2019. Ill people ranged in age from 35 to 92 years, with a median age of 72. Sixty-three percent of ill people were female. Of 23 ill people with information available, 22 hospitalizations were reported. Two deaths were reported. No additional ill people were reported after the initial investigation notice on August 23, 2019.

State and local public health officials interviewed ill people to ask about what they ate and other exposures they had before their illness started. CDC analyzed the interview data but did not identify a common food or exposure among ill people.

In Canada, a total, there were seven confirmed cases of Listeria monocytogenes illness in three provinces: British Columbia (1), Manitoba (1) and Ontario (5). Individuals became sick between November 2017 and June 2019. Six individuals were hospitalized. Individuals who became ill were between 51 and 97 years of age. The majority of cases (86%) were female.

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Based on the investigation findings, Rosemount brand cooked diced chicken was identified as a likely source of the outbreak. Rosemount cooked diced chicken was supplied to institutions (including cafeterias, hospitals and nursing homes) where many of the individuals who became sick resided, or visited, before becoming ill.

On August 18, 2019 the Canadian Food Inspection Agency issued a food recall warning for Rosemount brand cooked diced chicken meat 13mm – ½” (#16305), packdate – 01/21/2019. During the food safety investigation, the CFIA identified additional affected products and updated food recall warnings have been issued. For additional details on all recalled product names and lot codes, please consult CFIA’s website.

The collaborative outbreak investigation was initiated because of an increase of Listeria illnesses that were reported in June 2019. Through the use of a laboratory method called whole genome sequencing, two Listeria illnesses from November 2017 were identified to have the same genetic strain as the illnesses that occurred between April and June 2019. Although the outbreak investigation has been closed, the Public Health Agency of Canada will continue to monitor this event as part of their ongoing surveillance activities for food-related illnesses in Canada.

The U.S. CDC is investigating an outbreak of Listeria illnesses occurring in several states. The type of Listeria identified in the U.S. is closely related genetically (by whole genome sequencing) to the Listeria that was making people sick in Canada.

According to FSIS, Tip Top Poultry, Inc, a Rockmart, Ga., establishment, is recalling an undetermined amount of ready-to-eat (RTE) poultry products that may be adulterated with Listeria monocytogenes, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

The frozen cooked, diced or shredded, RTE chicken products were produced between January 21, 2019 and September 24, 2019. The products subject to recall can be found in this spreadsheet.

The products subject to recall bear establishment number “Est. P-17453” inside the USDA mark of inspection. These items were shipped to institutions nationwide in the United States and Canada (see the recalled products distributed in Canada).

The problem was discovered when the firm notified FSIS that multiple samples of product produced by Tip Top Poultry, Inc. confirmed positive for the presence of Listeria monocytogenes after being tested in Canada. The firm decided to recall all cooked, diced or shredded, RTE chicken products produced from January 21, 2019 through September 24, 2019 with product codes ranging from 10000 to 19999 and 70000 to 79999. Tip Top expanded the dates and the scope of the recall out of an abundance of caution.

According to press reports – The trial of Roger Stone got off to an unusual start Tuesday as jury selection proceedings were punctuated by his exit from the court due to what he said was food poisoning.

The unique scene at a federal courthouse in Washington accentuated what had already been a chaotic pretrial process as investigators trying to determine whether the longtime Donald Trump associate and political provocateur obtained information from WikiLeaks first had to interview — and in some cases do legal battle with — a range of eccentric witnesses. Stone has said he’s done nothing wrong.

The high-profile trial could bring out new details about what former special counsel Robert Mueller found regarding the Trump campaign and Russian interference in the 2016 election. But on Tuesday, it was Stone’s apparent illness that defined the first day in court.

“Mr. Stone is not feeling well,” defense attorney Robert Buschel told Judge Amy Berman Jackson at the bench shortly after the potential jurors were sworn in, according to transcripts of sidebar discussions with the judge.

On two occasions, Stone was allowed to leave the courtroom to use the restroom. The judge made him aware they could postpone the proceedings, since he had a right to be in court and face his potential jurors.

“I’m not going to order him to waive his constitutional rights, but we cannot spend a whole day doing what we should be able to do in a short period of time,” Jackson said, according to the transcript. “So, let him go, let him come back, and then we’re going to bring in the next juror.”

At one point the judge even offered anti-diarrheal medication to the defendant.

“I have Imodium in my chambers,” she said.

Eight out of ten hospitalized with one death.

On November 1, 2019, the CDC announced that along with public health and regulatory officials and the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS), they are investigating a multistate outbreak of Salmonella Dublin linked to ground beef.

Although laboratory tests have shown ground beef to be the likely cause, they have not yet identified the common supplier of the ground beef.  Several different types and brands of ground beef were consumed and purchased at a variety of locations.

Illnesses began on dates ranging from August 8, 2019, to September 22, 2019.  Currently there are 10 confirmed Salmonella Dublin cases reported in six different states.  Eight people have been hospitalized, with one death in California related to this outbreak.  The CDC reports that the illnesses have resulted in more severe symptoms than usually experienced with Salmonella Dublin.

Most of the victims ate the contaminated ground beef at home.  Laboratory testing confirmed the same strain of Salmonella Dublin in repackaged ground beef that had been eaten in an ill person’s home in California.  The outbreak strain of Salmonella Dublin was found in six samples of raw beef products collected from slaughter and processing facilities.

Symptoms of Salmonella Dublin include diarrhea, fever, and stomach cramps 12 to 72 hours after exposure.  The illness usually lasts 4 to 7 days, with most people recovering without medical treatment.  In some cases, the illness can become severe as bloodstream infections spread to other places in the body which often require hospitalization.  Vulnerable populations include children younger than 5 years and adults 65 and older.

The CDC is continuing to investigate this outbreak and will update the public if more information becomes available.

Being in the “food industry” for the last 26 years has given me a lot of insight into the good and the bad of how our food is produced.  Late last week when I stumbled upon yet another E. coli outbreak linked to leafy greens – specifically romaine – that had been hidden from public view, I was more disgusted that surprised.

Why keep from the public that 23 people were sickened and 11 hospitalized from once again consuming romaine lettuce grown on the central coast of California?  Although the consuming public was kept in the dark, it is without question that government, industry and academia knew that the outbreak happened, but they all chose to hide it until late this evening – so much for “transparency” and so much for “food safety culture.”

We will not have a safe food supply when facts are hidden from consumers. We will not have a safe food supply until there really is honesty and transparency by those in government, industry (growers, shippers, processors and retailers – grocery stores and restaurants) and academia charged with consumer food safety.

I call bullshit on the FDA, CDC and Health Departments of Arizona, California, Florida, Georgia, Illinois, Maryland, North Carolina, Nevada, New York, Oregon, Pennsylvania and South Carolina for hiding vital information from the public.  And, those in industry (growers, shippers, processors and retailers – grocery stores and restaurants) and academia, shame on you.

From the FDA this evening:

Today, the U.S. Food and Drug Administration is sharing news of a recent E. coli O157:H7 outbreak, involving 23 illnesses, that was likely associated with romaine lettuce. No deaths were reported. The active investigation has reached its end and the outbreak appears to be over. The FDA and the U.S. Centers for Disease Control did not identify actionable information for consumers during this investigation. Additionally, when romaine lettuce was identified as the likely source of the outbreak, the available data at the time indicated that the outbreak was not ongoing and romaine lettuce eaten by sick people was past its shelf life and no longer available for sale. The FDA is communicating details about the outbreak at this time to help ensure full awareness by the public and to highlight the ongoing importance of industry actions to help ensure the safety of leafy greens. Federal health officials do not believe there is a current or ongoing risk to public health.

CDC notified the FDA of this illness cluster in mid-September 2019 and the agency promptly initiated a traceback investigation. The FDA, CDC, along with state and local partners, investigated the illnesses associated with the outbreak. A total of 23 people infected with the outbreak strain of E. coli O157:H7 were reported from 12 states: Arizona (3), California (8), Florida (1), Georgia (1), Illinois (2), Maryland (1), North Carolina (1), Nevada (1), New York (1), Oregon (1), Pennsylvania (2) and South Carolina (1). Eleven people were hospitalized and no deaths were reported. Illnesses started on dates ranging from July 12, 2019 to Sept. 8, 2019. No illnesses were reported after CDC began investigating the outbreak on Sept. 17, 2019.

Investigators were sent to visit farms located in California’s central coast region which were identified through the traceback investigation. They collected and tested many environmental samples, and the outbreak strain was not identified. While romaine lettuce is the likely cause of the outbreak, the investigation did not identify a common source or point where contamination occurred. Since the outbreak strain was not detected in samples collected from farms during the traceback investigation, and there have been no new cases since Sept. 8, 2019, the outbreak appears to be over.

The FDA remains committed to improving the safety of leafy greens and traceability from farm to fork.

Again, bullshit!

I got “Georgia on my mind.” My heartfelt thanks to the North Georgia Health Department.

Hepatitis A is a vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus (HAV). It is usually transmitted person-to-person through food or objects contaminated by fecal material. Symptoms of hepatitis A can appear abruptly and can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, diarrhea, clay-colored stools, joint pain and jaundice (yellowing of the skin and eyes).

Due to an increase in reported cases of hepatitis A in eastern Alabama, southeastern Tennessee and northwest Georgia, and to prevent the spread of hepatitis A, the North Georgia Health District is conducting a vaccination campaign among our populations who are at greatest risk for becoming infected with hepatitis A, including persons incarcerated in jails, homeless persons, illicit drug users, and men who have sex with men; and we urge food service workers to get vaccinated, as well.

North Georgia Health District county public health departments are providing hepatitis A vaccinations for *free at Health Departments in Cherokee, Fannin, Gilmer, Murray, Pickens or Whitfield County, especially for the above people who are at greatest risk and for food service workers. Just click on the county name where you live in North Georgia and link to that county health department web page for contact information.

*Clients will not be charged a fee  for the hepatitis A vaccine; however, if acceptable health insurance or Medicare is available, these plans will be billed. If no health coverage is available, the vaccine will still be provided to the client at no cost.

Here is the latest from the CDC on the ongoing outbreak:

For the hundreds sickened the end is little comfort.

According to Spanish health official illness have reached 204 with at least three deaths.  In Andalusia, in southern Spain has reported the bulk of the cases with 197, with most of the cases in this community reported from Seville (162).

Of the patients confirmed in Andalusia, 58 percent presented symptoms compatible with acute gastroenteritis, 47% presented with fever, 10% (19) developed meningeal forms and four patients had sepsis.

Three fatalities have been reported to date–two people over 70 and a person over 90 years old.

4 laboratory confirmed cases have been registered (1 in Aragón, 1 in Castilla y León, 1 in Extremadura and 1 pregnant woman of 8 weeks in Madrid who lost the baby) and 3 cases confirmed by epidemiological link (1 in Extremadura and 2 in Aragon).

In addition, 66 probable cases and 58 suspects have been reported in Aragón, Asturias, Canary Islands, Castile and León, Castilla La Mancha, Catalonia, Community Valenciana, Extremadura, Madrid and Melilla.

A UK citizen identified in France is suspected to be associated with the same outbreak.

According to one press report, one New Zealand woman who was on a trip to Europe lost the child she was carrying at 26 weeks. 

The implicated food source is roasted pork meat, commercialized under the brand ‘La Mechá’, produced by a company in Seville, Spain. The company has recalled all products manufactured since May 2019 and discontinued production.

The manager of the company Magrudis – the source of the outbreak – and one of his sons are still in custody as their role in the case is investigated. 

Listeria bacteria was found in machinery used at its plant in Sevilla. Inspectors also found licensing irregularities. 

According to the NICD: “There is no evidence of an outbreak of listeriosis.”

The number of cases reported since the official end of the 2017/2018 listeriosis outbreak is well within (and in fact, below) the expected range for sporadic disease. Furthermore, there have been no unusual trends in the epidemiological patterns of disease, or in the whole genome sequencing analysis of isolates from patients; such data are analysed on an ongoing basis in order to detect possible clusters or outbreaks.

Listeria monocytogenes is ubiquitous in the environment, so it is likely that accidental contamination of food occurs fairly frequently, and that consumption of contaminated food may lead to listeriosis particularly in vulnerable people at high risk for disease.

Worldwide, most listeriosis cases are sporadic (i.e. isolated cases that are not linked to an outbreak, occurring predominantly in persons at high risk for disease), but occasional outbreaks do occur.

The population incidence of sporadic listeriosis ranges from 2 to 5 cases per 1 million population in the US, Europe, and Australia, where listeriosis has been under routine surveillance for many years and robust data is available.

With that in mind, at our current population size of 58.8 million, we would expect 117 to 294 sporadic cases in South Africa per year. Data for South Africa from 2013 show that prior to the 2017/2018 listeriosis outbreak, 55 to 113 cases per year were reported (see Figure below).

For the 12 months following the official end of the 2017/2018 outbreak (3 September 2018 – 18 September 2019), a total of 87 laboratory-confirmed listeriosis were reported. This is below the expected range. Outcome data is currently available for 77% (67/87) of cases, of which 31% (21/67) died. This is not unexpected, because listeriosis is a severe disease that targets vulnerable people at high risk and typically has a fatality rate of 20-30%.

According to press reports, recent numbers from the Washington Department of Health show the state’s hepatitis A outbreak continues to grow. The statewide total, as of Thursday, showed 72 confirmed cases since January 1. Of those cases, almost three dozen have led to hospitalization. On Monday, King County Public Health confirmed six new cases since an outbreak was declared in late July, bringing the county’s total to 24 for the year.

Hepatitis A is a contagious liver infection caused by a virus. Symptoms can range from none at all to liver failure and even death. Doctors say it most often gets into the body after someone touches an infected surface or does not wash their hands after using the bathroom. Washington’s cases align with a national trend tracked by the CDC.

Back in July, health officials announced cases in four counties: King, Snohomish, Spokane and Pend Oreille. At last update, Spokane County had 33 confirmed cases for the year.

Public Health says many cases are found among people experiencing homelessness, without steady access to sanitation or hygienic facilities, and among frequent drug users. The county has allotted close to $400,000 to provide hepatitis A vaccines to those living on the street, with clinics scheduled for most days until December.

“Hepatitis A can be serious and is very contagious from person to son,” said Dr. Jeff Duchin, Health Officer for King County Public Health.

“Vaccination is the best way to protect yourself and prevent the spread of hepatitis A to others.”

Public Health says other major cities have spent millions responding to larger outbreaks and the goal here is to be proactive.