July 2007

As the recall that has not been a recall winds on, more cases of botulism, or suspected cases are showing up.

More suspected botulism cases probed

State health officials are investigating a third suspected case of botulism that an Indiana resident may have contracted by eating one of the products included in a recent canned meat recall.

The person ate one of the products on Sunday and became ill, although officials will not know whether it is botulism until test results return in a few days, said Lynae Granzow, an epidemiologist with the Indiana Department of Health. Granzow said today she was not sure which of the recalled products the patient might have eaten.

“Even though this recall has been out and we keep asking the media and the public to communicate the message, persons still are unaware of it,” she said. “Make sure this is absolutely not on your shelves.”

So far, four confirmed cases of botulism have been reported — two from Indiana and two from Texas. All four people consumed Hot Dog Chili Sauce Original, a product made by Castleberry’s. But health officials in other states, including Hawaii and California, are also investigating possible cases.

Hawaii botulism test results awaited

A state Department of Health official yesterday discounted a second reported case of botulism on Maui because the symptoms “didn’t meet the criteria” for the foodborne illness.

Department spokeswoman Janice Okubo said the man who became ill, Wailuku attorney Keith Regan, was not hospitalized after going to the Maui Memorial Medical Center emergency room on Friday, and that no testing was ordered to determine if he had eaten food containing the botulinum toxin, which affects the nervous system and can cause paralysis and death.

Because no testing was done, Regan said, he doesn’t know if he had botulism or not. “I’m not sure. I just know I didn’t feel right, and when I heard about the other guy, it made me think about what I had been eating,” he said. Like Stockton, Regan said he was unaware that Cattle Drive brand chili was included in the recall, since the notices mentioned Castleberry’s, a name unfamiliar to most consumers.

This week’s Morbidity and Mortality Weekly Report (MMWR), a publication put out by the CDC, contains an update on the current investigation into the botulism outbreak that was traced to consumption of Castleberry’s chili products. 

Botulism Associated with Commercially Canned Chili Sauce — Texas and Indiana, July 2007

On July 7 and July 11, 2007, public health officials in Texas and Indiana, respectively, reported to CDC four suspected cases of foodborne botulism, two in each state. Investigations conducted by state and local health departments revealed that all four patients had eaten brands of Castleberry’s hot dog chili sauce before illness began. Botulinum toxin type A was detected in the serum of one Indiana patient and in a leftover chili mixture obtained from his home. CDC informed the Food and Drug Administration (FDA) of the apparent link between illness and consumption of the chili sauce. On July 18, FDA issued a consumer advisory, and the manufacturer, Castleberry’s Food Company (Augusta, Georgia), subsequently recalled the implicated brand and several other products produced in the same set of retorts (commercial-scale pressure cookers for processing canned foods) at the same canning facility. Examination of the canning facility in Georgia during the outbreak investigation had identified deficiencies in the canning process. On July 19, the U.S. Department of Agriculture Food Safety and Inspection Service (FSIS) issued a press release that announced a recall of chili and certain meat products from the Castleberry canning facility and provided recommendations to consumers. That recall was expanded on July 21 to include additional canned products. A fifth case of botulism potentially linked to one of the recalled products is under investigation in California. This report describes the ongoing investigation by members of OutbreakNet* and others and the measures undertaken to control the outbreak, which is the first outbreak of foodborne botulism in the United States associated with a commercial canning facility in approximately 30 years.

We have been investigating several potential cases of botulism after receiving calls and emails from around the country over the last several days.  Given the widespread reach of the potentially contaminated product, and how poor the recall has been done, the fact the the number of ill has been rising is not surprising.  Confirmed cases so far (in addition to this Hawaii case) are two each from Texas and Indiana and one each from California and Georgia.

The Associated Press reported today some good news:

A Maui man who was hospitalized after eating a can of chili that was recently recalled because of potential botulism contamination has been released. Jon Stockton, 33, of Hana, was discharged in stable and improved condition Saturday morning, a hospital supervisor said. Stockton had been hospitalized Thursday with muscle weakness and paralysis in his face after eating Cattle Drive brand chili, which is manufactured by Castleberry’s Food Co. of Augusta, Ga., and was part of a voluntary recall.

“My face started feeling like it had a Novocain shot in it, all numb,” Stockton said. “When it started, my eyes were twitching, like I couldn’t control them. then my tongue went numb. And then my chin yesterday, and today, my throat is feeling kind of dry.”

Botulism is a muscle-paralyzing disease caused by the Clostridium botulinum bacteria.

Food and Drug Administration investigators believe Castleberry’s failed to properly cook some or all of more than 90 potentially contaminated products, including chili sauces and dog food. The bacteria thrive in oxygen-free and moist environments like those of sealed cans.

I just landed at the Hawaii airport on my way to Australia and I see the following headline:

Botulism suspected in ailing Maui man

Hawaii health officials are investigating the case of a Maui man who might have contracted botulism from a recalled canned food product.

On Tuesday, Jonathan Stockton of Maui ate a can of Cattle Drive brand chili, one of the recalled products. Two days later he checked into Maui Memorial Medical Hospital with muscle weakness and paralysis in his face.

State Department of Health officials said yesterday that Stockton’s case meets some clinical criteria for botulism. Officials are trying to confirm the botulism poisoning by sending Stockton’s blood samples to the Centers for Disease Control and Prevention in Atlanta. If recovered, a sample of the chili will also be sent in for testing, officials said.

A week ago, Castleberry’s Food Co. in Augusta, Ga., recalled more than 90 brands of canned food, shutting down its plant. Two people in Texas and two in Indiana were confirmed to be sick and hospitalized from the contaminated food, according to the CDC. Castleberry’s makes Cattle Drive chili.

In California, officials are trying to confirm a link between a case of confirmed botulism in a San Diego woman and the recalled food.

Hawaii health officials are conducting spot checks to remove any of the recalled products that could still be on store shelves.

The last confirmed Hawaii botulism case was in 1990, according to Janice Okubo, state Health Department spokeswoman.

Or, When is a recall not really a recall?

The New York Times and Associated Press continue to report on the slow pace of the “recall” of contaminated Castleberry canned goods from stores all over the country:

Recalled Canned Foods Continue to Be Found on Grocery Shelves

Stores continue to sell recalled canned chili, stew, hash and other foods potentially contaminated with poisonous bacteria even after repeated warnings. Thousands of cans are being removed from shelves as quickly as investigators find them, more than a week after Castleberry’s Food began recalling more than 90 potentially contaminated products over fears of botulism.

The fact that this “voluntary recall” is still ongoing only underscores the need for change. RECALLS, should mean something. If a product has been found to be contaminated, it should be pulled from the shelves of stores quickly – “voluntary recalls” should be mandatory – no arguing, no excuses – it should be the law.

State health officials announce that a middle age woman from San Diego County has been diagnosed with botulism. Authorities are trying to determine if the 51-year-old San Diego County woman’s illness was caused by consuming a Castleberry product.

Health officials said Friday in a news release that the sickened woman reported buying and eating a can of Kroger Chile With Beans prior to getting ill in early July. The woman was hospitalized afterward and is now recovering at home.

“The confirmed case of botulism poisoning in San Diego reminds us of the serious health risk posed by this toxin,” said Dr. Mark Horton, the director of the California Department of Public Health. “Californians should remain vigilant about not consuming the recalled products. If you have the recalled product, discard it immediately.”

In June of this year I posted on www.foodpoisonblog.com an entry on Botulism.  I had no idea that this recall and outbreak would occur within weeks.  Andrew Bridges of the Associated Press wrote today:

Bursting cans of tainted food give new urgency to warnings about botulism

Cans of recalled food are bursting, swollen with the bacteria that causes botulism.  The bursting cans were among those being held by Castleberry’s Food Co., which announced last week a massive recall that now includes more than 90 potentially contaminated products, including chili sauces and dog foods.  News about the bursting cans gives new urgency to warnings from federal health officials to get rid of the recalled cans from pantries and store shelves.  Four people have been sickened and hospitalized by the contaminated food, according to the Centers for Disease Control and Prevention. The recall covers potentially tens of millions of cans of food; officials fear the tally will grow.

Food and Drug Administration investigators believe the company failed to properly cook some or all the products, allowing the Clostridium botulinum bacteria to survive the canning process.

The bacteria produce a toxin that causes botulism, a muscle-paralyzing disease.

“We’re not talking here about a bug that lands you in the bathroom for a few days with diarrhea. We’re talking about a toxin that puts you in the intensive care unit,” said Dr. David Acheson, the FDA’s lead food safety expert. “This is foodborne illness with an extra kick in it, big time.”

“The longer this stuff stays in the can, the worse it gets,” Acheson said.

The bacteria thrive in moist, oxygen-free environments; inside canned food is a perfect place.  As the bacteria grow and reproduce, they produce gases that can cause contaminated cans to swell and burst. Health officials warn the extremely potent toxin can infect people if it is inhaled, swallowed or absorbed through the eye or breaks in the skin.

Please see full Recall List here.

My first talk is next week at the 14th Annual Australian HACCP Conference – I will be giving them a United States perspective on Foodborne Illnesses and Class Actions.

Interestingly, today the press picked up a tentative Class Settlement in a Hepatitis A case we filed.

Tentative agreement reached in Houlihan’s hepatitis A case

A tentative settlement has been reached for diners exposed to hepatitis A at Houlihan’s restaurant in Geneva Commons. The agreement, reached July 12, turns the lawsuit filed by the Johnson family of Geneva into a class-action lawsuit. The lawsuit is open to anyone who ate or drank in the restaurant between Jan. 8 and 19 and subsequently received immunoglobulin shots from the Kane County Health Department or a private physician. The class-action status is only binding if the settlement wins final approval by the court Nov. 27.

An estimated 3,000 dined at the restaurant during the January time period when an employee infected with hepatitis was working and was potentially contagious. The health department gave shots to more than 2,000 people to minimize the effects of the exposure. Most at risk are patrons who had drinks with contaminated ice.

According to the Chicago Department of Health, as of noon today, a total of 757 people have reported that they became ill after they ate food purchased from the Pars Cove booth—up from the 749 reported Tuesday.  One hundred forty-six of the 757 are laboratory-confirmed cases of salmonellosis, with more results pending—up from the 133 reported on Tuesday. Of these 146 cases, 117 have been identified as Salmonella Heidelberg, one of the more common Salmonella serotypes in the United States.  A total of 35 people are known to have been hospitalized.

Custom Pack, Inc., a Hastings, Neb., establishment, is voluntarily recalling approximately 5,920 pounds of ground beef and buffalo products because they may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service announced today.

The products subject to recall include:

* 10-pound bags of “CUSTOM PACK, INC., GROUND BEEF.” Each label bears a package date of “6-1,” “6-4,” “6-5,” “6-7,” “6-8,” “6-11,” 6-12” or “6-13.”
* 25-pound boxes of “3.2 OZ. BEEF PATTIES.” Each box bears the package date of “6-7-07.”
* 25-pound boxes of “4 OZ. BEEF PATTIES.” Each box bears the package date of “6-7-07.”
* 25-pound boxes of “5 1/3 OZ. BEEF PATTIES.” Each box bears the package date of “6-7-07.”
* 25-pound boxes of “8 OZ. BEEF PATTIES.” Each box bears the package date of “6-7-07.”
* 6-pound boxes of “16-6 OZ. CHAR PATTIES.” Each box bears the package date of “6-7-07.”
* 12-pound boxes of “GROUND BUFFALO PATTIES.” Each box bears the package date of “6-7-07.”

Each package also bears the establishment number “Est. 5650” inside the USDA mark of inspection.

The ground beef products were produced between June 1 and June 13, 2007, and were distributed to restaurants and institutions in Nebraska. The ground buffalo patties were produced on June 7, 2007, and distributed to restaurants and institutions in Colorado. None of these products were sold through grocery stores.