Is E. coli O157:H7 associated with things other than feedlot cattle?

I had a few people call me recently, saying, I saw that movie, Food, Inc., which says that E. coli O157:H7 is predominately in feedlot cattle because of the grain they are fed, and that’s how the bug came to exist. So how did it get into Nestle cookie dough?

It’s sort of a mantra of raw milk enthusiasts and wannabe food safety types that E. coli O157:H7 is a product of feedlot cattle, and that grass-fed creatures are benign entities for the dinner plate.

A blogger yesterday wrote, “… hamburger tainted by e-coli, a virus that breeds in a cow’s stomach when it is feed grain instead of grass (which, of course, most cows are nowadays in order to fatten them quickly and cheaply).”

It’s a bacterium, not a virus.

Nicholas Kristof, a columnist for the N.Y. Times, wrote yesterday, on Sunday, June 21/09, that, “There is some evidence that pathogens, including E. coli, become much more common in factory farming operations. Move feedlot cattle out to a pasture for five days, and they will lose 80 percent of the E. coli in their gut, the film says.”

That evidence is about as strong as the whisps of evidence compiled by Danny Sugarman that The Doors’ frontman Jim Morrisson is still alive and didn’t die from excess in a Paris bathtub in 1971. But, every teenager goes through their Doors phase (I can only find the clip below in Spanish, but Canada’s The Guess Who stands up much better with the hindsight of time; they know they are drunken buffoons, and not a drunken buffoon trying to be a poet).

Scientific uncertainty can easily be exploited by the certainty of filmmakers, who cherry pick facts and flourish on rhetoric. And I guess if it’s repeated ad nauseum for 11 years by writers from the N.Y. Times to your-favorite-bullshit blogger it becomes fact.

That line, “Move feedlot cattle out to a pasture for five days, and they will lose 80 percent of the E. coli in their gut,” comes from a 1998 paper published in the journal Science by Diez-Gonzalez of Cornell University, and colleagues.

I had one of my colleagues, Rena Orr, write a review of the controversy back in Nov. 2000.

Since September 1998, there has been conflicting information on the effect of diet on E. coli shedding from cattle. The conflict arises in part from the effect of diet on the ability of E. coli to develop acid resistance. … Diez-Gonzalez et. al demonstrated that feeding a high-grain diet to cattle results in an acidic environment in the colon. Because the animals incompletely digested the starch in grains, some starch was able to reach the colon where it fermented, producing fermentation acids. The researchers believe an acidic environment selects for or induces acid resistance among the Escherichia coli population. … Diez-Gonzalez et al. concluded that if cattle were given hay for a brief period (five days) immediately before slaughter, the risk of foodborne E. coli infection would be significantly reduced because the acidity in the colon is greatly reduced. "Our studies indicate that cattle could be given hay for a brief period immediately before slaughter to significantly reduce the risk of food-borne E. coli infection."

The Science article received mainstream media attention, and was covered by the Associated Press and The New York Times, as well as scientific releases and reports. In the Irish Times, it was cited as the basis for concluding that because Irish cattle are fed a grass-based diet rather than grain, Ireland has a low incidence of E. coli O157:H7. Hancock et al. contend that this conclusion is unsupported or contradicted by several lines of evidence. The E. coli that contaminate beef typically originate from the hide, the hooves, or the equipment used in slaughter and processing rather than directly from the colon, and likely replicate in environments unlike the colon. Therefore, the induced acid resistance of E. coli contaminating beef is likely to be unrelated to the pH of its ancestral colonic environment. The E. coli O157:H7 bacterium uses several mechanisms to survive acid environments, some of which are innate and are not influenced by environment . Although acid resistance is likely a factor in an infective dose, induced acid resistance has not been shown to be a factor in E. coli O157:H7 infectivity by experimental (dose-inoculation) or observational (epidemiological) data . Therefore, acid resistance induced by exposure to weak acid may not influence the virulence of this pathogen.

Published data on E. coli O157:H7 tends to contradict or does not support the effects of the dietary change proposed by Diez-Gonzalez et al. In a recent study on three different grain diets (85% cracked corn, 15% whole cottonseed and 70% barley, or 85% barley), the fecal pH of the animals fed the corn diet was significantly lower (P < 0.05) than the fecal pH of the animals fed the cottonseed and barley and barley diets, likely resulting in a less suitable environment for E. coli O157:H7 in the hindgut of the corn fed animals (2000, Buchko et al). In the Journal of Food Protection, researchers concluded that changing from grain to a high roughage diet did not produce a change in the E. coli concentration that was large enough to deliver a drastic improvement in beef carcass hygiene. Sheep experiencing an abrupt diet change have higher concentrations and increased shedding of fecal E. coli O157:H7 for longer periods than sheep fed a consistent high-grain diet. Another study compared the duration of shedding E. coli O157:H7 isolates by hay-fed and grain-fed steers experimentally inoculated with E. coli O157:H7 as well as the acid resistance of the bacteria. The hay-fed animals shed E. coli O157:H7 longer than the grain-fed animals, and irrespective of diet, these bacteria were equally acid resistant.

These results suggest that the proposed dietary change would actually increase contamination with E. coli O157:H7. Also, the 1,000-fold reductions in total fecal E. coli demonstrated by Diez-Gonzales et al. are far greater than those recorded in cattle experiencing similar ration changes . Finally, extensive surveys show that grain-fed feedlot cattle have no higher E. coli O157:H7 infection prevalence than similarly aged dairy cattle fed forage (hay) diets. Abrupt feed change immediately before slaughter could have unexpected deleterious effects. The proposed diet change has the potential to increase the risk of bovine salmonella infections, a potential source of food poisoning. The dietary change results in sharply reduced volatile fatty acid concentrations in the large intestine as well as changes in the bacteria, allowing for colonization of Salmonella.

See, that’s a really long explanation. It’s not as soothing as, change cattle diet, disease prevented. And that was written nine years ago.

Mike Osterholm, director of the Center for Infectious Disease Research and Policy and professor in the School of Public Health at the University of Minnesota wrote a cleaner critique in 2007 in the Minneapolis-St. Paul Star Tribune:

"Russo cited conclusions from a 1998 study from Cornell University that cattle fed a diet of grass, not grain, had very few E. coli, and that those bacteria that survived in the cattle feces would not survive in the human when eaten in undercooked meat, particularly hamburger. This statement is based on a study of only three cows rotated on different diets and for which the researchers did not even test for E. coli O157:H7. Unfortunately, the authors extrapolated these incredibly sparse results to the entire cattle industry. The Cornell study is uncorroborated in numerous published scientific papers from renowned research groups around the world. Finally, work conducted by the Minnesota Department of Health as part of a national study on foodborne disease recently showed that eating red meat from local farms was a significant risk factor for E. coli infection. ...

And as my colleague David Renter wrote in Sept. 2006,

"Cattle raised on diets of 'grass, hay and other fibrous forage' do contain E. coli O157:H7 bacteria in their feces as do other animals including deer, sheep, goats, bison, opossum, raccoons, birds, and many others.

"Cattle diet can affect levels of  E. coli O157:H7, but this is a complex issue that has been and continues to be studied by many scientists.  To suggest switching cattle from grain to forage based on a small piece of the scientific evidence is inappropriate and irresponsible.  Several pieces of evidence suggest that such a change would not eliminate and may even increase E. coli O157:H7 in cattle.

"The current spinach outbreak may be traced back to cattle manure, but there are many other potential sources.  Simplistically attacking one facet of livestock production may be politically expedient, but instead provides a false sense of security and ignores the biological realities of E. coli O157:H7. In 1999, for example, 90 children were felled by E. coli O157:H7 at a fair in London, Ont. The source? A goat at a petting zoo, hardly an intensively farmed animal."

Last time I looked, E. coli O157:H7 and about 60 other shiga-producing E. coli that are known to cause illness in humans are present in about 10 per cent of all ruminants – cattle, sheep, goats, deer, elk -– and I can point to outbreaks associated with all of those species. Pigs, chickens, humans, birds and rodents have all been shown to be carriers of shiga-producing E. coli but the resevoir appears to be ruminants. The final report of the fall 2006 spinach outbreak identifies nearby grass-fed beef cattle as the likely source of the E. coli O157:H7 that sickened 200 and killed 4.

How the E. coli O157:H7 got into the cookie dough remains to be seen. Biology is complex and constantly changing – even at farmer’s markets, which was the big solution of Food, Inc. But it’s only a movie.

That Cornell paper can be found here:

Diez-Gonzalez, Francisco, Todd R. Callaway, Menas G. Kizoulis, James B. Russell. Grain Feeding and the Dissemination of Acid-Resistance Escherichia coli from Cattle. Science: Sept 11, 1998. Volume 281, Number 5383, pages 1666-1668.

When Katie Filion lived with us for a few months before setting off for graduate work in New Zealand, Amy and I would tell the 22-year-old, "‘oh, you should see this movie" – insert Monty Python and the Holy Grail, Wonderboys, or even more modern fare like Napoleon Dynamite – at which point she would politely recoil. Maybe she found our movies … old.

However, Katie did confess she now misses my homemade-from-scratch buckwheat pancakes with berries.

Have I got a movie for Katie.

Woody Allen’s 1973 classic, Sleeper, when the director was at a more, uh, slapstick stage of his career, features Allen as Miles Monroe, a jazz musician and health-food store owner living in Manhattan in 1973, who is cryogenically frozen without his consent, and not revived for 200 years. When Miles is arrested as a counterrevolutionary, he escapes by disguising himself as a robot, the kind frequently used in the future for mundane chores like cooking.

Maybe the Japanese like Woody Allen more than the French like Jerry Lewis because various prototype robo-chefs showed off their cooking skills at the International Food Machinery and Technology Expo in Tokyo last week, flipping Japanese pancakes, serving sushi and slicing vegetables.

Narito Hosomi, president of Toyo Riki, manufacturers of the pancake-cooking robot, which was apparently based on me, said,

"We all know that robots can be very useful. We want to take that utility out of the factory so that they can be used elsewhere.”

I have to agree, Katie. While clever, Sleeper is slow.

In Niles, Michigan, fourteen children, ages 8-10, attended the annual Lakeland Community Hospital’s ‘Take Your Child to Work Day.’ The primary lesson of the tour was emphasizing the hospitals’ top safety precaution: handwashing. JoEllen Gamso, RN, said, “The goal for the event was to identify the many ways that patient and associate safety is maintained in the workplace.” Before and after each department tour, every child was given a golf ball sized amount of hand-sanitizing foam to demonstrate the importance of clean hands.

During the evening of Thursday, June 18, the Colorado Department of Public Health and Environment urged Coloradans not to eat raw Nestle Toll House cookie dough because of possible contamination with E. coli O157:H7.

The next morning, the U.S. Food and Drug Administration warned consumers not to eat any varieties of prepackaged Nestle Toll House refrigerated cookie dough due to the risk of contamination with E. coli O157:H7. At the same time, Nestlé announced a voluntary recall of all Toll House refrigerated cookie dough products, “out of an abundance of caution.”

About 4:30 p.m. central time on Friday, June 19, 2009 (happy birthday, daughter Jaucelynn, avoid the raw cookie dough) colleague Evan reported that he had successfully obtained a package of Nestle Toll House refrigerated cookie dough (above, right, exactly as shown). I say obtained because he didn’t have to pay for it. Evan went to a local supermarket, and saw, “a young kid, armed with a box cutter, standing beside a cart full of Nestle Toll House products.

“I asked if I could have one of them, to which he replied, 'you're not going to get a refund for it are you?' I told him no, but he said he had to cut open the package so I couldn't return it. The kid wasn't wearing any gloves and was sweating, so I'm guessing he was out there for a while handling a potentially contaminated product.”

And he gave Evan the raw cookie dough, which Evan triple-bagged and refrigerated until Saturday.

Amy and Sorenne and I went grocery shopping this morning, and observed that the Nestle refrigerated products had been dutifully cleared out (left, exactly as shown). We did, however, buy a couple of other raw cookie dough products. I never eat the stuff, but understand that many are quite passionate about their raw cookie dough.

There are at least two potential problems with raw cookie dough: eating it, and cross-contamination. Evan and I videotaped a cooking experiment and the cookies get plenty hot to kill off potential pathogens (we’ll post that later).

Bill Marler has written about the uh, inadequacies of the labels on Nestle raw cookie dough. Not that anyone reads labels, or that everyone speaks English, but maybe there shoud be more of a declaration of potential risk.

And bigger type: not to sound like ole-man-grouchy-Powell, but even with my reading glasses I could barely read a damn thing on the label. The Kroger private selection brand says,

Keep refrigerated
Use before date on package
Do not eat unbaked cookie dough.

The Pillsbury refrigerated cookie dough says,

Do not microwave unbaked Poppin Fresh dough
Bake before enjoying
Do not use if unsealed.

It would seems with at least 66 people sick with a serious illness – E. coli O157:H7 – of which 25 had to be hospitalized and seven will suffer long-term kidney damage, these labels sorta suck.

Oh, and according to a story carried by Bloomberg,

“The Toll House cookie brand is named for the Toll House Inn in Whitman, Massachusetts, whose owner, Ruth Wakefield, is credited with inventing the chocolate chip cookie in the 1930s."
 

Evan Mitchell, another ex-pat Canadian living in Manhattan (Kansas) writes that last night, he and the wife had a biological urge …  for something cold (Kansas is humid in the summer).

Our house is within walking distance of Arby’s, and with their current “happier-hour” promotion (50% off all drinks), we couldn’t resist. After receiving our shakes, we needed straws which where located by the condiment stand. It was at this time that we almost barfed and our perceived hour of happiness was no longer happy.

Arby’s has a killer condiment stand. For no extra cost, one could triple pickle their roast beef melt; a true American deal that doesn’t exist in Canada. Although I’m a fan of sharing such luxuries with others, part of the ‘go green’ and don’t waste philosophy, I limit that selection to members of the human race; that means no bugs. The containers of pickles, peppers, onions, lettuce, olives, etc., were all occupied by little feasting winged insects. Although eating from a dish that has been uncovered and exposed to however many other bodily fluids (and stuff) in a day is gross, I was still disgusted and a little mortified by the sight.

Arby’s, that was gross.
 

My knowledge of foreign languages is limited to high school Spanish and learning while traveling. Thankfully, I have Amy, who translated all these French words into English, so I could understand what I was reading (and French-bites correspondent, Albert Amgar, who sent the story in the first place).

At Local Hospital of Penne-D’Agenais, France, Tuesday, June 16 was dedicated to handwashing. Representatives across all hospital services contributed in the “Clean Hands = Saved Lives” campaign. This included taking a training class, informing the public on handwashing, how handwashing contributes in reducing the risk of germs and soiling, and that handwashing reduces cross-contamination between people and objects. Handwashing is also suggested for the prevention of infectious disease spreading and foodborne illness [don’t eat poop].

Hands should be washed before and after handling food, after using the toilet or changing a diaper, and when taking care of others. Proper handwashing includes using soap, rubbing hands together fiercely, and drying with a paper towel.

In yet another example of different jurisdictions having different opinions about when to go public, the Colorado Department of Public Health and Environment sent out a press release last night urging Coloradans not to eat raw Nestle Toll House cookie dough because of possible contamination with E. coli O157:H7.

If the link is proven, cookie dough would join a long list of foods like produce, pet food, peanut butter and pot pies that consumers really have very little control over; it's up to the producers and processors. Which makes various consumer education programs like FightBac sorta backwards. Consumers have a role in food safety, but not with this stuff.

Colorado state health officials, the CDC and several other state health departments are investigating an outbreak of E. coli O157:H7 infections.

To date, 66 cases from 28 states have been identified. Preliminary evidence from the multi-state investigation suggests that Nestle Toll House cookie dough may be the source of the outbreak, although further investigation is ongoing.

Five cases have been reported in Colorado in the following counties: Denver, Douglas (2), Jefferson and Weld. Two of the people have been hospitalized, and one has developed a severe complication called hemolytic uremic syndrome. Of the four people interviewed so far by the state health department, all had consumed the raw cookie dough during the week before they became ill.

Alicia Cronquist, the foodborne disease epidemiologist at the state health department, said,

“We can’t be certain that raw cookie dough is the source of these infections, but we are concerned enough that it might be and want consumers to be aware.”

Daniel Rifkin, Wholesale Food Program manager for the Department of Public Health and Environment’s Consumer Protection Division, said,

“Nestle is currently evaluating what actions they will take regarding their product. In the meantime, it is important that consumers do not eat or use raw Nestle Toll House cookie dough for now. If you decide to use the product, ensure that the cookies are cooked thoroughly and wash your hands well after handling the raw dough. More information will be forthcoming.”

Some restaurants in Estacada, Oregon have learned the benefits of disclosing restaurant inspection results to the public, reports Escadanew.com. In Escada inspection results for local diners are posted at the premise, in the form of a “Complied” or “Failed to Comply” card in the establishment window, and the full report plus numerical score is available online.

Additionally Dirty Dining highlights those establishments that have received a high inspection score, between 90-100, and one business owner is reaping the benefits.

Hitchin Post Pizza has been in business for five years, and has scored well on all of its inspections, earning at least a 95 in the last five.

Manager Valerie Ann Ballantyne said her good inspection results have improved business,

“I was on Dirty Dining for being one of the 10 restaurants in Oregon with a perfect score. Just for being on Dirty Dining we had several people come in.”

She continued,

“I take pride in keeping my establishment very, very clean. It’s very, very important for people to come into a clean establishment and not have to worry about getting sick. I know I would never eat in a place that wasn’t clean.”

It’s not as easy as it may seem to receive a perfect score.

“You have to make sure the refrigerator is at the right temperature, the bleach buckets have the right consistency, the filters are clean...the list just goes on and on,” said Ballantyne.

Hitchin Post Pizza, and the other 23 dining establishments in the Estacada area, know what the standards are and expect a representative from the Clackamas County Health Department to visit at least twice a year.

In Escada establishments are inspected unannounced twice a year, with additional inspections when necessary. They are scored starting at 100 per cent and subtracting 1 or 2 points for non-critical items and 4 or 5 points for critical items, which are considered more serious and can cause food-borne illness.

The person who is still, inexplicably, Minister of Agriculture in Canada, Gerry-death-by-a-1,000-cold-cuts-and-isn’t-my-moustache-awesome Ritz, said last night that despite the recommendations of a parliamentary committee, who were stonewalled by bureaucrats, a full public inquiry into the Maple Leaf Listeria mess that killed 22 people last year was not necessary.

That’s true, if only the bureaucrats at Maple Leaf, the Canadian Food Inspection Agency, the Public Health Agency of Canada and dozens of others did their jobs and came publicly clean about who knew what when and what steps were taken to protect public health.

Until then, maybe the judicial route is best. But what a waste of resources, and more importantly, public confidence.