The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency and Health Canada to investigate an outbreak of Escherichia coli O157, commonly called E. coli. The outbreak involves three provinces and is linked to romaine lettuce. At this time, there are no product recalls associated with this outbreak. The outbreak investigation is ongoing, and this public health notice will be updated on a regular basis as the investigation evolves.

Currently, there are 21 cases of E. coli O157 illness under investigation in three provinces: Quebec (3), New Brunswick (5), and Newfoundland and Labrador (13). Individuals became sick in November 2017. Ten individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between the ages of 5 and 72 years of age. The majority of cases (71%) are female.

Many individuals who became sick reported eating romaine lettuce before their illnesses occurred. The Canadian Food Inspection Agency is working with public health officials to determine the source of the romaine lettuce that ill individuals were exposed to.

Food Safety News reports that the investigation continues, but initial test results show turkey was the source of Salmonella that sickened employees at a pre-Thanksgiving dinner at a Georgia tire factory.

At least five people had to be hospitalized and lab tests confirmed dozens were suffering from Salmonella infections after the Nov. 14-15 catered meals at the Toyo Tire production plant in White, GA. Angelo’s New York Style Pizza and Bistro of Cartersville, GA, catered the two-day event, which included turkey.

“Preliminary findings implicate catered turkeys as the cause of a recent Salmonella outbreak among employees attending an event at Toyo Tire,” according to Logan Boss, risk communicator for the Georgia Department of Health.

The Georgia Department of Public Health Northwest Health District continues the investigation to confirm the test results. Representatives of the department interviewed about 1,800 Toyo Tire employees after the department started getting reports of illnesses.

Angelo Nizzari, owner of the implicated restaurant, issued a statement in late November through his attorney John T. Mroczko. Nizzari said he was heartbroken about the incident and offered his sympathy to those sickened in the outbreak.

The restaurant closed temporarily for cleaning. Health department officials inspected it and Angelo’s reopened Nov. 22. Employees of the restaurant received “rigorous training in safe food handling from Bartow County Health Department environmental health specialists,” the department reported.

The Kroger Company has recalled Comforts FOR BABY Purified Water with Fluoride Added 1 GAL (3.78 L) with sell by dates from 4/26/2018 to 10/10/2018, after receiving complaints about mold in the product. Testing by Kroger has identified the mold as Talaromyces penicillium. The water is sold in clear containers, but the mold may not be visible with the naked eye.

The FDA is issuing this consumer alert to reach parents and caregivers who may have bought the product, which is intended for infants.

The products were distributed to Kroger stores, including Food 4 Less, Jay C, Jay C Food Plus, Kroger, Kroger Marketplace, Owen’s, Payless Super Market, and Ruler stores in Alabama, Arkansas, Georgia, Illinois, Indiana, Kentucky, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Virginia and West Virginia.  The Kroger Company has instructed its stores to remove the recalled products.

The recalled products are labeled with the UPC Code 0 41260 37597 2 and the plant code 51-4140. The labels also state DISTRIBUTED BY THE KROGER CO, CINCINNATI, OHIO 45202.

The recalled products have sell by dates from 4/26/2018 – 10/10/2018.

If you have purchased this water return it to the store for a refund.

In general, inhaling or touching mold or mold spores may cause allergic reactions in some people. Allergic responses include hay fever-type symptoms, such as sneezing, runny nose, red eyes, and skin rash. Allergic reactions to molds are common and can happen immediately after touching or inhaling mold spores, or later. Molds can also cause asthma attacks in people with asthma who are also allergic to mold. Molds can irritate the eyes, skin, nose, throat, and lungs, even in people who aren’t allergic to them.

Drinking water or other products contaminated with Talaromyces penicillium may affect infants who have HIV or other conditions that cause immune compromise. Consult your health care professional if you believe your infant may be affected.

The Washington State Department of Health announced today a Salmonella outbreak involving pre-cut watermelon, cantaloupe, or fruit mixes containing watermelon or cantaloupe in both Washington and Oregon.

People who purchased these products on or about Oct. 25 up to Dec. 1 from QFC, Fred Meyer, Rosauers, and Central Market in Washington and Oregon are urged not to eat the fruit and throw it away.

Eighteen people from King (5), Mason (1), Pierce (1), Snohomish (7), Thurston (1), and Yakima (1) counties and two individuals from Oregon have been diagnosed with Salmonella.

Lab results identified Salmonella Newport as the cause.

In Minnesota, the Bemidji Pioneer reported two Burger King restaurants in Bemidji temporarily closed Thursday after more than two dozen people contracted salmonella after eating there.  Doug Schultz, a spokesperson with the Minnesota Department of Health, said the department has confirmed 27 cases, and received reports of four more probable cases.

Both Burger King sites voluntarily decided to close Thursday. Most cases were identified in September, he said, but the victims may have been exposed to salmonella before then. Two additional cases came to light this week, prompting the closures.

 

Penn State Eberly College of Science have found house flies can carry Salmonella, E. coli and even bacteria which can lead to stomach ulcers and fatal sepsis. The research, published in Scientific Reports, says flies may have been overlooked by public health officials as a source of disease outbreaks.

The paper found that fly’s legs transferred most of the microbial organisms from one surface to another, suggesting even a brief step onto food could leave behind bacteria. Flies in urban areas were found to carry more bacteria than rural flies, with the scientists suggesting avoiding city parks for picnics and, instead, eating food in more rural locations.

”People had some notion that there were pathogens that were carried by flies, but had no idea of the extent to which this is true and the extent to which they are transferred.” said Dr. Donald Bryant, Professor of Biotechnology at Penn State University.

Maksud Khan of Satna, Madhya Pradesh in India, arrived at the hospital experiencing stomach pains that doctors presumed was food poisoning, but an endoscopy revealed the cause to be metal objects.

Those objects — 236 coins, 100 nails, dozens of razor blades, a 6-inch piece of a rusted iron shackle, four needles, and a few glasses pieces — were found in the man’s stomach.

Khan’s relatives said he was suffering from depression, which may have triggered the habit.

Likely a new thing to add to my list of things not to eat.

BACKGROUND

In 2016, a multijurisdictional team investigated an outbreak of Shiga toxin–producing Escherichia coli (STEC) serogroup O121 and O26 infections linked to contaminated flour from a large domestic producer.

METHODS

A case was defined as infection with an outbreak strain in which illness onset was between December 21, 2015, and September 5, 2016. To identify exposures associated with the outbreak, outbreak cases were compared with non-STEC enteric illness cases, matched according to age group, sex, and state of residence. Products suspected to be related to the outbreak were collected for STEC testing, and a common point of contamination was sought. Whole-genome sequencing was performed on isolates from clinical and food samples.

RESULTS

A total of 56 cases were identified in 24 states. Univariable exact conditional logistic-regression models of 22 matched sets showed that infection was significantly associated with the use of one brand of flour (odds ratio, 21.04; 95% confidence interval [CI], 4.69 to 94.37) and with tasting unbaked homemade dough or batter (odds ratio, 36.02; 95% CI, 4.63 to 280.17). Laboratory testing isolated the outbreak strains from flour samples, and whole-genome sequencing revealed that the isolates from clinical and food samples were closely related to one another genetically. Trace-back investigation identified a common flour-production facility.

CONCLUSIONS

This investigation implicated raw flour as the source of an outbreak of STEC infections. Although it is a low-moisture food, raw flour can be a vehicle for foodborne pathogens.

Samuel J. Crowe, Ph.D., M.P.H., Lyndsay Bottichio, M.P.H., Lauren N. Shade, B.S., Brooke M. Whitney, Ph.D., Nereida Corral, M.P.H., Beth Melius, M.N., M.P.H., Katherine D. Arends, M.P.H., Danielle Donovan, M.S., Jolianne Stone, M.P.H., Krisandra Allen, M.P.H., Jessica Rosner, M.P.H., Jennifer Beal, M.P.H., Laura Whitlock, M.P.H., Anna Blackstock, Ph.D., June Wetherington, M.S., Lisa A. Newberry, Ph.D., Morgan N. Schroeder, M.P.H., Darlene Wagner, Ph.D., Eija Trees, D.V.M., Ph.D., Stelios Viazis, Ph.D., Matthew E. Wise, M.P.H., Ph.D., and Karen P. Neil, M.D., M.S.P.H. N Engl J Med 2017; 377:2036-2043November 23, 2017DOI: 10.1056/NEJMoa1615910

I had a good talk the R.J. Wilson of Healthway a few weeks ago – love the illustration.

Most of us live in relatively ignorant bliss when it comes to our food. We know that we shouldn’t eat from the salad bar of a seedy motel, for instance, and that we’re better off avoiding fast-food sushi.

Ultimately, however, we don’t really know what happens to our food before it’s presented to us.

Studies show that 76 million people are affected by food illness every year. Those illnesses can be caused by bacteria, viruses, molds, and even parasites—and in some cases, the symptoms are life-threatening.

Food poisoning attorney Bill Marler has seen just about everything. He has represented clients in some of the biggest food safety cases on record, and over time, his professional life has shaped his food preferences.

I have a different relationship with food because of my profession.

In early 2016, Marler compiled a list of six foods that he never eats (although, as we’ll explain shortly, he’s taken occasional liberties with one of those foods). The article quickly went viral, which didn’t surprise the attorney.

“I get asked a lot about what foods I stay away from,” Marler explains to HealthyWay. “It was one of those kind of things where I finally decided to just put them [together], and I came up with six.”

But while Marler thought that the piece would do well, he might not have anticipated its reach.

“My daughter called me and said, ‘Dad, you’re trending [online],’” he recalls. “It was the first time she actually thought I was interesting!”

We spoke with Marler to review the original list—and to find out whether he’s really serious about some of these.

1. The first item isn’t exactly a hard one to pass up…

What’s healthier than raw sprouts? They’re a great addition to any sandwich, right?

Not quite. In the past 20 years, over 30 reported illness outbreaks resulted from sprout consumption, including numerous cases of salmonella and E. coli.

In 2014, 19 people were hospitalized with salmonella poisoning from eating sprouts. Marler warns that there have been too many outbreaks to not pay attention to the risks.

The U.S. government’s consumer food safety website, Foodsafety.gov, includes this warning: “Children, the elderly, pregnant women, and persons with weakened immune systems should avoid eating raw sprouts of any kind (including alfalfa, clover, radish, and mung bean sprouts).”

Of course, the site also notes that cooking the sprouts kills the harmful bacteria, so if you prefer your bean sprouts cooked, you’ve got nothing to worry about.

Plus, sprouts are…well, kind of gross, so we don’t really mind avoiding them. Unfortunately, the list gets harder from here.

2. Marler admits to cheating on this one.

This one isn’t so much about the food as the way it’s prepared.

Pre-cut fruit seems like a great idea, in theory; you get delightfully sliced pieces of perfectly ripened fruit filled with vitamins, minerals, and antioxidants.

However, in his original article, Marler wrote that he avoids pre-cut fruit “like the plague.”

As Marler wrote, the extra handling and processing increases the chances that the fruit will be contaminated. According to the Australian Institute of Food Safety, pre-cut fruit is one of the most common foods associated with foodborne illnesses.

Still, Marler admits that he doesn’t exactly avoid cut fruits “like the plague.” He was using a bit of hyperbole to get his point across.

“If I’m traveling or looking for a quick lunch, sometimes it’s just too convenient,” he says.

He does recommend eating whole fruits instead; that should help people avoid listeria, a bacteria that can cause gastrointestinal and nervous system issues.

3. Ready for a healthy breakfast? Well…sorry in advance.

This one might be hard for some people to stomach; we can’t imagine asking for our eggs over-hard.

Even though much has changed in the way of the handling and processing of eggs nowadays, it wasn’t long ago that people were getting sick from raw eggs. In the early ’80s and ’90s, salmonella was an epidemic, but in 2010, the CDC reported around 2,000 cases of salmonella contamination involving eggs.

Salmonella can live both inside and outside the shells of eggs. Symptoms of salmonella poisoning can last for over a week and include cramps, diarrhea, and fever. Infectious disease experts recommend keeping eggs refrigerated until they’re ready to be prepared.

Marler admits that eggs are getting safer. “[Salmonella in eggs] is less of a problem than it was, say, 10 years ago,” he says. “But it’s still a risk that is, in my view, not worth taking.”

Not to disagree with our expert, but we’ll note that the risk is quite limited. Per Forbes, about one in 20,000 eggs is infected with salmonella. That’s a pretty small number, all things considered. Cooking your eggs (properly) limits the growth of bacteria and reduces the chance of salmonella poisoning.

Still, a representative of Foodsafety.gov tells HealthyWay that eggs still pose a pretty significant risk, particularly to immunocompromised people, and consumers need to understand that risk before partaking.

4. This food trend might seem healthy, but that’s not the case.

Pasteurization removes some of the nutrients in juice and milk and that doesn’t bode well with the super-health-conscious crowd. As a result, raw milk and juices have become more popular over the past few years, despite warnings from the FDA.

Marler argues that there’s no benefit compelling enough to minimize the risks involved with these drinks. Since pasteurization is an important safety procedure that eliminates harmful parasites, bacteria, and viruses from beverages, it would be irresponsible to risk possible infection for a couple of extra nutrients.

Of course, his opinion is informed by his case work. In 1996, Marler fought for several children against the popular beverage company Odwalla. One client developed a serious affliction called hemolytic uremic syndrome (HUS) from drinking unpasteurized apple juice. HUS is caused by E. coli and is linked to anemia and kidney failure.

Ultimately, Odwalla was held responsible and had to pay a $1.5 million fine and another $12 million to the victims.

5. We’ve got bad news for meat eaters.

Although something of a delicacy, rare steak (and other kinds of beef) carry with them a host of potential foodborne pathogens, including listeria, salmonella, and E. coli. Marler recommends steering clear of meat that is cooked rare.

He suggests that steak should only be consumed if it’s medium-well or well, which should kill the harmful bacteria.

It may not be the most delicious way to eat a steak, but Marler says the risks outweigh the rewards. The FDA cautions that red meat needs to be cooked to 145 degrees Fahrenheit (160 degrees for ground meats) in order to be safe.

Ground meat products (like hamburgers and meatloaf) need to be cooked even more thoroughly since bacteria that sits on the surface of the meat is often ground inside of it.

Still, we had to ask: Does he really order all of his steaks well done? Yes, although he recalled one meal in which a restaurant confused his order with his colleague’s.

“They switched the order, and I quickly looked at his steak and my steak and realized it,” Marler recalls. “We had to switch them back.”

6. But Marler received the most complaints for this final item.

Most people know that oysters are not the cleanest food available, but often people don’t realize why. Oysters filter feed, which means they eat (and hold on to) everything that’s in the water—and we mean everything.

When you eat raw oysters, you ingest their bacteria (somewhat obviously). Marler says that he has seen many more issues with the consumption of raw oysters over the last five years as compared to 20 years ago, and he believes that warmer water temperatures are to blame.

Why? Well, higher water temperatures mean more microbial growth, which means more cases of foodborne illness. In order for an oyster to be safe from bacteria and viruses, it must be cooked thoroughly. That reduces the risk of an illness, but doesn’t eliminate it altogether.

“We’re starting to see more cases [involving oysters],” Marler says, noting that, despite the pushback from his friends on the East Coast, he wouldn’t take the mollusks off of his list.

So, would Marler make any changes to this list?

Nope. He says that while he’s seen contamination with specific brands, he doesn’t think he’d make any additions.

“There’ve been lots of outbreaks linked to, for example, soy nut butter,” Marler says. “But [the list] includes things that, historically, in my experience, have been much more risky. They’re involve products that don’t have a ‘kill’ step—they’re not cooked.”

He also says that while he’s fairly strict about his own diet, he doesn’t ask his friends to order differently at restaurants.

“Most people know what I do, and they either don’t care or they change their order,” Marler says with a laugh. “I have a different relationship with food because of my profession.”

Perhaps I need to add in flour in cookie dough?

More than 45 million turkeys are eaten on Thanksgiving Day, with a never-ending list of side dishes and desserts. The Thanksgiving meal is by far the largest and most stressful meal many consumers prepare all year, leaving room for mistakes that can make guests sick. But never fear, the U.S. Department of Agriculture (USDA) Food Safety and Inspection Service (FSIS) is available with tips and resources to make this Thanksgiving safe and stress-free.

“Turkey and other meat and poultry may contain Salmonella and Campylobacter that can lead to serious foodborne illness,” said acting FSIS Administrator Paul Kiecker. “By properly handling and cooking your turkey, you can avoid these harmful pathogens and ensure your family has a safe and healthy Thanksgiving feast.”

Begin by following these five steps:

Wash your hands, but not your turkey

Washing your hands before cooking is the simplest way to stop the spread of bacteria, while washing your turkey is the easiest way to spread bacteria all over your kitchen. According to the 2016 Food and Drug Administration Food Safety Survey, 68 percent of consumers wash poultry in the kitchen sink, which is not recommended by the USDA. Research shows that washing meat or poultry can splash bacteria around your kitchen by up to 3 feet, contaminating countertops, towels and other food. Washing doesn’t remove bacteria from the bird. Only cooking the turkey to the correct internal temperature will ensure all bacteria are killed.

The exception to this rule is brining. When rinsing brine off of a turkey, be sure to remove all other food or objects from the sink, layer the area with paper towels and use a slow stream of water to avoid splashing.

To stuff or not to stuff

For optimal food safety, do not stuff the turkey. Even if the turkey is cooked to the correct internal temperature, the stuffing inside may not have reached a temperature high enough to kill the bacteria. It is best to cook the stuffing in a separate dish.

Take the temperature of the bird

Although there are various ways to cook a turkey, the only way to avoid foodborne illness is to make sure it is cooked to the correct internal temperature as measured by a food thermometer. Take the bird’s temperature in three areas — the thickest part of the breast, the innermost part of the wing and the innermost part of the thigh — make sure all three locations reach 165ºF. If one of those locations does not register at 165ºF, then continue cooking until all three locations reach the correct internal temperature.

Follow the two-hour rule

Perishable foods should not be left on the table or countertops for longer than two hours. After two hours, food falls into the Danger Zone, temperatures between 40-140ºF, where bacteria can rapidly multiply. If that food is then eaten, your guests could get sick. Cut turkey into smaller slices and refrigerate along with other perishable items, such as potatoes, gravy and vegetables. Leftovers should stay safe in the refrigerator for four days.

When in doubt call the USDA Meat and Poultry Hotline

If you have questions about your Thanksgiving dinner, call the USDA Meat and Poultry Hotline at 1-888-MPHotline (1-888-674-6854) to talk to a food safety expert. You can also chat live at AskKaren.gov, available from 10 a.m. to 6 p.m. ET, Monday through Friday, in English and Spanish.

If you need help on Thanksgiving Day, the Meat and Poultry Hotline is available from 8 a.m. to 2 p.m. ET.

  1. Safely Thaw Your Turkey

Thaw turkeys in the refrigerator, in a sink of cold water that is changed every 30 minutes, or in the microwave. Never thaw your turkey by leaving it out on the counter. A frozen turkey is safe indefinitely, but a thawing turkey must defrost at a safe temperature. When the turkey is left out at room temperature for more than two hours, its temperature becomes unsafe as it moves into the danger zone between 40°F and 140°F, where bacteria can grow rapidly.

  1. Safely Handle Your Turkey

Raw poultry can contaminate anything it touches with harmful bacteria. Follow the four steps to food safety – cook, clean, chill, and separate – to prevent the spread of bacteria to your food and family.

  1. Safely Stuff Your Turkey

Cooking stuffing in a casserole dish makes it easy to make sure it is thoroughly cooked. If you put stuffing in the turkey, do so just before cooking. Use a food thermometer to make sure the stuffing’s center reaches 165°F. Bacteria can survive in stuffing that has not reached 165°F and may then cause food poisoning. Wait for 20 minutes after removing the bird from the oven before removing the stuffing from the turkey’s cavity; this allows it to cook a little more. Learn more about how to prepare stuffing safely.

  1. Safely Cook Your Turkey

Set the oven temperature to at least 325°F. Place the completely thawed turkey with the breast side up in a roasting pan that is 2 to 2-1/2 inches deep. Cooking times will vary depending on the weight of the turkey. To make sure the turkey has reached a safe internal temperature of 165°F, check by inserting a food thermometer into the center of the stuffing and the thickest portions of the breast, thigh, and wing joint. Let the turkey stand 20 minutes before removing all stuffing from the cavity and carving the meat. Learn more about safe minimum cooking temperatures and how to use a food thermometer for turkey and other foods.

  1. Take Care with Leftovers

Clostridium perfringens are bacteria that grows in cooked foods left at room temperature. It is the second most common bacterial cause of food poisoning. The major symptoms are vomiting and abdominal cramps within 6 to 24 hours after eating.

  • Clostridium perfringens outbreaks occur most often in November and December.2
  • Many of these outbreaks have been linked to foods commonly served during the holidays, such as turkey and roast beef.

Refrigerate leftovers at 40°F or colder as soon as possible and within two hours of preparation to prevent food poisoning.

Use a food thermometer to check for a safe internal temperature.

 Thanks to CDC

According to local press reports, Westchester County has treated 250 people who may have been exposed to hepatitis A at Sleepy Hollow Country Club, officials said today.

Those people received preventive treatment after a club employee was infected by one of the five people who were exposed to hepatitis A at bartaco in Port Chester, said Caren Halbfinger, a spokeswoman for the Westchester Department of Health.

The department is offering free treatment at its clinic at 134 Court St. in White Plains for anyone who ate or drank at the club between Oct. 30 and Nov. 4.

The Health Department will offer hepatitis A vaccine to most people. Infants under 1 year old and people with immune-compromising conditions will be given immune globulin.

The county clinic is providing treatment from 9 a.m. to 4 p.m. today and Tuesday, 9 to 11 a.m. on Wednesday and Thursday, and 9 a.m. to 3 p.m. on Friday. Officials said treatment is most effective within two weeks of exposure.

Phelps Hospital in Sleepy Hollow is offering treatment for anyone who attended its gala at the country club on Nov. 3. Treatment is available at the hospital at 755 N. Broadway from 10 a.m. to 5 p.m. Monday through Friday this week.

Anyone who ate or drank at the club between Oct. 21 and Oct. 29 may also have been exposed, but the treatment is only effective within two weeks of exposure, officials said. Anyone who is too late for treatment is still urged to contact their health care provider immediately, though, so that anyone they may have exposed can receive treatment.

Health officials said they did not expect this outbreak to affect as many as people as bartaco’s outbreak, which included treatment of more than 3,000 people who were potentially exposed to hepatitis A.