CDC Updates Salmonella Heidelberg Cases to 430 People in 23 States and Puerto Rico

FSIS is prepared to take additional actions or expand the investigation

The U.S. Centers for Disease Control and Prevention announced Thursday afternoon that, as of Jan. 15, a total of 430 persons infected with seven outbreak strains of Salmonella Heidelberg have been reported from 23 states and Puerto Rico.

The situation prompted a public health alert on Oct. 7, 2013, from the U.S. Department of Agriculture’s Food Safety and Inspection Service due to concerns that the illness was associated with chicken products produced at three Foster Farms processing facilities in California.

Most of the ill persons (74 percent) have been reported from California. The number of those ill identified in each state is as follows: Alaska (1), Arkansas (1), Arizona (19), California (321), Colorado (9), Connecticut (1), Delaware (1), Florida (4), Idaho (5), Illinois (1), Kentucky (1), Louisiana (1), Michigan (3), Missouri (5), North Carolina (1), Nevada (10), New Mexico (2), Oregon (10), Puerto Rico (1), Texas (10), Utah (2), Virginia (4), Washington (16), and Wisconsin (1).

Among 418 persons for whom information is available, illness onset dates range from March 1, 2013, to Dec. 26, 2013. Ill persons range in age from less than one year to 93 years, with a median age of 18 years. Fifty-two percent of ill persons are male. Thirteen percent of ill persons have developed blood infections as a result of their illness. Typically, approximately 5 percent of persons ill with Salmonella infections develop blood infections. No deaths have been reported.

Thirty-eight percent of ill persons have been hospitalized.The number of reported infections from the outbreak strains of Salmonella Heidelberg has returned to baseline levels, indicating that this particular outbreak appears to be over. However, activities related to this investigation are ongoing.

Epidemiologic, laboratory, and traceback investigations conducted by local, state, and federal officials indicate that consumption of Foster Farms brand chicken is the likely source of this outbreak of Salmonella Heidelberg infections.

This investigation is ongoing. FSIS is prepared to take additional actions or expand the investigation based on any new evidence.

Source: http://www.foodsafetynews.com/2014/01/cdc-updates-salmonella-cases-to-430-people-in-23-states-and-puerto-rico/#.Utk6EvQtrWQ

Healthy People 2020 Reviews Progress on Food Safety Objectives

Food Safety Modernization Act (FSMA) to production of food safety

The Healthy People 2020 initiative recently held a public webinar to update stakeholders on progress toward food safety objectives.

Addressing the goals to reduce infections from pathogens commonly transmitted through food, the Center for Food Safety and Applied Nutrition (CFSAN), cited new tools provided under the Food Safety Modernization Act (FSMA). The mandatory recall authority was used twice in 2013 to remove Salmonella-tainted pet treats.

For Shiga toxin-producing E. coli, the FSIS tests a broader range of source products for ground beef, has instituted sampling for 0:157 STECs, has incorporated new methodologies into outbreak investigations, and proposed regulations to label products containing mechanically tenderized beef. Also developing guidance for retail markets to help reduce Listeria contamination and a possible retail enforcement strategy.

To address preventing an increase in the proportion of non typhoidal Salmonella and Campylobacter jejuni isolates in humans that are resistant to antimicrobial drugs, the FDA’s plan to phase out the use of certain antibiotics in food animals.

A focus on reducing severe allergic reactions to food among adults has led FDA to modernize Good Manufacturing Practices (GMPs) to protect against allergen cross-contact, develop improved methods for the accurate measurement of allergens in complex foods, and tackle problematic food combinations such as undeclared milk in dark chocolate. FSIS took steps to refocus inspectors’ attention to potentially allergenic ingredients and now believes it has made an impact in reducing the number of recalls related to undeclared allergens.

And, to help increase the number of consumers following key food safety practices, FDA launched mobile-compatible versions of its site and FoodSafety.gov. 

Source:http://www.foodsafetynews.com/2014/01/healthy-people-2020-progress/#.UtQCedLuJyx

FSIS Releases Comprehensive Strategy to Reduce Salmonella

The Salmonella Action Plan presents a number of aggressive steps the agency will take to prevent Salmonella-related illnesses

The U.S. Department of Agriculture’s (USDA) Food Safety and Inspection Service (FSIS) today released its Salmonella Action Plan that outlines the steps it will take to address the most pressing problem it faces--Salmonella in meat and poultry products. An estimated 1.3 million illnesses can be attributed to Salmonella every year.

The Salmonella Action Plan is the agency’s strategy to best address the threat of Salmonella in meat and poultry products.  The plan identifies modernizing the outdated poultry slaughter inspection system as a top priority. By focusing inspectors’ duties solely on food safety, at least 5,000 illnesses can be prevented each year. 

Enhancing Salmonella sampling and testing programs is also part of this comprehensive effort,  ensuring that these programs factor in the latest scientific information available and account for emerging trends in foodborne illness. Inspectors will also be empowered with the tools necessary to expeditiously pinpoint problems.  With more information about a plant’s performance history and with better methods for assessing in-plant conditions, inspectors will be better positioned to detect Salmonella earlier, before it can cause an outbreak.

In addition, the plan outlines several actions FSIS will take to drive innovations that will lower Salmonella contamination rates, including establishing new performance standards; developing new strategies for inspection and throughout the full farm-to-table continuum; addressing all potential sources of Salmonella; and focusing the Agency’s education and outreach tools on Salmonella.

These efforts will build upon the work that USDA has done over the past several years. In 2011, USDA strengthened the performance standards for Salmonella in poultry with a goal of significantly reducing illnesses by 20,000 per year.  And through the Salmonella Initiative Program, plants are now using processing techniques designed to directly reduce Salmonella in raw meat and poultry.  Thanks to these innovative technologies and tough policies, Salmonella rates in young chickens have dropped over 75 percent since 2006.

Learn more about the Salmonella Action Plan.

http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/foodborne-illness-and-disease/salmonella/sap

Como prevenir  el riesgo de adquirir Salmonella por el consumo de huevos

Medidas a considerar según la CDC para impedir la contaminación

Los huevos, al igual que la carne, el pollo, la leche y otros alimentos, no causan enfermedades si se manipulan de manera adecuada. Los huevos en su cáscara se conservan mejor en el refrigerador y representan menos riesgos de enfermar si se cocinan completamente de manera individual y se consumen  de inmediato.

Al cocinar los huevos, se reduce el número de bacterias presentes; sin embargo, un huevo con la yema líquida sigue presentando un riesgo mayor que otro con la yema bien cocinada. Las claras y las yemas poco cocidas han sido asociadas a brotes de infecciones por Salmonella Enteritidis. Las claras y las yemas de los huevos deben consumirse poco después de prepararse y no se deben mantener bajo el calor o a temperatura ambiente por más de 2 horas.

Principales medidas a considerar para prevenir el riesgo:

1.    Mantener los huevos  refrigerados  (≤7°C) todo el tiempo.

2.    Lavarse las manos, los utensilios de cocina y las superficies de preparación de comida con agua y detergente si han estado en contacto con huevos crudos.

3.    Los huevos deben cocinarse hasta que la clara y la yema estén firmes y consumirse poco después de preparados.

4.    Evitar el consumo de huevos crudos o a medio cocer, especialmente en niños pequeños, ancianos y personas con sistemas inmunitarios debilitados.

Una persona infectada por las bacterias de Salmonella Enteritidis presenta fiebre, dolor de estómago y diarrea a partir de las 12 a 72 horas después de haber consumido un alimento o una bebida contaminado. La enfermedad dura generalmente de 4 a 7 días y en la mayoría de los casos las personas se recuperan sin necesidad de recibir un tratamiento con antibióticos. Sin embargo, la diarrea puede ser muy intensa y hacer que la persona se enferme tanto que requiera ser hospitalizada.

Fuente: http://www.cdc.gov/spanish/especialesCDC/SalmonellaHuevos/

CDC reports first STEC documented cases of E.coli O104 illnesses in the USA

Clinical laboratories should adhere to STEC testing recommendations because they are critical for identification of rare or novel STEC pathogens.

Six illnesses and one death associated with E.coli 0104:H4 but none of the US patients recalled consumption of raw fenugreek sprouts. This is the second-largest shiga toxin–producing E.coli (STEC) outbreak worldwide and the first documented STEC O104:H4 illnesses in the US.

The previous outbreak killed 50 and sickened 4,000, was centered in Northern Germany but affected 16 countries in Europe and North America.

The recent outbreak that occurred between May 26 and June 16, six confirmed cases were identified in five states: Arizona (one), Massachusetts (one), Michigan (two), North Carolina (one), and Wisconsin (one). The ages of patients ranged from 38 to 72 years, two patients were female and five reported travel to or from Germany in the three weeks before their illness. Patients reported consumption of fresh produce while in Germany, such as tomatoes, lettuce, and cucumbers. However, none recalled eating sprouts, the food vehicle ultimately implicated. “These events highlight challenges in investigating outbreaks, particularly those caused by rare pathogens or associated with food vehicles that are consumed in small quantities as part of other dishes,” said the report.

Clinical laboratories should adhere to STEC testing recommendations because they are critical for identification of rare or novel STEC pathogens. Four (66%) patients were reported by physicians to have developed HUS, requiring dialysis and ventilator support and one patient died.

Surveillance involved case-finding, use of laboratory testing protocols specific to non-O157 STEC, interviews to identify potential exposures of interest, and documentation of clinical courses.

Researchers from Michigan State University later decoded the E.coli strain, finding increased production of Shiga toxin was the probable reason for its virulence as it has a longer incubation period.

The outbreak described in this report, relies on having robust public health infrastructure in place. Such infrastructure, including systematic disease surveillance, laboratory capacity, and the ability to conduct epidemiologic and traceback investigations, is essential for maintaining a safe food supply. Sustaining and enhancing capacity to conduct these activities, both internationally and domestically, will be critical in confronting future challenges related to known and novel pathogens.

Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6250a3.htm

The 10 Biggest Foodborne Illness Outbreaks of 2013

Chicken and fresh produce lead the pack

Food Safety News has compiled a list of 10 of the biggest U.S. outbreaks in 2013 (this list excludes Norovirus outbreaks and only includes pathogenic outbreaks associated with grocery products or restaurants..

10. E. coli O157:H7 from Glass Onion chicken salads, 33 sick. Trader Joe’s customers in four states fell ill after eating one of two pre-made salad products from Glass Onion Catering. At least seven people were hospitalized, with two developing hemolytic uremic syndrome (HUS).

9. Salmonella from Hacienda Don Villo in Channahon, IL, 35 sick. Health investigators traced 35 Salmonella illnesses back to this Mexican restaurant in Grundy County, but they could never pinpoint the exact food source. At least one person was hospitalized, and one employee was among those who tested positive for Salmonella. 

8. E. coli O121 from frozen Farm Rich foods, 35 sick. Prompting a large recall of frozen mini pizza slices, cheeseburgers and quesadillas, this outbreak sickened predominantly minors across 19 states. Of those confirmed ill, 82 percent were 21 years of age or younger. Nine were hospitalized. The company recalled all products created at one Georgia plant between June 2011 and March 2013.

7. Salmonella from imported cucumbers, 84 sick. Investigators eventually traced this outbreak of Salmonella Saintpaul back to cucumbers imported from Mexico. Of those confirmed ill, 17 were hospitalized. The importers were barred from bringing more products into the U.S. until they could prove the products were not contaminated. 

6. E. coli O157:H7 from Federico’s Mexican Restaurant in Litchfield Park, AZ, 94 sick. Investigators have implicated lettuce served at the restaurant as the likely source of the E. coli, but no other restaurants in the area had cases connected to them. The lettuce may have been cross-contaminated from another food at the restaurant, or the restaurant may have received a highly contaminated batch. Two victims developed HUS as a result of their infections. 

5. Salmonella from Foster Farms chicken, 134 sick. The first of two Foster Farms outbreaks in 2013 hit Washington and Oregon the hardest, but then spread out across 13 states. At least 33 people were hospitalized, with infections likely resulting from cross-contamination or undercooking of highly contaminated raw chicken. Foster Farms has not issued a recall for either of the two major outbreaks caused by chicken it produced this year. 

4. Hepatitis A from Townsend Farms frozen organic berries, 162 sick. At least 71 people were hospitalized after eating an organic berry mix purchased at Costco stores in the Southwest. The exact source of the outbreak was eventually traced back to pomegranate seeds from Turkey which were contained within the mix.

3. Salmonella from dining at Firefly restaurant in Las Vegas, NV, 294 sick. Patrons of this popular Las Vegas tapas restaurant fell ill after dining within a five-day stretch in April. The owners ultimately closed up shop and re-opened the restaurant in a new location. 

2. Salmonella from Foster Farms chicken, 416 sick. While this outbreak appears to be ongoing, hundreds of individuals have fallen ill over the course of the year in connection with raw chicken processed at Foster Farms facilities in California. At least 162 people have been hospitalized after likely undercooking the contaminated raw chicken or handling it in a way that lead to accidental cross-contamination. Foster Farms has refused to issue a recall, and cases continue to appear as recently as early December. 

1. Cyclospora from salads and cilantro, 631 sick. The outbreak of this foodborne parasite also takes the title for most confusing, as it appeared to be two separate Cyclospora outbreaks working in tandem. One set of patients – predominantly from Iowa and Nebraska – clearly appeared to be connected to Olive Garden and Red Lobster restaurants (both owned by Darden Restaurants), while, just weeks later, patients in Texas began cropping up with no apparent connection to those restaurants. The Darden illnesses were tentatively traced to lettuce supplier Taylor Farms de Mexico, but no contamination could be found at the farms. Meanwhile, many of the Texas illnesses seemed to implicate fresh cilantro grown in Puebla, Mexico. 

Fuente: http://www.foodsafetynews.com

E. coli: The big six strains are here

USDA and CDC start to test beef for more enterohemorrhagic strains of E. coli

Most strains of Escherichia coli, or E. coli, are harmless. But some produce toxins that can sicken or kill people. The USDA banned the most commonly enterohemorrhagic strain identified — E. coli O157:H7 — from raw ground beef, a pathogen that can attach to vegetables and survive. It’s scheduled to ban another six enterohemorrhagic strains in past June. Birds and flies are usual vectors of these enteric pathogens.

Here are some outbreaks associated with those six enterohemorrhagic strains:

E. coli O26: A multi-state outbreak linked to raw clover sprouts at Jimmy John’s sandwich shops sickened more than two dozen people and hospitalized seven this year. In 2010, Cargill recalled about 8,500 pounds of ground beef because it may have been contaminated with this strain and led to three illnesses in New York and Maine. A more recent outbreak due to O26 was reported recently in Germany.

E. coli O45: Through 2008, CDC had identified three outbreaks linked to this strain. Two were suspected to involve infections from contact with animals at a petting zoo and a family farm.

E. coli O103: In 2000, two people were hospitalized in an outbreak possibly linked to water-based punch at a banquet hall in Washington State.

E. coli O111: The first community outbreak linked to this strain in the United States sickened five dozen girls attending a Texas cheerleading camp in 1999. More recently, one person was killed in a 2008 outbreak traced to an Oklahoma restaurant; hundreds were sickened. In both cases, the exact source of contamination is unknown.

E. coli O121: As of 2008, the largest outbreak tied to this strain involved contaminated lettuce that sickened 42 people at a catered event in Utah.

E. coli O145: Shredded romaine lettuce from an Ohio processing plant was contaminated with this strain and sickened more than two dozen people in 2010. Three developed kidney failure. No deaths have been reported.

Sources: CDC and USDA

UK’s FSA Publishes 2014 Food Safety Priorities

A major portion of the plan addresses Campylobacter, Britain’s most common cause of food poisoning.

In the plan, FSA is proposing to study how to modify processing equipment to limit Campylobacter contamination, how the pathogen attaches to chicken surfaces, why practices required for good hygiene are inconsistently applied and how to improve adherence, what factors affect variations in Campylobacter disease rates, which antimicrobial treatments could remove surface contamination, how frequently cross-contamination occurs in household kitchens and what might be the best practices for safely cooking chicken.

FSA also plans to promote new food safety guidance regarding Listeria monocytogenes in hospitals, nursing homes and other healthcare settings.

With the emergence of Hepatitis E in pork and Hepatitis A in berries and processed foods, these viruses are another concern. “Evidence points to these viruses being more heat stable than bacteria and this has raised questions concerning current processing or cooking conditions,” the plan states. So the agency plans to review literature and do further experiments to analyze heat stability.

In early 2013, curry leaves used in a ready-to-eat dish in Northeast England led to an outbreak of nearly 1,000 cases of Salmonella, Shigella and Enteroaggregative E. coli. As a result, FSA plans to address the need for better advice on curry leaf risk reduction.

The agency will also be studying the proportion of foodborne pathogens acquired in the home as opposed to external settings, the diversity of Enteroaggregative E. coli strains, exposure to metals and other elements in the U.K. diet, potential alternatives for food preservatives, the risks associated with buying food online, and bacteriophages – viruses that can kill bacteria and reduce microbiological contamination of foods.

And, in light of the horsemeat scandal earlier this year, FSA wants to develop tools for detecting horsemeat in heavily processed foods and determining the origin of foods.

Some projects FSA has already undertaken include reviewing the available rapid testing methods for detecting marine biotoxin in shellfish and researching toxoplasma in food and livestock.

Other aspects of the plan address food allergies and nutrition.

Source: http://www.food.gov.uk/news-updates/news/2013/aug/campylobacter#.UrwhO7SQNn8

FDA Proposes New Rule on ‘Antibacterial’ Soaps

Antibacterial hand soaps and body washes should demonstrate their products are safe and more effective than normal soap.

U.S. regulators on Monday 16 issued a proposed rule that would require makers of antibacterial hand soaps and body washes to demonstrate their products are safe and more effective than soap and water in preventing infection and the spread of bacteria.

"Although consumers generally view these products as effective tools to help prevent the spread of germs, there is currently no evidence that they are any more effective at preventing illness than washing with plain soap and water," the U.S. Food and Drug Administration said in a statement.

The FDA said research has suggested long-term exposure to antibacterial chemicals, such as triclosan in liquid soaps and triclocarban in bar soaps, could have hormonal affects and allow bacteria to mutate into harder-to-control strains.

The agency said companies that fail to demonstrate the safety and effectiveness of their products would have to reformulate them to back up the product claims, or re-label them to keep them on store shelves.

Such products are widely sold and touted, and include SoftSoap products from Colgate Palmolive, Cetaphil from Galderma Laboratories, and Dial products from Henkel AG.

The FDA said the action is part of a larger ongoing review by the agency to ensure that antibacterial ingredients are safe and effective. But the proposed rule would not affect hand sanitizers, wipes or antimicrobial products used in healthcare settings, the agency said.

The move comes five days after the FDA issued new guidelines to phase out the use of antibiotics as a growth enhancer in livestock, also in an effort to stem a surge in human resistance to antibiotics.

"Due to consumers' extensive exposure to the ingredients in antibacterial soaps, we believe there should be a clearly demonstrated benefit ... to balance any potential risk," said Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research.

Almost all soaps labeled "antibacterial" or "antimicrobial" contain at least one of the antibacterial ingredients addressed in the FDA's proposed rule, most notably triclosan and triclocarban, and some labeled "deodorant" may also contain these ingredients, the agency said.

The proposed rule will be available for public comment for 180 days. Concurrently, companies will be given one year to submit new data and information, followed by a 60-day rebuttal comment period.

Source: FDA

FSIS launches a new Salmonella reduction plan

An estimated 1.3 million illnesses can be attributed to Salmonella every year.

USDA’s Food Safety and Inspection Service released today a plan to reduce Salmonella in meat and poultry products, a priority coming into tighter focus as another outbreak of Salmonella Heidelberg has sickened hundreds across the country.

The Salmonella Action Plan prioritizes modernizing the poultry slaughter inspection system. Shifting FSIS inspectors to more offline, food safety duties will prevent at least an estimated 5,000 illnesses each year, the agency said.

An estimated 1.3 million illnesses can be attributed to Salmonella every year.

“Far too many Americans are sickened by Salmonella every year. The aggressive and comprehensive steps detailed in the Salmonella Action Plan will protect consumers by making meat and poultry products safer,” said Under Secretary for Food Safety Elisabeth Hagen, whose resignation from her post at FSIS will take effect mid-December.

The new plan prescribes enhanced sampling and testing programs that take into account “the latest scientific information available” and emerging trends in foodborne illness. Inspectors will “be empowered with the tools necessary to expeditiously pinpoint problems.” Equipped with more information about a plant’s performance history and better methods for assessing in-plant conditions, inspectors will better be able to detect salmonella earlier, ostensibly before it can cause an outbreak.

The plan also outlines several actions FSIS will take to foster new innovations toward lowering contamination rates, including establishing new performance standards; developing new strategies for inspection farm to table; addressing all potential sources of  Salmonella; and focusing the agency’s education and outreach tools on Salmonella.

The strategy announcement comes as FSIS, the Centers for Disease Control and Prevention and other health agencies continue to wrestle with an outbreak of Salmonella Heidelberg linked to three Foster Farms chicken plants in California. The outbreak has sickened nearly 390 people in 23 states.

Earlier impetus was provided also by an outbreak in 2011 of the same strain emanating from ground turkey that sickened 136 people in 34 states and forced Cargill to recall 36 million pounds of product.

FSIS followed with strengthened performance standards for salmonella in poultry, with a goal of significantly reducing illnesses by 20,000 per year. Through the Salmonella Initiative Program, plants currently are using processing technologies designed to directly reduce the pathogen in raw meat and poultry, and prevalence in broilers has dropped by more than 75 percent since 2006, FSIS said.

Source: USDA FSIS