FSnet Aug. 28/08 -- III BARFBLOG: Stick it in: Use a thermometer to cook foods so your friends donít barf at football New International Food Safety Network Infosheet -- 31 patrons of Bar-B-Q Center in Lexington, NC Ill with norovirus UK: Families ill after outbreak of E.coli CDC: Salmonella outbreak appears to be over US: Salmonella outbreak ends with questions Outbreak of Salmonella Serotype Saintpaul infections associated with multiple raw produce items --- United States, 2008 FLORIDA: Strawberry growers gather for food safety updates National Post Editorial Board: Listeriosis outbreak points at a broken system Some key dates in the development of the cross-CANADA listeriosis outbreak 'Eat meat and die!' warning drives home lifesaving message SPAIN probes possible fourth human case of mad cow disease CALIFORNIA: Raw milk program has done great things for community US: Back to school food safety tips for parents and students how to subscribe BARFBLOG: Stick it in: Use a thermometer to cook foods so your friends donít barf at football 28.aug.08 barfblog Andrew Reece http://barfblog.foodsafety.ksu.edu/2008/08/articles/food-safety-communication/stick-it-in-use-a-thermometer-to-cook-foods-so-your-friends-dont-barf-at-football/index.html U.S. college football kicks off Saturday. Time to put on your favorite schoolís colors and brush up on that fight song. Thousands of students and alumni will be heading out to the stadium, tailgating, and firing up those grills. Hamburgers, chicken, ribs, or beans, there will be plenty of food on hand. Use a food thermometer to make sure you arenít serving your friends and family undercooked meats. Make sure to cook ground beef to 160ƒF(1), while chicken needs to reach 165ƒF(2). That way when your team takes the field, you arenít puking or stuck on the toilet. And using a thermometer will make you a better cook. People are impressed by this. Good food safety will allow you to fully enjoy the tailgating atmosphere, so you can cheer your school onto victory. Itís all on video, http://www.youtube.com/watch?v=YmyMmjfFo5Y References 1: Ryan, Suzanne M., Mark Seyfert, Melvin C. Hunt, Richard A. Mancini. Influence of Cooking Rate, Endpoint Temperature, Post-cook Hold Time, and Myoglobin Redox State on Internal Color Development of Cooked Ground Beef Patties. Journal of Food Science. Volume 71 Issue 3 Page C216-C221, April 2006 http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2621.2006.tb15620.x?prevSearch=authorsfield%3A%28M.C.+Hunt%29 2: Focus On: Chicken. Food Safety and Inspection Service. United States Department of Agriculture. April 4, 2006. http://www.fsis.usda.gov/factsheets/chicken_food_safety_focus/index.asp   top New International Food Safety Network Infosheet -- 31 patrons of Bar-B-Q Center in Lexington, NC Ill with norovirus 28.aug.08 International Food Safety Network http://www.foodsafety.ksu.edu/articles/1229/iFSN-infosheet-8-28-08.pdf The newest food safety infosheet, a graphical one-page food safety-related story directed at food handlers, is now available at foodsafetyinfosheets.ksu.edu. Infosheet highlights: -Linked to food handler who wasn't ill -A food handler who had recently cared for an ill family member likely introduced norovirus into the kitchen -Infected people can shed large amounts of norovirus in their vomit and poop -Norovirus can persist on common kitchen surfaces for at least 3-6 weeks Infosheets are created weekly by iFSN and are posted in restaurants, retail stores, on farms and used in training throughout the world. If you have any infosheet topic requests, or photos, please contact Ben Chapman at bchapman@uoguelph.ca   top UK: Families ill after outbreak of E.coli 28.aug.08 Evening Express David Ewen and Alison Rennie http://www.eveningexpress.co.uk/Article.aspx/810344?UserKey=0 http://barfblog.foodsafety.ksu.edu/2008/08/articles/e-coli/memories-of-walkerton-drinking-water-in-scotland-wells-sickens-15-with-e-coli-o157/index.html Up to 15 people ñ including children ñ were this afternoon being treated for E.coli after an outbreak of the bug near Aberdeen. Seven cases have already been confirmed with a further eight people showing symptoms. Public health chiefs have launched an investigation. They believe the source is a shared private water supply to eight homes in South Auchinclech, near Westhill. The e.coli bug can be a killer for young children and the elderly but NHS Grampian refused to say what age range of people had been struck down. A spokesman said: ìThe numbers involved are so small, we are concerned about identifying the individuals.î Three victims were reportedly taken to hospital. Aberdeen-based Prof Pennington, a world expert in e.coli, said the source of the contamination was likely to be cattle manure. He said: ìThere is quite a strong possibility it got washed into the water supply by heavy rain. ìThe water purification system probably got overwhelmed. Ö Once somebodyís been affected, weíve just got to keep our finger crossed.î   top CDC: Salmonella outbreak appears to be over 28.aug.08 Associated Press Ricardo Alonso-Zaldivar http://ap.google.com/article/ALeqM5jgFWGWTW9iJ8-l2sKdiURx-NrlJgD92RCRP80 WASHINGTON ó The Centers for Disease Control and Prevention say the salmonella outbreak that sickened more than 1,440 people appears to be over. A joint investigation by CDC and the Food and Drug Administration found strong evidence that jalapeno peppers were a major carrier of the bacteria, and that serrano peppers were also a carrier. The salmonella strain that caused the outbreak was traced back to a produce distribution center in Texas, and to a farm in Mexico that grew peppers. The extensive probe found no contaminated tomatoes, but investigators say they cannot rule out that tomatoes might have been a carrier, particularly early on. It was the largest outbreak of foodborne illness in the United States in the past decade.   top US: Salmonella outbreak ends with questions 28.aug.08 New York Times Mike Nizza http://thelede.blogs.nytimes.com/2008/08/28/salmonella-outbreak-ends-with-questions/?hp The United States governmentís response to the Salmonella outbreak has emerged in a series of utterly frank briefings, so it was fitting that officials wrote the last chapter with a hint of uncertainty. ìThe outbreak appears to be over,î a Centers for Disease Control and Prevention report released said today. ìHowever, C.D.C. and state health departments are continuing to conduct surveillance for cases of infection with the outbreak strain.î While the first-order problem of stopping the illness was apparently solved, the C.D.C. has a few holes remaining in tracing the pathogenís origins. Here are the C.D.C.ís preliminary findings on the roles of three major produce suspects in carrying Salmonella: ñ JalapeÒo peppers: ìmajor vehicleî ñ Serrano peppers: ìalso were a vehicleî ñ Tomatoes: ìpossibly were a vehicle for infection, particularly early in the outbreakî The relatively long explanation for the third item reflected a failure to find salmonella in any tomatoes linked to the illnesses, as was the case for the peppers. But a much longer section of the report listed several signs that that they were involved: Tomatoes possibly were a vehicle for infection, particularly early in the outbreak. In the initial case-control study, illness was significantly associated with consumption of raw tomatoes and not with foods containing peppers, such as salsa or guacamole. Consumption of jalapeÒo or serrano peppers was not assessed in this initial study because in hypothesis-generating interviews conducted with 19 case-patients, only five (26%) reported eating peppers other than red or green bell peppers in the week before illness began. In addition, a survey of 75 case-patients in Texas whose illnesses began before June 7, using a questionnaire that asked specifically about pepper consumption, found a relatively low proportion who reported eating raw jalapeÒo (39%) or raw serrano (8%) peppers in the week before illness began, whereas reported raw tomato consumption was high (85%). Finding the outbreak strain on two types of peppers from two farms supports the possibility of contamination of other produce items, including tomatoes, during growing, processing, or distribution. The final ruling on whether tomatoes sickened Americans will be of great interest to growers and others in the food industry. F.D.A. warnings against tomatoes in June slowed sales, but the outbreak failed to slow. Just as investigators began to turn other suspects, one group blamed $100 million in food industry losses on what became known as the tomato scare. Whether todayís evidence was worth that much in lost business remains to be seen. Back in July, state health officials considered whether a mistake had been made over tomatoes, and how to address it. From The Baltimore Sun: ìItís bad, and I think everyone will be very apologeticî if it turns out tomatoes werenít the source, said Tim Jones, Tennesseeís state epidemiologist, describing himself as ìincreasingly concernedî about whether tomatoes are to blame. To be sure, the lingering questions serve another purpose for the F.D.A. and C.D.C. ìThese findings indicate that additional measures are needed to enhance food safety and reduce illnesses from produce that is consumed raw,î the report said. Dr. David Acheson, the agencyís associate commissioner for foods, named a few ideas in a conference call with reporters today. From Reuters: We need Congress to give the FDA authority Ö for mandatory controls for fresh foods,î Acheson told the briefing. ìWe need to develop technologies which will enable us to detect pathogens in fresh produce more quickly,î he added. And industry must do more electronic tracking of products. ìIndustry is responsible for safe products and tracking (them),î Acheson said. ìThe point is that not all industry is doing it and there need to be standards.î He also said that irradiating fresh spinach and lettuce, a practice approved earlier this month, was ìpart of a solution.î Unfortunately, USA Today reported today that several significant hurdles remain before food producers embrace the safeguard.   top Outbreak of Salmonella Serotype Saintpaul infections associated with multiple raw produce items --- United States, 2008 29.aug.08 MMR Weekly August 29, 2008 / 57(34);929-934 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5734a1.htm?s_cid=mm5734a1_x On May 22, 2008, the New Mexico Department of Health (NMDOH) notified CDC about four persons infected with Salmonella Saintpaul strains that were indistinguishable from each other by pulsed-field gel electrophoresis (PFGE) and 15 other persons with Salmonella infections whose isolates had not yet been characterized. In the following weeks, cases continued to be reported, and the outbreak expanded to include 43 states, the District of Columbia (Figure 1), and Canada. This report is an interim summary of results from seven epidemiologic studies, traceback investigations, and environmental investigations related to the outbreak. Further data collection and analyses are ongoing. As of August 25, 2008, a total of 1,442 persons had been reported infected with the outbreak strain. At least 286 persons have been hospitalized, and the infection might have contributed to two deaths. The outbreak began late in April 2008, and most persons became ill in May or June. The outbreak appears to be over; however, CDC and state health departments are continuing to conduct surveillance for cases of infection with the outbreak strain. Preliminary epidemiologic and microbiologic results to date support the conclusion that jalapeÒo peppers were a major vehicle by which the pathogen was transmitted and serrano peppers also were a vehicle; tomatoes possibly were a vehicle, particularly early in the outbreak. Contamination of produce items might have occurred on the farm or during processing or distribution; the mechanism of contamination has not been determined. These findings indicate that additional measures are needed to enhance food safety and reduce illnesses from produce that is consumed raw. Epidemiologic Studies A case was defined as laboratory-confirmed infection with Salmonella Saintpaul with XbaI pattern JN6X01.0048, the outbreak strain. Of the 1,442 cases reported, public health agencies have reported illness onset information for 1,414 patients. Illnesses began during April 16--August 11; most persons became ill in May or June (Figure 2). Complete demographic information is available for 565 ill persons. Of these, 52% were male; 79% were white, 8% were American Indian/Alaska Native, 3% were black, 2% were Asian/Pacific Islander, and 7% reported other or multiple races. Hispanic ethnicity was reported for 22%. Patient ages ranged from <1 to 99 years (median age: 33 years), and the highest incidence was among persons aged 20--29 years. Cases were distributed among 43 states, the District of Columbia, and Canada, with particularly high incidence rates in New Mexico and Texas (Figure 1). Soon after the first cases were detected in mid-May 2008, additional cases were identified in Texas and the Navajo Nation through PulseNet (the national molecular subtyping network for foodborne disease surveillance). Nineteen ill persons were initially interviewed in detail to generate hypotheses about the source of their illnesses. To identify the source, NMDOH, the Texas Department of State Health Services (TXDSHS), Navajo Nation, the Indian Health Service (IHS), and CDC conducted a multistate case-control study of laboratory-confirmed infections. For this case-control study, a case was defined as diarrheal illness (three or more loose stools in a 24-hour period) that began on or after May 1 in a person infected with the outbreak strain. Controls were well persons in the community matched by age and location using reverse telephone directories and by face-to-face interviews. The matched analysis included 51 case-patients and 106 controls. Using a questionnaire based on hypotheses generated by the preliminary interviews, study participants were asked about foods consumed during the week preceding their illness. On univariate analysis, illness was significantly associated with eating raw tomatoes (matched odds ratio [mOR] = 6.7) and had a borderline association with eating tortillas (mOR = 2.8) in the week preceding illness onset (Table). Illness remained significantly associated with eating raw tomatoes (mOR = 5.6) after adjusting for consumption of tortillas (Table). Illness was not significantly associated with eating salsa (mOR = 1.7), guacamole (mOR = 1.6), or any other food item (Table). In June, increasing numbers of cases were reported from a growing number of states. State and local health departments identified clusters of illness in restaurants by interviewing ill persons whose isolates had the outbreak PFGE pattern and asking about exposures to suspect foods and about any recent meals at restaurants. Beginning on June 20, TXDSHS and CDC investigated a cluster of 47 ill persons associated with a Mexican-style restaurant in Texas. For this case-control study, a case was defined as diarrheal illness (three or more loose stools in a 24-hour period) in a person who ate at the restaurant in the week before illness began; culture confirmation was not required. Controls were well meal companions. The analysis included 47 case-patients and 36 controls. On multiple logistic regression, illness was significantly associated only with eating salsa (adjusted odds ratio [aOR] = 62.3) (Table). The salsa ingredients included raw tomatoes and raw jalapeÒo peppers. Beginning on June 24, TXDSHS and CDC investigated another cluster of 33 ill persons, this one associated with a local Mexican-style restaurant chain in Texas. For this case-control study, a case was defined as diarrheal illness (three or more loose stools in a 24-hour period) in a person who ate at either of two restaurants in the chain during the week before illness began; culture confirmation was not required. Controls were well meal companions and restaurant patrons identified by credit card receipts. The analysis included 33 case-patients and 62 controls. Illness was significantly associated only with eating salsa (aOR = 7.5) (Table). The salsa ingredients included commercially canned tomatoes and raw jalapeÒo peppers, but not raw tomatoes. These results indicated that jalapeÒo peppers were a likely source of illness. Beginning on June 26, to further investigate possible food vehicles, CDC and state and local health departments in 29 states conducted a second multistate case-control study of laboratory-confirmed infections identified through PulseNet. A case was defined as diarrheal illness (three or more loose stools in a 24-hour period) that began on or after June 1 in a person infected with the outbreak strain. Controls were well persons in the community matched by age and location using reverse telephone directories. The matched analysis included 141 cases and 281 controls. After adjusting for sex, Hispanic ethnicity, and additional age variation, illness was significantly associated with eating at a Mexican-style restaurant in the week preceding illness onset (mOR = 4.6) (Table). Illness also was significantly associated with eating pico de gallo (mOR = 4.0), corn tortillas (mOR = 2.3), and freshly prepared salsa (mOR = 2.1) (Table). Illness was not significantly associated with any other individual food items or ingredients. Beginning on June 30, the Minnesota Department of Health investigated a cluster of 19 persons with Salmonella Saintpaul infection associated with a natural food restaurant. For this case-control study, a case was defined as diarrheal illness (three or more loose stools in a 24-hour period) in a person infected with the outbreak strain who ate at the restaurant in the week before illness began. Controls were well meal companions and restaurant patrons identified by credit card receipts. The analysis included 19 case-patients and 73 controls. On univariate analysis, illness was significantly associated with eating any of several items including salsa, guacamole, red bell peppers, cilantro, and jalapeÒo peppers. Both types of peppers had been diced before they arrived at the restaurant. On multivariate analysis, illness was only significantly associated with eating raw, jalapeÒo peppers (OR = 62.0) (Table). This study provided more evidence that consumption of raw jalapeÒo peppers was a major risk factor for illness. Beginning on July 7, the North Carolina Division of Public Health, the Mecklenburg County Health Department, and CDC investigated a cluster of 13 ill persons associated with a local Mexican-style restaurant. For the case-control study, a case was defined as diarrheal illness (three or more loose stools in a 24-hour period) in a person infected with the outbreak strain who ate at the restaurant in the week before illness began. Controls were well restaurant patrons identified by credit card receipts. The analysis included four case-patients and 113 controls. On multivariate analysis, illness was significantly associated only with eating guacamole (aOR = 8.7) (Table). The guacamole ingredients included avocado, raw Roma tomatoes, raw red onions, raw serrano peppers, cilantro, salt, and lime juice, but not jalapeÒo peppers. This study demonstrated that not all of the outbreak illnesses could be linked to eating jalapeÒo peppers. During May 22--August 7, state and local health departments in 14 states and the District of Columbia reported a total of 33 restaurant-associated clusters of illness. The median number of laboratory-confirmed cases for all clusters was four; 26 (79%) of the 33 clusters had eight or fewer laboratory-confirmed cases. Raw jalapeÒo peppers were not served in four of the restaurants, serrano peppers were not served in 19 restaurants, and raw tomatoes of various types were served in all restaurants. Of the four restaurants without raw jalapeÒo peppers, two had serrano peppers. During July 11--25, NMDOH, the Arizona Department of Health Services, Navajo Nation, IHS, and CDC conducted a household-based case-control study among non-restaurant--associated cases in New Mexico, Arizona, and the Navajo Nation. A case-household was defined as a household with a case (defined as diarrheal illness [three or more loose stools in a 24-hour period] beginning on or after June 1 in a person infected with the outbreak strain). Control-households were enrolled systematically from the same community and had no members who reported diarrheal illness on or after June 1. The matched analysis included 41 case-households and 107 control-households and compared the presence of specific foods in the household regardless of whether the respondent remembered eating them. On univariate analysis, illness in the household was significantly associated with having a raw jalapeÒo pepper in the household (mOR = 2.9), and illness had a borderline association with having a raw serrano pepper in the household (mOR = 3.0) during the week preceding illness onset (Table). Illness was not significantly associated with the presence of any other food item in the household. A concurrent case-control study that evaluated individual-level exposures asked the case-patient in each case-household and respondents in control-households about recent food exposures. This study did not identify an association between illness in the case-patients and eating raw jalapeÒo or serrano peppers. These results suggested that at the time these illnesses were occurring, jalapeÒo peppers and perhaps serrano peppers were likely vehicles for illness among persons not associated with a restaurant cluster, although persons might not have specifically recalled consuming the peppers. Environmental and Traceback Investigations The Food and Drug Administration (FDA) traced back the processing and distribution pathway for tomatoes associated with several ill persons. These tracebacks did not converge onto a single packer, distributor, or growing area of tomatoes. Tomatoes linked to ill persons and tomatoes randomly collected from the distribution chain in several states were cultured; none of these cultures yielded Salmonella. FDA traced the source of the jalapeÒo peppers associated with illness in the two previously described Texas restaurant-associated clusters to distributors in Texas that received jalapeÒo peppers from Mexico. On July 21, FDA reported isolation of the outbreak strain from a jalapeÒo pepper sample obtained from one of these distributors. The pepper likely was grown on a farm in Tamaulipas, Mexico (farm A); this farm also grew serrano peppers and Roma tomatoes. FDA did not isolate the outbreak strain from environmental samples from farm A, but did isolate the outbreak strain from a sample of serrano peppers and a sample of water from a holding pond used for irrigation from another farm (farm B) in Tamaulipas. Farm B also grew jalapeÒo peppers, but not tomatoes. Farms A and B provided produce to a common packing facility in Mexico that exports to the United States. In addition, on July 29, the Colorado Department of Public Health and Environment (CDPHE) reported isolation of the outbreak strain from a jalapeÒo pepper collected from the household of a person in Colorado who had developed illness with the outbreak strain. CDPHE traced this pepper from the grocery store where it had been purchased to another distributor in Texas, which reportedly received jalapeÒo peppers from farms in Mexico; however, the specific farms have not been identified. Control Measures Since June 3, CDC, FDA, and public health partners have issued multiple public advisories recommending that consumers avoid eating certain produce items. A limited advisory recommending that consumers in New Mexico and Texas avoid eating certain types of tomatoes was issued on June 3, and the advisory was expanded nationwide on June 7 (Figure 2). After associations were identified between illness and eating jalapeÒo and serrano peppers, CDC and FDA issued successive advisories recommending that consumers avoid eating jalapeÒo and serrano peppers grown in Mexico; the first nationwide jalapeÒo pepper advisory was issued on July 9 (Figure 2). The tomato advisory was lifted on July 17; the jalapeÒo and serrano pepper advisories remain in effect. Reported by: J Jungk, MPH, J Baumbach, MD, M Landen, MD, New Mexico Dept of Health. LK Gaul, PhD, L Alaniz, MPH, T Dang, MPH, EA Miller, PhD, Texas Dept of State Health Svcs. J Weiss, PhD, Arizona Dept of Health Svcs. E Hedican, MPH, K Smith, DVM, Minnesota Dept of Health. F Grant, T Beauregard, Mecklenburg County Health Dept; D Bergmire-Sweat, MPH, D Griffin, J Engel, MD, North Carolina Div of Public Health. S Cosgrove, S Gossack, Colorado Dept of Public Health and Environment. A Roanhorse, H Shorty, Navajo Nation Div of Health. J Cheek, MD, J Redd, MD, I Vigil, MD, Div of Epidemiology and Disease Prevention, Indian Health Svc; Food and Drug Admin; Div of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vector-Borne, and Enteric Diseases; EIS officers, CDC. Editorial Note: Contaminated produce eaten raw is an increasingly recognized vehicle for transmission of Salmonella and other pathogens (1). Each year, approximately 36,000 laboratory-confirmed cases of Salmonella infection are reported in the United States through national serotype-based surveillance (2). Salmonella Saintpaul is an uncommon serotype, causing, on average, 1.6% of all reported laboratory-confirmed Salmonella infections each year. In 2007, only 40 human isolates of the outbreak strain were submitted to PulseNet. This report describes the largest foodborne disease outbreak identified in the United States in the past decade, based on the number of culture-confirmed cases. Because many persons with Salmonella illness do not seek care or have a stool specimen tested, many more illnesses likely have occurred than those reported (3). In this outbreak, epidemiologic studies revealed associations between illness and more than one raw produce item. Although most multistate enteric disease outbreaks have been linked to a single food vehicle, an outbreak attributed to both parsley and cilantro grown on one farm has been reported (4). The initial case-control study identified an association between illness and eating raw tomatoes. Subsequent studies identified an association between illness and eating raw jalapeÒo peppers, an item commonly eaten with tomatoes in Mexican-style cuisine. Epidemiologic data also suggested an association with raw serrano peppers. These associations triggered product alerts and led to product tracing and microbiologic studies, which indicated that jalapeÒo and serrano peppers grown, harvested, or packed in Mexico were contaminated with the outbreak strain. The epidemiologic and microbiologic results support the conclusion that jalapeÒo peppers were a major vehicle by which the pathogen was transmitted, and that serrano peppers also were a vehicle. Consumption of peppers was not implicated in either of the two multistate case-control studies. However, produce items such as peppers that are typically consumed in small quantities as ingredients of other dishes might not be remembered and can be difficult to implicate (5). Neither raw jalapeÒo nor serrano peppers have been identified previously as a vehicle for a foodborne disease outbreak in the United States. Little is known about the survival and growth characteristics of Salmonella on these peppers, although rapid growth in jalapeÒo pepper extract has been reported (6). Tomatoes possibly were a vehicle for infection, particularly early in the outbreak. In the initial case-control study, illness was significantly associated with consumption of raw tomatoes and not with foods containing peppers, such as salsa or guacamole. Consumption of jalapeÒo or serrano peppers was not assessed in this initial study because in hypothesis-generating interviews conducted with 19 case-patients, only five (26%) reported eating peppers other than red or green bell peppers in the week before illness began. In addition, a survey of 75 case-patients in Texas whose illnesses began before June 7, using a questionnaire that asked specifically about pepper consumption, found a relatively low proportion who reported eating raw jalapeÒo (39%) or raw serrano (8%) peppers in the week before illness began, whereas reported raw tomato consumption was high (85%). Finding the outbreak strain on two types of peppers from two farms supports the possibility of contamination of other produce items, including tomatoes, during growing, processing, or distribution. Local, state, tribal, and federal response capacity often is strained during large and complex outbreaks, and structure and capabilities vary among jurisdictions. This can cause delays in identifying cases and in conducting investigations. In this outbreak investigation, the median time from illness onset to submission of the PFGE pattern of patients' Salmonella isolates to PulseNet was 17 days; 90% were submitted within 27 days. Faster transfer of bacterial strains to public health laboratories and faster subtyping in those laboratories would result in more timely investigation of cases of infection. Epidemiologic investigations can benefit from faster methods for interviewing ill and well persons, improved interview formats, and rapidly adaptable electronic data gathering and transmission platforms. Improvements in the ability to trace contaminated produce quickly and accurately also would improve the speed of investigations, the speed and specificity of recalls, and the determination of the ultimate causes of contamination. For several years, CDC has been improving the efficiency of epidemiologic investigations through OutbreakNet, the network of public health officials that investigates outbreaks of enteric illnesses nationwide, and through participation in the Council to Improve Foodborne Outbreak Response,* a multidisciplinary working group. In addition, FDA has been enhancing the safety of produce by collaborating with state officials, academia, and industry on multiyear initiatives to increase the safety of leafy greens and tomatoes. FDA and its partners are working to improve guidance and policies intended to minimize outbreaks and to improve produce-safety research and education. References 1. Sivapalasingam S, Friedman CR, Cohen L, Tauxe RV. Fresh produce: a growing cause of outbreaks of foodborne illness in the United States, 1973--1997. J Food Prot 2004;67:2342--53. 2. CDC. PHLIS surveillance data: Salmonella annual summary, 2005. Atlanta, GA: US Department of Health and Human Services, CDC; 2007. Available at http://www.cdc.gov/ncidod/dbmd/phlisdata/salmonella.htm. 3. Voetsch A, Van Gilder TJ, Angulo FJ, et al. FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States. Clin Infect Dis 2004;38:S127--34. 4. Naimi TS, Wicklund JH, Olsen SJ, et al. Concurrent outbreaks of Shigella sonnei and enterotoxigenic Escherichia coli infections associated with parsley: implications for surveillance and control of foodborne illness. J Food Prot 2003;66:535--41. 5. Mahon BE, P–nk” A, Hall WN, et al. An international outbreak of Salmonella infections caused by alfalfa sprouts grown from contaminated seeds. J Infect Dis 1997;175:876--82. 6. Nutt JD, Li X, Woodward CL, et al. Growth kinetics response of a Salmonella typhimurium poultry marker strain to fresh produce extracts. Bioresour Technol 2003;89:313--6. * Information available at http://www.cifor.us.   top FLORIDA: Strawberry growers gather for food safety updates 28.aug.08 The Packer.com Doug Ohlemeier http://thepacker.com/icms/_dtaa2/content/wrapper.asp?alink=2008-11511-954.asp&stype=topnews&fb= PLANT CITY, Fla. ó As they were preparing to put their winter crops in the ground, Florida strawberry growers and shippers heard how to keep what happened to tomato growers from striking the strawberry industry. At the Florida Strawberry Growers Associationís Aug. 26-27 Agritech 2008 meeting, growers learned what they can do to keep updated on food safety developments and heard updates on how legislative action in Washington, D.C., could affect their harvesting workforce. Ted Campbell, the Dover-based associationís newly appointed executive director, said concerns about safety, food security and traceability along with availability and prices will remain the focus of todayís food system. ìWe all watched in agony as tomatoes got crucified in the media,î Campbell said, referring to an outbreak of salmonella that the Food and Drug Administration, in part, blamed on tomatoes. ìAnd they had a pretty good safety and traceback process in place,î he said. ìUnfortunately, their acquittal and execution was pretty low-key. Thatís wrong. Now is the critical time to work with government, health regulators, buyers and the media on how such incidents are handled in the future. We have to be completely alert that what happened to the tomato people is possible.î Walter Kates, director of the labor relations division of the Florida Fruit & Vegetable Association, Maitland, updated growers on immigration reform situation in Washington, D.C. He noted proposed changes in the H-2A program involving housing could aid Florida growers. Despite any potential positive reforms, the issue remains contentious, Kates said. ìI donít care who is elected president,î he said. ìWe, in my opinion, wonít see any comprehensive reform legislation passed, at least for the first term. It has become such an emotional issue and is very divisive. A group over here wants the borders closed while the group that wants amnesty refuses to have any guest worker program. Itís just a real mess, aside from the emotional side of it.î The 26th yearly conference attracted 315 participants, said Sue Harrell, the associationís director of marketing.   top National Post Editorial Board: Listeriosis outbreak points at a broken system 28.aug.08 National Post Kelly McParland http://network.nationalpost.com/np/blogs/fullcomment/archive/2008/08/28/national-post-editorial-board-listeriosis-outbreak-points-at-a-broken-system.aspx The listeriosis outbreak that began with tainted meats processed at one of Maple Leaf Foodsí Toronto facilities is undoubtedly a tragic event. Contaminated meat has been conclusively linked to 29 cases of illness, including 15 deaths, in Ontario, B.C., Saskatchewan and Quebec. As the death toll rises and class action lawsuits against Maple Leaf pick up steam, we must apportion the blame for this incident where it is merited ó both to Maple Leaf and to the federal government. Changes to the way food inspection takes place in this country appears to be a major factor in this outbreak. Food inspectors, including the one responsible for the Toronto plant, are simply stretched too thin to perform their jobs properly. In March, the Canadian Food Inspection Agency (CFIA) introduced a new compliance verification system that imposed more uniform standards, but also created a larger administrative burden for its inspectors, thereby limiting their time performing on-site inspections. When inspectors feel forced to choose between ìdropping the paper workî and ìdropping the inspection work,î you have a broken system. Federal Health Minister Tony Clement has been surprisingly absent from the public eye during the crisis, choosing instead to travel to Denver for the Democratic National Convention. His response ó that he is ìavailable all hours of the day and nightî ó hardly inspires confidence. Leadership in a crisis cannot be delivered via BlackBerry. Maple Leaf Foodsí excellent post-outbreak performance ó the company followed health officialsí recommendations in a timely fashion, issued a sweeping meat recall, shut down its Toronto plant at a cost of $20-million, issued multiple apologies and acted in an open, forthcoming manner ó does not erase its culpability. Listeria is a commonly found bacterium and only causes illness when present in large quantities. The fact that significant amounts of the bacteria ended up in its meat products means that something went seriously awry. Several class-action lawsuits have already been filed against Maple Leaf Foods ó potentially resulting in settlements in the billion-dollar range. Surely those who have lost relatives or experienced serious illness themselves deserve compensation. Stephen Harper has declared that the outbreak demonstrates that ìitís necessary to reform and revamp our food and product inspection regimes.î Whatever the proposed solutions, fixing this mess cannot consist merely of delegating responsibility to the food industry. When it comes to keeping the Canadian food supply safe, a combination of public inspection and private responsibility is essential. The CFIA must be given the resources to do its job, and the private sector must learn from Maple Leafís mistakes.   top Some key dates in the development of the cross-CANADA listeriosis outbreak 28.aug.08 The Canadian Press http://canadianpress.google.com/article/ALeqM5hXT2A03u-PgHBvgJQNCMp-Nd2seg TORONTO ó June 2: Earliest date from which meat prepared at Maple Leaf Foods plant in north Toronto later begins to fall under suspicion of Listeria contamination. Mid-July: Two people living at the same Toronto nursing home die and are diagnosed with a similar bacterial infection. Ontario health officials begin actively investigating cases of people falling ill. Aug. 5: Samples taken from Toronto nursing home test positive for listeriosis. Aug. 6: Canadian Food Inspection Agency notified of the results of Toronto sample testing; returns to nursing home to collect additional samples of meats and cheese. Aug. 13: Maple Leaf notifies distributors they are under investigation; remaining inventory of Sure Slice roast beef, corned beef and Black Forest ham is put on hold. Aug. 14: CFIA officials consult with public health officials in Toronto, who in turn tell hospitals and long-term care facilities to stop serving certain meat products and begin collecting additional samples. Aug. 16: CFIA officials meet with Health Canada and recommend a recall. Aug. 17: Two specific ready-to-eat products produced at Toronto plant - Sure Slice roast beef and corned beef - are recalled. Aug. 19: Tests on recalled products come back positive; Maple Leaf prepares to expand recall. Aug. 20: Federal officials confirm one death, 16 other cases linked to listeriosis outbreak. Products from two more Maple Leaf production lines are recalled, bringing total to 23. Toronto plant at the heart of the recall is shut down; Maple Leaf projects cost of recall at about $2 million. Aug. 22: Officials confirm listeriosis associated with the outbreak caused the deaths of two elderly women in Ontario, bringing official death toll to three. Health officials in B.C. report death linked conclusively to outbreak strain of listeriosis, but death is later reclassified as "under investigation." Royal Touch Foods recalls Shopsy's Reuben sandwich, which contains recalled meat. Aug. 23: Officials confirm link between outbreak and Maple Leaf products produced in Toronto. Maple Leaf chief executive Michael McCain issues abject apology, describes crisis as "the toughest situation we've faced in the 100 years of this company's history." Aug. 24: As a precaution, Maple Leaf expands the recall to include all 220 products produced at the plant at an estimated cost of about $20 million. Television commercial featuring McCain's apology begins to air. Aug. 25: Public Health Authority of Canada officials say six deaths in Ontario conclusively caused by outbreak strain of listeriosis, with six others - five in Ontario, one in B.C. - under investigation. Lucerne Foods announces recall of some Mac's and Safeway sandwiches across Western Canada, after some sandwich meat was named in Maple Leaf's latest recall. Aug. 26: Prime Minister Stephen Harper speaks on the outbreak for the first time, defending Conservative government's handling of the file. Atlantic Prepared Foods Ltd. and Metro Ontario Inc. recall several sandwich products sold in Maritimes and Ontario. Public Health Authority of Canada officials say numbers of deaths under investigation up to nine from previous six, with 29 confirmed cases nationwide. Aug. 27: Frances Clark, 89, of Madoc, Ont., becomes first victim of Listeria outbreak identified. Clark died on Aug. 25 in hospital. Public Health Authority of Canada officials reduce the number of deaths conclusively caused by the outbreak strain of listeriosis to five from six. The Canadian Food Inspection Agency and Costco Wholesale Canada Ltd. recall two products that contain a ready-to-eat deli meat product previously recalled by Maple Leaf. The CFIA recalls Cooked Ham and Salami sandwiches sold in Sobeys, Foodland and IGA stores in Ontario because they may contain a ready-to-eat deli meat product previously recalled by Maple Leaf. Aug. 28: Public Health Authority of Canada officials raise number of deaths conclusively caused by the outbreak strain of listeriosis to eight from five. Twenty-nine cases have been conclusively linked to the outbreak, and an additional 36 suspected cases remain under investigation.   top 'Eat meat and die!' warning drives home lifesaving message 28.aug.08 People for the Ethical Treatment of Animals (PETA) Lindsay Rajt 757-622-7382 http://www.peta.org/mc/NewsItem.asp?id=11877 Toronto -- In the wake of a deadly listeria outbreak that has been traced to deli meat and is suspected of killing as many as 15 people, PETA is seeking to display a billboard so blunt and accurate that it could shock people into permanently chucking their ham and salami and filling their refrigerators with healthy and humane vegetarian fare. Behind the billboard's attention-grabbing headline "Eat Meat and Die!" is a lighter-coloured text that lists some of the deadly consequences of meat: "Listeria, E. coli, Campylobacter." The ad steers people to PETA's Web site GoVeg.com for healthy eating tips, information on food-borne illness and other diseases, and vegetarian recipes. More than 570,000 kilograms of meat have recently been recalled in response to the outbreak that has affected people in Ontario, British Columbia, Saskatchewan, and QuÈbec. Such incidents highlight one of PETA's beefs with meat: Besides causing immeasurable suffering for the animals who are raised on filthy factory farms and killed in frightening and painful ways for a fleeting taste of their flesh, meat can also be deadly to consumers. The threat of listeria, E. coli, campylobacter, and other bacterial infections is only the beginning. Eating meat is linked to Canada's top killer diseases, including heart disease, cancer, stroke, diabetes, and obesity. Meat-eaters are four times more likely to be obese as vegetarians are, and they are 10 times more likely to suffer from heart disease. A low-fat vegetarian diet has been proved to reverse heart disease. "Listeria is but one symptom of an incredibly cruel and literally sickening industry," says PETA President Ingrid E. Newkirk. "Our message is, 'Eat meat and die, or go vegetarian and live.' The only way to make meat safe is to throw it out." For more information or to view the billboard, please visit blog.PETA.org or click here. http://blog.peta.org/archives/2008/08/attack_of_the_k_1.php   top SPAIN probes possible fourth human case of mad cow disease 27.aug.08 AFP http://afp.google.com/article/ALeqM5j8g4ED89khVw3PN7Gi95ij7xjm7Q MADRID -- Spanish health authorities said Wednesday they were looking into the possibility that a woman who died last week at a hospital in Leon suffered from the human variant of mad cow disease. If laboratory tests confirm the 64-year-old had Creutzfeldt-Jakob Disease (CJD), the human variant of bovine spongiform encephalopathy (BSE) or mad cow disease, it will be the fourth death from the disease in Spain. "We are currently carrying out tests at a laboratory in Alcorcon to determine if the disease is Creutzfeldt-Jakob or not," a health ministry spokesman told AFP.   top CALIFORNIA: Raw milk program has done great things for community 27.aug.08 The Daily Triplicate http://www.triplicate.com/news/story.cfm?story_no=9943 Sarah Valley of Crescent City writes that the raw milk program has done great things for both my family and this community. Over 20 years ago, my then 9-year-old daughter was stricken with a very rare medical condition called Guillaine-Barre syndrome. An ordinary virus, the same one that all her friends and siblings had, had attacked her body very differently and left her paralyzed from the neck down. She plateaued just as they were about to put her on a respirator. For three months, I lived at Rogue Valley Memorial Hospital with my daughter and 6-month-old son. It was an excruciatingly painful experience and one I wouldn't wish upon anyone, but having gone through this experience, and the knowledge I gained from it, the last thing I would want is for the cause of the illness to be misplaced. There was no investigation into how my daughter became sick. There was no need. It wasn't the virus that actually caused her illness. It was a cruel trick that her own body had played on her. The doctors told me that it was most likely to attack someone with a very good immune system. My daughter has since gotten better and is now a healthy mother of two. Now there is a lot of talk in the community that raw milk was the cause of a case of Guillaine-Barre syndrome. I cannot speculate on whether or not the campylobacter came from the raw milk or some other source. There is no need. I have been drinking raw milk for two years and educating myself about its effects. Since I began drinking raw milk, I have lost the pain in my hip joints and just feel better. The raw milk program has done great things for both my family and this community. I feel we should have the right to make our own health choices. No one has decided that all tomatoes should now be pasteurized. Cigarettes are still sold everywhere, drugs are approved that have not been tested long enough to examine the long-term effects, but for some reason, the government feels that we should not be able to purchase milk without killing every healthy organism in it. The Alexandres' dairy milk program is one that could be an example for other dairy farmers. I appreciate the Alexandres and all that they have done for me and my family.   top US: Back to school food safety tips for parents and students 28.aug.08 United States Department of Agriculture, Food Safety and Inspection Service http://www.fsis.usda.gov/News_&_Events/NR_082808_02/index.asp Food Safety and Inspection Service: Diane Van (301) 344-4777 Partnership for Food Safety Education: Shelley Feist (202) 220-0651 WASHINGTON - It's time to pull out the backpacks and clean the lunch boxes as children head back-to-school this month. Packing safe lunches for school and for work is critically important. Since September is also National Food Safety Education MonthÆ, the U.S. Department of Agriculture and the non-profit Partnership for Food Safety Education are providing tips to help parents keep their children and themselves healthy. Parents are reminded to follow the Be Food Safe basic practices of Clean, Separate, Cook and Chill to help reduce their family's risk of foodborne illness. When packing lunches to take to school or the office, keep the following food safety tips in mind: * Wash your hands with warm water and soap for at least twenty seconds before you prepare food or after playing outside, touching pets and using the bathroom. Sing "Happy Birthday" twice while washing hands to make sure you are washing long enough to send germs down the drain! * Work on a clean surface. To prevent cross-contamination, always use a clean cutting board. Use one cutting board for fresh produce or bread and a separate one for meat, poultry and seafood. * Rinse fruits and vegetables under running tap water, including those with skins and rinds that are not eaten. Dry with a paper towel. * If lunches are made at home the night before, keep them in the refrigerator until it's time to go. Make sure the refrigerator is 40ƒ F or below at all times and use an appliance thermometer to check the temperature. * Use an insulated lunch box, with an insulated bottle for hot foods or a frozen gel pack or a frozen juice box to keep perishable foods cold. * Wash insulated lunch totes or boxes with hot soapy water after each use. Smart students and parents never leave perishable foods out at room temperature for more than two hours. Toss any perishable food not eaten at lunchtime. For free stuff for kids, teachers and parents Parents and after-school providers are urged to help kids learn about food safety by getting them involved in fun, educational activities. Free work sheets, curriculum materials and a handwashing poster are available at www.fightbac.org. Consumers with food safety questions can "Ask Karen," the FSIS virtual representative available 24 hours a day at AskKaren.gov. The toll-free USDA Meat and Poultry Hotline 1-888-MPHotline (1-888-674-6854) is available in English and Spanish and can be reached from l0 a.m. to 4 p.m. (Eastern Time) Monday through Friday. Recorded food safety messages are available 24 hours a day.   top FSnet is produced by the International Food Safety Network at Kansas State University, and is supported at the Gold Fork level by: Marler Clark. FSnet is supported at the Sterling Fork level by: CropLife Canada, Ontario Ministry of Agriculture, Food and Rural Affairs , New Zealand Food Safety Authority, Monsanto Canada, and the Ontario Cattlemen's Association. Fsnet is supported at the Silver-plate Fork level by: The National Restaurant Association, Unilever, Sholl Group/Green Giant Fresh, Feedlot Health Management Services, McDonald's, and Syngenta Crop Protection Canada. The Food Safety Network presents a unique opportunity to bring together all those associated with agriculture and food, to enhance the safety of the food supply. To provide financial support to the Food Safety Network, please visit http://www.foodsafety.ksu.edu/en/donations.php. For information on collaboration or fee-for-service opportunities, please contact Dr. Doug Powell: dpowell@ksu.edu To subscribe to the html version of FSnet, send mail to: (subscription is free) listserv@listserv.ksu.edu leave subject line blank in the body of the message type: subscribe fsnet-L firstname lastname i.e. subscribe fsnet-L Doug Powell (replace fsnet-L with fsnettext to subscribe to the text version) To unsubscribe to the html version of FSnet, send mail to: listserv@listserv.ksu.edu leave subject line blank in the body of the message type: signoff fsnet-L (replace fsnet-L with fsnettext to unsubscribe from the text version) For more information about the FSnet research program, please contact: Dr. Douglas Powell associate professor dept. diagnostic medicine/pathobiology Kansas State University Manhattan, KS 66506 cell: 785-317-0560 fax: 785-532-4039 dpowell@ksu.edu http://www.foodsafety.ksu.edu archived at http://archives.foodsafety.ksu.edu/fsnet-archives.htm