Eight Seattle area hospitals have promised to change their food to make it healthier for patients, staff and visitors, including a commitment to local food.

That’s according to a blog post at the Seattle Post-Intelligencer, which also notes the hospitals signed a Healthy Food in Health Care Pledge.

Holly Freishtat, Sustainable Food Specialist for Washington Physicians for Social Responsibility, says,

"Hospitals are changing the culture of food in healthcare by sourcing local produce, hormone-free milk, meat without hormones or antibiotics, sustainable seafood and through hosting farmers' markets, community- supported agriculture boxes for employees."

What's missing is any discussion about the microbiological safety of, especially, fresh local produce.

As more producers and suppliers adapt to meet the demand for local produce, here are some basic questions:

• where is the farm located

• what type of fertilizer is used;

• what is the water source and how frequently is it tested; and,

• is the produce harvested, stored and transported safely, by staff who practice outstanding personal hygiene.?

Beyond the questions, the real challenge, as I've said many times before, is,

"Whether your food comes from down the street or around the globe, you want to verify that producers and processors are actually doing what they are supposed to be doing."

How about sourcing food from the place that can boast the fewest number of sick patrons?

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Some 50 attendees at the world's leading feminist science fiction convention. WisCon32, which rocked Madison, Wisconsin's Concourse Hotel May 23-25, 2008, were stricken with symptoms similar to those of stomach flu.

Officials with Dane County and the Madison Public Health Department think some attendees might have been exposed to the illness before the convention since they developed symptoms so soon after arriving. The sick ones may have then infected others through personal contact and shared access to food.

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Five people have been struck down with Hepatitis A in an outbreak traced to Zanzibar Cafe on Latrobe Street in Melbourne's city centre.

Victoria's Department of Human Services said the outbreak has been linked to a food handler who also worked part time as a cleaner.

A 65-year-old man from Doncaster, a 32-year-old woman from Reservoir, a 51-year-old man from East Malvern and a 54-year-old man from Aspendale were among those affected. The department was notified of a fifth case on Friday afternoon.

An extensive clean up of the cafe had been carried out under the supervision of Melbourne City Council.

Hepatitis A is found in feces of the infected person and can be spread by direct contact with food, beverages or crockery.

Dude wash your damn hands. And don't eat poop.

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Following this morning's report of a new European study demonstrating the potential for internalization of Salmonella in produce, Ben Chapman pulled together the following notes on the topic.

Irrigation water containing raw sewage or improperly treated effluents from sewage treatment plants may contain hepatitis A, Norwalk viruses, or enteroviruses in addition to bacterial pathogens such as E.coli O157:H7, Salmonella spp. and Shigella spp. (Beuchat, 1998).

Produce can also be contaminated with pathogens due to internalization of pathogens both through the root system and flesh or stem scars. Evidence of infiltration of bacteria into vegetables is reported in several articles (Bartz 1982; Bartz and Showalter 1981; Burnett et al., 2000; Seo and Frank 1999; Zhuang et al., 1995). Clear evidence exists to conclude that pathogens can be incorporated into fresh produce. So far, this evidence is based on laboratory experiments, not actual real world situations. Past research suggests that pathogens can enter lettuce plants through its roots and end up in the edible leaves. Small gaps in growing roots through which plant pathogens infect tissue may also allow E. coli entry (Solomon et al, 2002b; Warriner et al., 2003a, Warriner et al., 2003b).

The uptake of Salmonella spp. by roots of hydroponically grown tomato plants has been shown. Within one day of exposure to a high concentration mixture of Salmonella spp. pathogen cells were found in the hypocotyls, cotyledons, stems and leaves of young plants; though whether fruit is affected is not known at this time (Guo et al., 2002).

Solomon and colleagues (2002a) discovered that the transmission of E.coli O157:H7 to lettuce was possible through both spray and drip irrigation. They also found that the pathogen persisted on the plants for 20 days following application and submerging the lettuce in a solution of 200ppm chlorine did not eliminate all viable E.coli O157:H7 cells. This suggests that irrigation water of unknown microbial quality should be avoided in lettuce production (Solomon et al., 2002a).  In a follow-up experiment, Solomon and colleagues (2002b) explored the transmission of E. coli O157:H7 from manure-contaminated soil and irrigation water to lettuce plants. The researchers recovered viable cells from the inner tissues of the lettuce plants and found that the cells migrated to internal locations in plant tissue and were thus protected from the action of sanitizing agents These experiments demonstrated that E. coli O157:H7 can enter the lettuce plant through the root system and migrate throughout the edible portion of the plant (Solomon et al., 2002b).

The risk of contamination of produce due to Salmonella spp. was found to be increased when soil and water were present, and that soil and water actually act as reservoirs of the pathogen. Xuan and colleagues (2002) found that soil and water were factors in the infiltration of salmonella into the tissues of tomato. This supports the theory that preharvest contact with contaminated soil or water increased the contamination potential by certain pathogens and can lead to problems in pathogen removal and the efficacy of sanitizers.

Flesh scarring can provide a suitable environment for pathogen growth, and decreases the value of employing sanitizers, either in the packing shed or by consumers (Xuan et al., 2002).

The uptake of Salmonella spp. by roots of hydroponically grown tomato plants has also been shown. Within one day of exposure to a high concentration mixture of Salmonella spp. pathogen cells were found in the hypocotyls, cotyledons, stems and leaves of young plants; though whether fruit is affected is not known at this time (Guo et al., 2002).

In a 2006 review, Vectors and conditions for preharvest contamination of fruits and vegetables with  pathogens capable of causing enteric diseases,  Larry Beuchat of the Center for Food Safety and Department of Food Science and Technology at the University of Georgia, concluded:

"Manure, manure compost, sewage, sludge, irrigation water, and runoff water represent
avenues for introduction of pathogenic bacteria, parasites, and viruses to soil in which
fruits and vegetables intended to be eaten raw are grown. Pathogens vary in their
ability to survive in soil amendments and in soil. Inactivation rates and persistence in
soil are also influenced by soil type, rainfall, temperature, and agronomic practices.
Some pathogens can survive in soil for periods of time exceeding those needed to grow
plants from seeds or seedlings to the point of harvest. Pathogens originating from
preharvest environments may contaminate the surface of produce and evidence is
mounting that contamination of internal tissues can also occur. Prevention of
preharvest contamination of fruits and vegetables is an essential part of a systems
approach focused on applying interventions designed to achieve delivery of
microbiologically safe produce to the consumer."

References

Bartz, J.A. 1982. Infiltration of tomatoes immersed at different temperatures to different depths in suspensions of Erwinia carotovora subsp. carotovora. Plant Disease. 66:302-305.

Bartz, J.A., and R.K. Showalter. 1981. Infiltration of tomatoes by aqueous bacterial suspensions. Phytopathology. 71: 515-518.

Beuchat, 2006. Vectors and conditions for preharvest contamination of fruits and vegetables with  pathogens capable of causing enteric diseases. British Food Journal 108 (1): 38-53.

Beuchat, L.R. 1998. Surface decontamination of fruits and vegetables eaten raw: a review. WHO/FSF/FOS/Publication 98.2. World Health Organization. Geneva. 49pp.

Burnett, S.L., Chen. J. and Beuchat, L.R. 2000. Attachment of Escherichia coli O157:H7 to the surfaces and internal structures of apples as detected by confocal scanning laser microscopy. Applied and Environmental Microbiology. 66: 4679-4687.

Guo, X., van Iersel, M. W., Chen, J., Brackett, R. E. and Beuchat, L. R. 2002. Evidence of association of salmonellae with tomato plants grown hydroponically in inoculated nutrient solution. Applied  Environmental Microbiology. 68: 3639-3643.

Hedberg, C.W., Angulo, F.J., White, K.E., Langkop, C.W., Schell, W.L., Stobierski M.G., Schuchat, A., Besser, J.M., Dietrich, S., Helsel, L., Griffin, P.M., McFarland J.W. and Osterholm M.T. 1999. Outbreaks of salmonellosis associated with eating uncooked tomatoes: implications for public health. Epidemiology and Infection 122: 385-93.

Seo, K. H., and J. F. Frank. 1999. Attachment of Escherichia coli O157:H7 to lettuce leaf surface and bacterial viability in response to chlorine treatment as demonstrated by using confocal scanning laser microscopy. Journal of Food Protection.  62: 3-9.

Solomon, E. B., Yaron, S., and Matthews, K.R. 2002b. Transmission of Escherichia coli O157:H7 from contaminated manure and irrigation water to lettuce plant tissue and its subsequent internalization. Applied Environmental Microbiology. 68: 397-400.

Solomon, E.B., ,Potenski, C.J. and Matthews, K.R. 2002a. Effect of irrigation method on transmission to and persistence of Escherichia coli O157:H7 on lettuce. Journal of Food Protection. 65: 673–676.

Warriner K., Ibrahim F., Dickinson M,. Wright C. and Waites W.M. 2003a. Internalization of human pathogens within growing salad vegetables. Biotechnology & Genetic Engineering Reviews.  20: 117-134.

Warriner K., Ibrahim F., Dickinson M,. Wright C. and Waites W.M. 2003b. Interaction of Escherichia coli with growing salad spinach plants. Journal of Food Protection. 66: 1790-1797.

Xuan, G., Jinru, C., Brackett, R.E., Beuchat, L.R. 2002. Survival of salmonella on tomatoes stored at high relative humidity, in soil, and on tomatoes in contact with soil. Journal of Food Protection. 65: 274-279.

Zhuang, R.-Y., Beuchat, L.R. and Angulo. F.J. 1995. Fate of Salmonella montevideo on and in raw tomatoes as affected by temperature and treatment with chlorine. Applied Environmental Microbiolology. 61: 2127-2131.

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Scientists and journalists have a couple of things in common -- at least that's what I was told all those years ago.

Both require the ability to ask the right question. And both have to sell the same idea at least three times to make a living.

Yesterday, Bob Brackett, senior vice president and chief science and regulatory affairs officer for the Grocery Manufacturers Association, wrote in the Denver Post that "no other country in the world can claim a safer food supply than the United States."

Except that a couple of Canadian researchers at the University of Regina have done just that, issuing a report last week which purports to rank 17 industrialized countries.

The problem is, based on what is publicly available, it's impossible to tell how countries were ranked on various scores.

For example, the report says,

"Canada would be considered as one of the world’s leading countries in relation to consumer affairs in food safety. In terms of incidences of reported illness by food-borne pathogens, Canada is (in) the normal range since it has the incidence between 5,000 and 15,000 per 100,000 persons. Even if Canada has more incidences, it has a decreasing trend of late, which means that all levels of the government had begun to control the situation."

Based on a population of just over 33 million, that means 1.65 -- 4.95 million reported illnesses by foodborne pathogens, I'm assuming per year. Nowhere near that many cases of foodborne illness are actually reported. And the best guess on the actual incidence of foodborne illness in Canada is 11-13 million cases per year, slightly higher that the World Health Organization's estimate of 30 per cent of citizens in developed countries getting sick from the food and water they consume each year.

The report authors also claim,

"Canada was also rated as a 'progressive' country based on its food safety education programs for consumers. Unlike other countries, the level of cooperation among the different levels of government in the country is significant and most programs target all segments of the population."

Apparently, no effort was made to assess whether such information was accurate.

Canada finished fifth, and the U.S. came in seventh. The United Kingdom had the highest ranking of the 17 countries studied. Make mine piping hot.

Who has the safest food in the world? Wrong question.

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A couple of what appears to be staff-related Salmonella outbreaks have occurred in the past month in Princeton, New Jersey and Norwalk, Ohio.  Reports of both outbreaks suggest that poor hygiene amongst staff led to over 100 total cases.  No food source has been identified in the Ohio outbreak, but it is suggested that shredded cheese was prepared by a food handler who was shedding Salmonella.

These outbreaks are also the stories we have concentrated on in today's iFSN food safety infosheet.  Click here to download the infosheet.

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As I wrote in Nov. 2005, I'm convinced my mother tried to kill me through foodborne illness.

Not intentionally, of course. But twice a year, on average while growing up, I'd spend a couple of days on the couch, passing liquid out of both ends, while mom comforted me with flat ginger ale, crushed ice (we even had one of those kitchen necessities -- an ice crusher, in groovy pink, suitable for early 1970s suburbia) and soothing words like, "It's just the flu honey, you'll feel better soon."

Now, British researchers who searched the scientific data for evidence that flat soda pop -- a home remedy for diarrhea and vomiting passed down from generation to generation -- prevents dehydration in children with gastroenteritis have reached a conclusion: No.

According to their report in this month's issue of Archives of Disease in Childhood, biochemical analyses "clearly show" various carbonated drinks contain low levels of sodium and potassium, and far more sugar than oral rehydration solutions. Cola contained up to seven times the amount of glucose the World Health Organization recommends for oral rehydration.

"Carbonated drinks, flat or otherwise, including cola, provide inadequate fluid and electrolyte replacement and cannot be recommended."

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A report for the U.K.'s Highland Council documented more than 160 food hygiene complaints that were investigated by officials last year, including one claiming a caterpillar was found in vegetables served at a table and another claiming to have found a fly in a frozen baguette.

The report by principal food safety officer Alan Yates also reveals that officials sent 1,168 warning letters to establishments alerting them to contraventions of public health legislation.

The report also shows officers carried out 2,958 visits across the north in connection with food hygiene, and 826 in connection with food standards – the composition and labelling of food.

The report comes as the Food Standards Agency (FSA) has proposed a UK-wide system to grade the hygiene of restaurants, cafes, supermarkets and other food outlets.

The results would be displayed on doors or windows, as well as on a website to allow consumers to check ratings, in an effort to improve standards and cut food poisoning.

The agency believes a national scheme is needed to replace the plethora of "scores on doors", with nearly half the 435 local authorities already having or being about to introduce their own systems. In some areas, consumers and the media have had to use freedom of information legislation to find out the verdict of hygiene inspectors.

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Anyone see the Memorial Day edition of the Today Show? Amy and I are set up in an apartment in Montreal and the channel selection is limited, so it was on in the background.

Apparent BBQ guru John Willoughby (right) was on, preparing Grilled cowboy steak with barbecued leeks and wholegrain apricot mustard. The video is available for viewing at http://www.msnbc.msn.com/id/21134540/vp/24828622#24828622.

Willoughby shows how simple it is to cross-contaminate -- directly or indirectly --  and to remain completely unaware of the transfer of potentially dangerous microorganisms from raw meat to hands and tongs, and back to cooked meat and clean plates.

Cross-contamination is simple -- and it happens everyday on TV, in food service and in the home. One approach may be to think like a microorganism -- be the bug -- and take steps to contain the bug, without going all Howard Hughes.

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