Listeria is Thankfully Rare – About 1,600 people in the US get sick from Listeria germs each year.

However, Listeria is a Killer – Listeria is the 3rd leading cause of death from food poisoning.

Listeria Attacks the Most Vulnerable – At least 90% of people who get Listeria infections are either pregnant women and their newborns, people 65 or older, or people with weakened immune systems.

From an FDA Christmas Eve Recall Notice:  Happy Apples, is issuing a voluntary recall of Happy Apple Brand caramel apples with a best use by date between August 25th and November 23rd 2014, because it has the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

Happy Apple caramel apples are sold in single pack, three packs, four packs and eight packs and each package will have a best use by date on the front of the label. They were available for retail sale through grocery, discount and club stores, generally in the produce section and were distributed to retailers in the following states: Alabama, Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Washington, Wisconsin.

As has been reported in the news, the Center for Disease Control has noted 29 illnesses in 10 states linked to the outbreak and they have advised consumers not to eat commercially produced, pre-packaged caramel apples until more is known.  Canada has also reported two likely Listeria illnesses.

Happy Apple reported that it recently received notice from Bidart Brothers, one of its apple suppliers to the Orosi California facility, that there may be a connection between this outbreak and the apples that they supplied to that facility.

According to the St. Louis Post-Dispatch, Happy Apples in 2007 agreed to pay $599,000 to settle federal charges following the raid by federal agents. Federal authorities said the company had employed dozens of people illegally for more than five years.

Commercial, pasteurized ice cream outbreaks are really quite rare – see Outbreak Database.

Yesterday, Snoqualmie Gourmet Ice Cream, Inc. issued a voluntary recall of all ice cream, gelato, custard and sorbet for all flavors and container sizes produced on or after January 1, 2014 until December 15, 2014 because these products have the potential to be contaminated with Listeria monocytogenes.

The voluntary recall was initiated based on the confirmation positive result of Listeria monocytogenes in the samples collected within the production facility and analyzed by Washington State Department of Agriculture (WSDA).  However, today the Washington State Department of Health (WSDH), confirmed that at least two people – both men in their 50’s have been hospitalized in Seattle with Listeria infections linked to the recalled ice cream.

The ice cream, gelato, custard and sorbet were distributed in Arizona, Idaho, California, Oregon, and Washington may have been further distributed and sold in various retail outlets in Alaska, Colorado, Montana, Nevada, New Mexico, North Dakota, Texas, Utah, and Wyoming.

The products are labeled Snoqualmie Ice Cream, Snoqualmie Gelato, Snoqualmie Custard, Snoqualmie Sorbet or Emerald & Spruce Ice Cream or Top Pot Hand Forged Ice Cream and have a production date code located on the bottom of the container.  The date codes included either end in “4”, e.g. XXX4 (pints and cups) or are listed by date: January 1, 2014 through December 15, 2014 (trays & tubs).

As of December 15, 2014, a total of 111 people infected with the outbreak strains of Salmonella Enteritidis have been reported from 12 states. Connecticut (8), Maine (4), Maryland (5), Massachusetts (35), Montana (1), New Hampshire (6), New York (21), Ohio (3), Pennsylvania (17), Rhode Island (7), Vermont (3), Virginia (1).

Collaborative investigation efforts of state, local, and federal public health and regulatory agencies indicate that bean sprouts produced by Wonton Foods, Inc. are the likely source of this outbreak.  On November 21, 2014, Wonton Foods Inc. agreed to destroy any remaining products while they conducted a thorough cleaning and sanitization and implemented other Salmonella control measures. On November 24, the firm completed the cleaning and sanitation and resumed production of bean sprouts. The firm resumed shipment on November 29, 2014.

CDC recommends that consumers, restaurants, and other retailers always practice food safety for sprouts.  Children, older adults, pregnant women, and persons with weakened immune systems should avoid eating raw sprouts of any kind (including alfalfa, clover, radish, and mung bean sprouts). Cook sprouts thoroughly to reduce the risk of illness. Cooking sprouts thoroughly kills any harmful bacteria.

Snoqualmie Gourmet Ice Cream, Inc. has issued a voluntary recall of all ice cream, gelato, custard and sorbet for all flavors and container sizes produced on or after January 1, 2014 until December 15, 2014 because these products have the potential to be contaminated with Listeria monocytogenes.

Listeria monocytogenes is an organism that can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

The ice cream, gelato, custard and sorbet were distributed in Arizona, Idaho, California, Oregon, and Washington may have been further distributed and sold in various retail outlets in Alaska, Colorado, Montana, Nevada, New Mexico, North Dakota, Texas, Utah, and Wyoming.

The products are labeled Snoqualmie Ice Cream, Snoqualmie Gelato, Snoqualmie Custard, Snoqualmie Sorbet or Emerald & Spruce Ice Cream or Top Pot Hand Forged Ice Cream and have a production date code located on the bottom of the container.  The date codes included either end in “4”, e.g. XXX4 (pints and cups) or are listed by date: January 1, 2014 through December 15, 2014 (trays & tubs).

The voluntary recall was initiated based on the confirmation positive result of Listeria monocytogenes in the samples collected within the production facility and analyzed by Washington State Department of Agriculture (WSDA).  The company is working with the FDA and WSDA to investigate the root cause.

“The thought that a caramel apple could sicken and kill people is a little disconcerting,” Bill Marler said. “It’s been hard for the family; it’s been a shock to them.”

As of December 22, 2014, a total of 29 people infected with the outbreak strains of Listeria monocytogenes have been reported from 10 states: Arizona (4), California (1), Minnesota (4), Missouri (5), New Mexico (5), North Carolina (1), Texas (4), Utah (1), Washington (1), and Wisconsin (3). Illness onset dates range from October 17, 2014, to November 27, 2014. Nine illnesses have been associated with a pregnancy (occurred in a pregnant woman or her newborn infant). No miscarriages or fetal losses have been reported. Among people whose illnesses were not associated with a pregnancy, ages ranged from 7 to 92 years, with a median age of 66 years, and 41% were female. Three invasive illnesses (meningitis) occurred among otherwise healthy children aged 5–15 years. All 29 ill people have been hospitalized and, five deaths have been reported. Listeriosis contributed to three of these deaths and it is unclear whether it contributed to a fourth. The fifth death was unrelated to listeriosis.

At this point in the investigation, CDC’s Advice to Consumers remains the same. Out of an abundance of caution, CDC recommends that U.S. consumers not eat any commercially produced, prepackaged caramel apples, including plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings, until more specific guidance can be provided. These products could have a shelf life of more than one month. CDC, the involved states, and FDA continue to work closely on this rapidly evolving investigation, and new information will be provided as it becomes available.

UPDATE – FIRST LAWSUIT FILED – COMPLAINT

The Ongoing Risk of Listeria:

Listeria monocytogenes is an organism, which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.

Illnesses as of Friday Evening:

As of Friday the Centers for Disease Control and Prevention (CDC) reports that 28 people (although the Washington State Department of Health reports 29) have been infected with the outbreak strains of Listeria monocytogenes from 10 states linked to commercially produced, prepackaged caramel apples.  The states reporting illnesses are:

  • Arizona (4), California (1), Minnesota (4), Missouri (5), New Mexico (5), North Carolina (1), Texas (4), Utah (1), Washington (1) and Wisconsin (2).

Twenty-six ill people have been hospitalized. Among the 26 people hospitalized, five deaths have been reported.  The States reporting deaths are:

  • Minnesota (2), California (1), Texas (1) and Missouri (1).

Listeria was a contributing factor, but not cause of the Missouri death.  I spoke this morning to family of 81-year-old woman who died of Listeria in California on December 2 after purchasing and consuming a caramel apple shortly before Halloween.  The family has been informed that she is a link to the outbreak by California health officials.  The same officials came and picked up discarded product that may be leftovers from the consumed product.  The caramel apples were purchased at Safeway in Felton, California.

Nine illnesses were pregnancy-related (occurred in a pregnant woman or her newborn infant).

Three invasive illnesses (meningitis) were among otherwise healthy children aged 5–15 years.

Outbreak Investigation as of Saturday Morning:

The information CDC has at this time indicates that commercially produced, prepackaged caramel apples are the source of the outbreak

The most detailed information comes from the Minnesota Department of Health.  Minnesota cases purchased prepackaged caramel apples from Cub Foods, Kwik Trip, and Mike’s Discount Foods, which carried Carnival brand and Kitchen Cravings brand caramel apples.  Both brands are made by H. Brooks, a 110-year old company in New Brighton. The company only sells the caramel apples in Minnesota and Wisconsin.

At this time, no illnesses related to this outbreak have been linked to apples that are not caramel-coated and not prepackaged or to caramel candy.

Public health investigators are using the PulseNet system to identify cases that may be part of this outbreak.  DNA “fingerprinting” is being performed on the Listeria bacteria isolated from ill persons using pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS).  Two outbreak clusters were identified by the PFGE technique, and Listeria isolates within each cluster were found to be highly related by the WGS technique but distinct between the two clusters. CDC is investigating the two clusters together because one person was infected with both Listeria strains simultaneously and also because illnesses in the two clusters have occurred during a similar time period and in similar regions of the country.

Advise to Consumers from Health Officials:

Out of an abundance of caution, CDC recommends that U.S. consumers not eat any commercially produced, prepackaged caramel apples, including plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings, until more specific guidance can be provided.  If you are experiencing symptoms of listeriosis, please seek immediate medical attention.

What More Information to Expect in Coming Days:

  • Given the long incubation period – 3 to 70 days – for a Listeria infection to manifest after eating the product, it is likely that the numbers of ill will increase that they are reported by hospitals to local and state health authorities and then to the CDC.
  • It is expected that the Federal Food and Drug Administration (FDA) will announce Monday more information where the product was manufactured, shipped and sold.
  • It is also expected to hear more from the CDC on the likely point of Listeria contamination in the production of this product.

Media Coverage:

It was a busy Friday helping explain to the media the issues surrounding this unusual and tragic Listeria outbreak.

Washington Post

ABC News

Oregonian

KPIX (San Francisco)

KHQ (Spokane)

King (Seattle)

Kkot Saem Sprouts, Inc. of Spanaway, Washington is voluntarily recalling Soybean Sprouts and Mungbean Sprouts sold under brand names Kkot Saem, Winter Blossom Bean Sprouts, and Winter Blossom because the sprouts may be contaminated with Listeria monocytogenes.

The products were distributed at H-Mart in Washington and Oregon, and G-Mart in Oregon.

The last date of distribution was December 16, 2014. The mungbean sprouts have a five-day shelf life from the packing date and soybean sprouts have a shelf life of up to two weeks from the packing date.

Thirty-eight outbreak associated cases were detected during this investigation of an outbreak of Campylobacter jejuni infections among football team affiliated individuals in Durand, Wisconsin. Analysis of data pertaining to foods consumed during the team dinner demonstrates that consuming milk during the team dinner was associated with illness. Thirty- eight (100%) ill individuals reported consuming milk during the team dinner and 71% of the ill individuals reported consuming only the Farm A unpasteurized milk.

Farm A bulk tank milk sampled six days after the team dinner was negative for Campylobacter and Shiga toxin-producing E. coli. Cattle can shed Campylobacter and Shiga toxin-producing E. coli intermittently, and contamination of milk may occur during and after milking. The bulk tank milk sample collected on September 24 was not representative of milk that was served during the team dinner. Collection and testing of bovine manure samples proved to be a better method to detect bacteria that were present at the Farm A.

Nine bovine manure samples collected from Farm A were positive for Campylobacter jejuni. PFGE subtyping of Campylobacter jejuni isolates from case attendees detected 3 outbreak associated patterns (Patterns A-C), Pattern A was the predominant pattern identified. PFGE subtyping of Campylobacter jejuni isolates from the bovine manure collected from Farm A also detected Pattern A. The results of the epidemiologic and laboratory investigations conducted by DPH, PCHD, DATCP, WVDL and WSLH determined that consumption of Farm A unpasteurized milk during the Thursday team dinner was associated with the occurrence of Campylobacter jejuni infections among football team-affiliated individuals.

See Report:  “An outbreak of Campylobacter jejuni infections associated with consumption of unpasteurized milk.”

THE 2014 VILLA ROMANO GREEN FARMS BOTULISM OUTBREAK

In late May 2014 John Napierski, purchased seven jars of VR Greens Farms (VRGF) Basil Pine Nut Pesto at a Farm Stand operated at the Bella Collina Towne and Golf Club in San Clemente, California.  While on a road trip east, Mr. Napierski gave two jars to friends in Denver, Colorado. He then continued his trip to Ohio and gave two jars to his daughter, Kathryn (“Katy”), who was a nursing student working and attending college in Cincinnati.  Katy and her friend, Arielle Allen, used a portion of one jar of pesto as an ingredient in a chicken pasta dish they cooked at home and shared on July 13. On July 15 Katy complained of a sore throat and difficulty swallowing. Arielle started to have similar symptoms on July 17.  Over the next ten days both women continued to experience neurological symptoms.  Both women had multiple medical encounters before botulism was suspected as the cause of their symptoms. Katy was admitted to Bethesda North Hospital on July 17 and transferred to the University of Cincinnati Medical Center on July 18. Arielle was admitted to the University of Cincinnati Medical Center on July 27 due to worsening bulbar and facial weakness. Arielle’s admission to the hospital prompted the attending neurologist to note her friendship with Katy and similarity in symptoms between the two women.  He diagnosed both Katy and Arielle as having suspected botulism and notified public health authorities. Botulism antitoxin was obtained from the Centers for Disease Control and Prevention (CDC) and administered to Arielle on the evening of July 28. Serum and stool collected from Arielle and Katy did not test positive for C. botulinum. The toxin, however, was found in pesto sauce leftover from the chicken pasta meal.

Investigators at the City of Cincinnati Health Department and the Ohio Department of Health quickly determined that Katy and Arielle had shared a meal of pasta with chicken and jarred pesto sauce. During a visit to Arielle’s apartment, investigators found leftover chicken pasta with pesto in the apartment refrigerator. This was collected for laboratory testing for the presence of Clostridium botulinum toxin as was an unopened jar of pesto that Katy had. On July 29 Ohio investigators notified the CDC, the Food and Drug Administration (FDA), and the California Department of Public Health (CDPH) Food and Drug Branch (FDB) that two Ohio residents had botulism and that the suspected source was VRGF Basil Pine Nut Pesto.  CDPH FDB contacted Dominic Romano, owner of VRGF, and informed him of the illnesses.

Continue Reading A Botulism Tale: Two Young Women and One Jar of Pesto Sauce

As of December 18, 2014, a total of 28 people infected with the outbreak strains of Listeria monocytogenes have been reported from 10 states.  Arizona (4), California (1), Minnesota (4), Missouri (5), New Mexico (5), North Carolina (1), Texas (4), Utah (1), Washington (1) and Wisconsin (2). 26 ill people have been hospitalized. Among the 26 people hospitalized, five deaths have been reported. Listeriosis contributed to at least four of these deaths.  Nine illnesses were pregnancy-related (occurred in a pregnant woman or her newborn infant).  Three invasive illnesses (meningitis) were among otherwise healthy children aged 5–15 years.

The information CDC has at this time indicates that commercially produced, prepackaged caramel apples may be contaminated with Listeria. Listeria can cause a serious, life-threatening illness. In interviews, ill persons answered questions about foods consumed and other exposures in the month before becoming ill.   At this time, no illnesses related to this outbreak have been linked to apples that are not caramel-coated and not prepackaged or to caramel candy. Although limited information is currently available about the specific brand(s) of commercially produced, prepackaged caramel apples consumed, the finding that most of the ill people reported consuming these apples suggests that these Listeria infections are likely related to commercially produced, prepackaged caramel apples. Investigators are rapidly working to determine specific brands or types of commercially produced, prepackaged caramel apples that may be linked to illnesses and to identify the source of contamination.

Out of an abundance of caution, CDC recommends that U.S. consumers not eat any commercially produced, prepackaged caramel apples, including plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings, until more specific guidance can be provided. These products could have a shelf life of more than one month.