The last few weeks have sounded remarkably familiar to Spring 2020 when we faced a nationwide (and Canada) Salmonella outbreak linked to California grown onions.  We are now facing a similar outbreak – smaller at this point (over 650 vs over 1,600 sickened) – but it will be interesting to see if the root cause of the outbreak tracks as the below 2020 cause.

Here is what the FDA said in May 2020:

The U.S. Food and Drug Administration (FDA) has released a report on its investigation of the Salmonella Newport outbreak that caused more than 1,600 reported illnesses in the U.S. and Canada between June and October 2020. The FDA worked with the U.S. Centers for Disease Control and Prevention (CDC), state partners, and Canadian officials (Public Health Agency of Canada and Canadian Food Inspection Agency) to investigate the outbreak, which was linked through epidemiology and traceback to whole red onions supplied by Thomson International Inc., headquartered in Bakersfield (Southern San Joaquin Valley) with additional operations in Holtville (Imperial Valley), California. The outbreak is the largest Salmonella foodborne illness outbreak in over a decade. The report released today includes an overview of the traceback investigation, subsequent on-site interviews, visual observations of the growing fields, and environmental sampling, and various factors that potentially contributed to the contamination of red onions with Salmonella.

Although a conclusive root cause could not be identified, several potential contributing factors to the 2020 Salmonella outbreak linked to red onions were identified. These include:

  • potentially contaminated sources of irrigation water;
  • sheep grazing on adjacent land;
  • signs of animal intrusion, including scat (fecal droppings), and large flocks of birds that may spread contamination; and
  • food contact surfaces that had not been inspected, maintained, or cleaned as frequently as necessary to protect against the contamination of produce.

In sampling conducted in Holtville, CA, the FDA found Salmonella Newport in 10 water (irrigation, seepage, and drainage) and one sediment subsamples. However, the whole genome sequencing of these samples did not match the outbreak strain.

Although a conclusive root cause could not be identified, several potential contributing factors to the 2020 red onion outbreak were identified, including a leading hypothesis that contaminated irrigation water used in a growing field in Holtville, CA may have led to contamination of the onions.

In light of this report, the FDA encourages all farms to:

  • assess growing operations to ensure implementation of appropriate science and risk-based preventive measures, including applicable provisions of the FDA Food Safety Modernization Act (FSMA) Produce Safety Rule and good agricultural practices;
  • implement industry-led root-cause analyses to determine how the contamination likely occurred when pathogens are identified through pre-harvest or post-harvest testing of produce, or microbiological surveys;
  • be aware of and consider the risks that may be posed by adjacent and nearby land uses, especially as it relates to the presence of livestock and the interface between farmland, rangeland, irrigation water, and other agricultural areas;
  • consider additional tools such as pre-harvest and/or post-harvest sampling and testing of products to help inform the risk assessment and clarify the need for specific prevention measures; and
  • improve traceability by increasing digitization, interoperability and standardization of traceability records; and
  • follow good agricultural practices to maintain and protect the quality of water sources.

Although the present outbreak appears to be onions grown in Mexico provided nationwide and to Canada though various suppliers in the United States, it will me interesting of we are just seeing history repeat itself.

It also will be interesting if the slow roll out of the FDA “water rule” had an impact in both of the outbreaks?

Here are the compliance dates:

“Larger farms are now required to comply with the agricultural water requirements by January 26, 2022, while small farms have until January 26, 2023 and very small farms until January 26, 2024.  This rule does not change the compliance dates for sprout operations.”

Food Safety News and the Roanoke Times report that the patient count in a hepatitis A outbreak linked to Virginia restaurants continues to grow, with 44 people now confirmed as infected. One of the patients has required a liver transplant and one has died.

The cousin of the transplant patient reports the operation took place this past weekend. The outbreak patient’s husband and daughter were also infected, according to the cousin.

The patient who died, James Hamlin, and his wife Victoria frequently ate at one of the implicated Famous Anthony’s restaurants, according to the Roanoke Times. James died on Oct. 8 at age 75. “His daughter, Dana Heston of Cave Spring, said Hamlin was a strong and healthy man. He worked out three times per week — lifting weights, riding a stationary bike and walking. He did not have any serious medical conditions,” according to the Times. Victoria Hamlin was also infected, but is recovering.

More than half of the patients — 26 as of Oct. 15 — have been so sick that they had to be admitted to hospitals. That is a higher rate of hospitalization than is usually seen in hepatitis A outbreaks.

The outbreak is associated with three Famous Anthony’s restaurant locations in the Roanoke, VA, area. An employee who worked at all three locations is believed to be the source of the infections. No other details about the employee, including health status, have been released.

The National Center for Biotechnology Information (NCBI) shows:

Salmonella – 653 isolates – 652 clinical (people) and 1 mixed produce

Group: PDG000000002.2315

Cluster: PDS000094913.28

Distance between selected isolates: minimum = 0 SNPs, maximum = 9 SNPs, average = 1 SNPs

Target creation date range: 2021-08-20 to 2021-10-15

As of a few moments ago, the CDC reports:

As of October 14, 2021, 592 people infected with the outbreak strain of Salmonella Oranienburg have been reported from 36 states. Illnesses started on dates ranging from May 31, 2021, to September 29, 2021. Sick people range in age from less than 1 year to 97 years, with a median age of 36, and 57% are female. Of 363 people with information available, 116 (32%) have been hospitalized and no deaths have been reported.

Members of the Coalition for Poultry Safety Reform welcome the announcement today by the United States Department of Agriculture Food Safety and Inspection Service (USDA FSIS) launching a new effort to reduce Salmonella illnesses associated with poultry products.

The Coalition for Poultry Safety Reform is a newly-formed group composed of individuals and organizations, listed below, representing a broad array of interests and expertise related to poultry safety, including organizations that represent consumers and victims of foodborne illness, members of the poultry industry, leading food safety scientists, and current and former state and federal officials. Our multistakeholder coalition aims to serve as a resource for ideas and insights on effective, practicable, and science-based approaches to poultry safety reform that will benefit the public by reducing foodborne illnesses while ensuring continued consumer access to safe, affordable food.

We applaud Secretary Tom Vilsack and Deputy Under Secretary Sandra Eskin for demonstrating strong leadership and commitment to meaningful poultry safety reform aimed at reducing illnesses from Salmonella.

Decreasing Salmonella and Campylobacter contamination of poultry products is a top priority of the coalition. The rates of illness in the United States due to Salmonella and Campylobacter have remained persistently high for the last 20 years, despite efforts by federal regulators aimed at reducing bacterial contamination in poultry products. The announcement today by USDA FSIS addresses Salmonella, but does not address Campylobacter.

In the announcement, USDA Secretary Vilsack committed to “taking action to help prevent Salmonella contamination throughout the poultry supply chain and production system to protect public health.” The agency laid out a process for Salmonella reform that will begin with stakeholder feedback on specific strategies, including pilots to gather data and information.

“Reducing Salmonella infections attributable to poultry is one of the Department’s top priorities,” said USDA Deputy Under Secretary Eskin, who is leading the initiative.

Throughout this reform process, the coalition will be advocating for comprehensive reform that fully upgrades the current regulatory system to protect public health. Specifically, members of the coalition believe that:

  1.  The current system for regulating poultry safety is broken. While current prevalence-based pathogen reduction performance standards are leading to reduced Salmonella levels in products, the performance standard method is not producing the desired public health outcomes.
  2. To achieve better results, USDA must transform and strengthen its standards. The current performance standards system should be replaced with standards that are objective, risk-based, achievable, enforceable, and flexible enough to adapt to emerging evidence and the latest science. Modernized standards should not stifle innovation. Instead, they should invite innovation and technological development.
  3. Food safety should extend from farm to fork. While the USDA FSIS cannot directly regulate food safety practices on the farm, a modernized Hazard Analysis and Critical Control Point (HACCP) framework should address risk reduction across the full production process from raw material to finished packaging, including defining the responsibility of poultry processors to consider preharvest practices and interventions in their HACCP plans. The plans should also verify that suppliers of live birds have implemented scientifically appropriate risk-reduction measures in accordance with modern best practices.
  4. USDA must address both Salmonella and Campylobacter in poultry. Salmonella and Campylobacter should be addressed in parallel but separate proceedings, as larger knowledge gaps exist for Campylobacter than Salmonella and different timelines and risk mitigation approaches may be necessary. This includes reviewing and reinvigorating programs around Salmonella that exist within the National Poultry Improvement Plan.
  5. Regulatory reform should be paired with investment in research. While the science has advanced sufficiently to support regulatory improvements today, ongoing research is also needed to support continued progress towards reducing Salmonella and Campylobacter, including epidemiologic data and analysis to improve attribution of illness to specific commodities and products.

The members of the Coalition for Poultry Safety Reform are:

Consumer Representatives

Center for Science in the Public Interest

  • James Kincheloe, Food Safety Campaign Manager
  • Peter Lurie, President and Executive Director and former Associate Commissioner, FDA
  • Sarah Sorscher, Deputy Director of Regulatory Affairs

Consumer Federation of America

  • Thomas Gremillion, Director of Food Policy

Consumer Reports

  • Brian Ronholm, Director of Food Policy and former USDA Deputy Under Secretary, Food Safety

Environmental Working Group

  • Scott Faber, Senior Vice President, Government Affairs

Stop Foodborne Illness (STOP)

  • Mitzi Baum, Chief Executive Officer
  • Amanda Craten, Board Member and Mother of Salmonella Illness Survivor
  • Vanessa Coffman, Director of the Alliance to Stop Foodborne Illness
  • Shrinidhi Joshi, Dave Theno Food Safety Fellow

Affected Consumer Members of STOP

  • David Clubb, Salmonella Illness Survivor
  • Mary Graba, Campylobacter Illness Survivor
  • Diana Goodpasture, Salmonella Illness Survivor
  • Melissa and Ruby Lee, Mother and Salmonella Illness Survivor

Food Safety Scientists

  • Craig W. Hedberg, University of Minnesota
  • Glenn Morris, Jr., University of Florida
  • Martin Wiedmann, Cornell University

Industry Members

Butterball LLC 

  • Alice Johnson, Senior Vice President, Food Safety

Perdue Farms 

  • Bruce Stewart-Brown, Senior Vice President, Technical Services and Innovation

Tyson Foods

  • Scott Brooks, Senior Vice President, Food Safety & Quality Assurance

Wayne Farms LLC

  • Bryan Miller, Vice President, Quality Assurance and Food Safety
  • Michael Robach, Chief Executive Officer, The Robach Group LLC

Current and Former State and Federal Officials

Association of Food and Drug Officials

  • Steven Mandernach, Executive Director
  • Jerold R. Mande, former USDA Deputy Under Secretary, Food Safety
  • Michael Taylor, former USDA FSIS Administrator and Acting Under Secretary, Food Safety

The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) today announced that it is mobilizing a stronger, and more comprehensive effort to reduce Salmonellaillnesses associated with poultry products. The agency is initiating several key activities to gather the data and information necessary to support future action and move closer to the national target of a 25% reduction in Salmonella illnesses.

“Far too many consumers become ill every year from poultry contaminated by Salmonella,” said Agriculture Secretary Tom Vilsack. “We need to be constantly evolving in our efforts to prevent foodborne illness to stay one step ahead of the bad bugs. Today we’re taking action to help prevent Salmonella contamination throughout the poultry supply chain and production system to protect public health.”

Despite consistent reductions in the occurrence of Salmonella in poultry products, more than 1 million consumer illnesses due to Salmonella occur annually, and it is estimated(PDF, 1.4 MB) that over 23% of those illnesses are due to consumption of chicken and turkey.

“Reducing Salmonella infections attributable to poultry is one of the Department’s top priorities,” said USDA Deputy Under Secretary Sandra Eskin, who is leading the initiative. “Time has shown that our current policies are not moving us closer to our public health goal. It’s time to rethink our approach.”

USDA intends to seek stakeholder feedback on specific Salmonella control and measurement strategies, including pilot projects, in poultry slaughter and processing establishments. A key component of this approach is encouraging preharvest controls to reduce Salmonella contamination coming into the slaughterhouse. The data generated from these pilots will be used to determine if a different approach could result in a reduction of Salmonella illness in consumers.

The effort will leverage USDA’s strong research capabilities and strengthen FSIS’ partnership with the Research, Education and Economics (REE) mission area to address data gaps and develop new laboratory methods to guide future Salmonella policy. Meanwhile, the National Advisory Committee for Microbiological Criteria in Foods, an independent federal advisory committee, will be asked to advise on how FSIS can build on the latest science to improve its approach to Salmonella control. Since it is not just the presence or absence of Salmonella, but the quantity of bacteria that can impact the likelihood of illness, FSIS will examine how quantification can be incorporated into this approach. Moreover, with emerging science suggesting that not all Salmonella are equally likely to cause human illness, FSIS will focus on the Salmonella serotypes and the virulence factors that pose the greatest public health risk.

Moving forward, this initiative will require collaboration and ongoing dialogue with stakeholders — industry, consumer groups, and researchers alike. USDA looks forward to working closely with stakeholders on informing and implementing key activities of this framework in the very near future.

USDA touches the lives of all Americans each day in so many positive ways. In the Biden-Harris Administration, USDA is transforming America’s food system with a greater focus on more resilient local and regional food production, fairer markets for all producers, ensuring access to safe, healthy and nutritious food in all communities, building new markets and streams of income for farmers and producers using climate smart food and forestry practices, making historic investments in infrastructure and clean energy capabilities in rural America, and committing to equity across the Department by removing systemic barriers and building a workforce more representative of America. To learn more, visit www.usda.gov.

As of October 6, 2021, 20 people sickened with Listeria from an unknown source was announced by the FDA.

As of October 14, 2021, 592 people infected with the outbreak strain of Salmonella Oranienburg have been reported from 36 states. Illnesses started on dates ranging from May 31, 2021, to September 29, 2021. Sick people range in age from less than 1 year to 97 years, with a median age of 36, and 57% are female. Of 363 people with information available, 116 (32%) have been hospitalized and no deaths have been reported.

Kentucky Cabinet for Health and Family Services reports that ten Kentuckians recently tested positive with a strain of E. coli O157:H7. Of the cases, two individuals developed a rare but serious condition called hemolytic uremic syndrome (HUS). Public health investigators have not yet identified the source of the outbreak but have noted that some sort of food distribution is likely.

WFXR reports that the Roanoke City and Alleghany Health Districts announced Tuesday that the number of people infected with hepatitis A more than doubled over the last two weeks following an outbreak at three Famous Anthony’s locations, going from 14 to 35 cases.

Health officials first reported the outbreak on Sept. 24, saying that a person who worked at three different Famous Anthony’s locations tested positive for the highly contagious infection.

Then, on Sept. 28, the Roanoke City and Alleghany Health Districts’ director, Dr. Cynthia Morrow, reported that four more cases of the virus associated with the restaurant chain had been discovered, with at least three people hospitalized.

During her most recent update on Tuesday, Oct. 12, Dr. Morrow announced that approximately 35 hepatitis A cases have been confirmed in connection with this exposure, but that number is expected to rise as health officials investigate potential new cases that came in over the weekend.

Dr. Morrow says there have also been a handful secondary cases after people who were infected earlier on transmitted the virus to other people within their own households. However, there are no major clusters of such secondary infections.

In addition, there have been more than 20 hospitalizations reported as of Tuesday associated with this hepatitis A outbreak, according to Dr. Morrow.

Dr. Morrow says this is disappointing, but not surprising considering the long incubation period for hepatitis A — which can be up to 50 days — and the amount of time it can take people to seek medical care even after they start to show symptoms. The number of hepatitis A cases tied to this outbreak are expected to continue rising over the next few weeks.

The health districts say that anyone who visited any of the following Famous Anthony’s locations between Aug. 10 and Aug. 26 could have been exposed:

4913 Grandin Road
6499 Williamson Road
2221 Crystal Spring Avenue

According to health officials, if you have been exposed and are not vaccinated against hepatitis A, you should monitor yourself for the symptoms listed below, which can develop 15 to 50 days after exposure:

Jaundice (yellowing of the skin or the eyes)
Fever
Fatigue
Loss of appetite
Nausea
Vomiting
Abdominal pain
Dark urine
Light-colored stools

Besides getting the hepatitis A vaccine, Dr. Morrow says practicing good hand hygiene and cooking hygiene are ways to help ward off the virus.

Trichinellosis is a parasitic disease that results from consumption of raw or undercooked meat infected by roundworm species in the genus Trichinella. Early signs and symptoms occur 1–2 days after ingestion and include diarrhea, abdominal pain, fatigue, nausea, and vomiting. Systemic signs and symptoms, which typically occur 1–2 weeks after ingestion and last for 1–8 weeks, include facial and periorbital edema, fatigue, fever (remittent) and chills, headache, muscle soreness, pruritus (with or without a rash), nausea, difficulty coordinating movement, neurologic complications, and cardiopulmonary impairment.

The best way to prevent trichinellosis is to cook meat to a temperature of 71 degrees C (160 degrees F).

According to Food Safety News, health officials in Córdoba revealed that 244 cases of trichinosis had been registered in Totoral, Colón, Unión, Capital and Río Cuarto.

The Ministry of Health of Córdoba said almost 200 of the sick people live in the town of Villa del Totoral. Patients were treated in different health care centers. The Ministry of Agriculture and Livestock and the National Service of Agrifood Health and Quality (SENASA) are monitoring the outbreak.

Investigations have found a link to pork meat, sausages, and salami from different businesses in Villa del Totoral.  An earlier warning revealed 22 people were sick in Villa del Totoral and the city of Córdoba.

In the province of Buenos Aires, eight cases of trichinosis had previously been confirmed in the town of Cañuelas with another five probable. Officials in Chascomus, also in Buenos Aires, reported some infections in the city and several people have fallen ill in the city of Chacabuco after eating sausages.

 

On October 6, 2021, the FDA reported that it was investigating a 20 person Listeria outbreak linked to an unknown food product.

Interestingly, or perhaps coincidentally, the FDA and Fullei Fresh published the following recall announcement on October 6, 2021:

The purpose of this announcement is to advise you that Fullei Fresh is voluntarily recalling Bean Sprouts and Soy Sprouts as a precaution due to possible exposure to listeria monocytogenes. Affected lots are numbered consecutively between 251 and 271. They were harvested and shipped to distributors between September 14 and October 5, 2021. Both conventional and organic bean sprouts as well as soy sprouts are voluntarily recalled. No other products are affected at this time as they are grown and packed in segregated departments.

Fullei Fresh conventional bean sprouts are sold in 5 lb bulk, 10 lb bulk and 8 oz retail packs. Organic bean sprouts are sold in 5 lb bulk and 4 oz retail packs. Soy sprouts are sold in 5 lb bulk and 10 lb bulk. The lot numbers are printed on the retail packs and on bulk cardboard boxes in the barcode (the last 3 digits.)

For those that pay attention to outbreaks and FDA recalls, usually the recall, without illnesses, are prompted by a positive product or environmental test.  Here, we only got:

There have been no known illnesses reported in connection with these products.

So, is there a link between a Listeria outbreak and the recall of Bean Sprouts and Soy Sprouts?

Listeria:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Listeriaoutbreaks. The Listeria lawyers of Marler Clark have represented thousands of victims of Listeria and other foodborne illness outbreaks and have recovered over $800 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Listeria lawyers have litigated Listeria cases stemming from outbreaks traced to a variety of foods, such as lettuce, polony, deli meat, cantaloupe, cheese, celery and milk.

If you or a family member became ill with a Listeria infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Listeria attorneys for a free case evaluation.