A day after Missouri health types announced the source of the Schnucks-salad-bar-related E. coli O157 outbreak may never be found, the feds announced they found a source.

The U.S. Centers for Disease Control (CDC) reported today that as of Dec. 4, 2011, 60 persons infected with the outbreak strain of E. coli serotype O157:H7 had been reported from 10 states.

Collaborative investigative efforts of state, local, and federal public health and regulatory agencies indicate that romaine lettuce is the likely source of illnesses in this outbreak, and contamination likely occurred before the product reached retail stores.

CDC called Schnucks Chain A, and the farm the lettuce was traced to Farm A, without saying in what state the lettuce originated. But one of the Missouri health types did, saying a grower in California was suspected of being connected but records were “insufficient to complete the picture.”

The public reporting of this outbreak reeks of the Leafy Greens Cone of Silence – that the most noticeable achievement since the California Leafy Greens Marketing Agreement was created in the wake of the 2006 E. coli O157-in-spinach mess is the containment cone of silence that has descended upon outbreaks involving leafy greens.

Things didn’t sound quite right back on Oct. 28, 2011, when St. Louis County health officials first publicly confirmed that the source of the E. coli O157 strain that had sickened 23 people was foodborne, but that the investigation was ongoing. Though retailers have not been asked to pull any food, Schnucks voluntarily replaced or removed some produce in salad bars and shelves, beginning Oct. 26, 2011.

"Once we heard that the health department had declared an outbreak, we took some proactive steps with our food safety team to switch products out that recent history told us could be potential sources," said Schnucks spokeswoman Lori Willis.

A Schnucks store, Culinaria in downtown St. Louis, put a sign up on empty shelves that read in part, "Due to a voluntary recall on pre-packed lettuce, we will not be able to produce these pre-made salads. Be assured quality is our main concern. All of the lettuce on the salad bar is fresh and not involved with the recall."

As a retailer, Schnucks drew my attention earlier this year when it announced it was expanding its so-called Peace of Mind initiative from pricing to quality assurance with a new website, www.peaceofmindquality.com, that emphasizes the chain’s dedication to quality and food safety. Unfortunately, quality and safety are seemingly used interchangeably on the website when they are actually two different concepts.

A table of leafy green related outbreaks is available at http://bites.ksu.edu/leafy-greens-related-outbreaks.

I'm not feeling peace of mind.

More from the CDC report:

As of December 4, 2011, 60 persons infected with the outbreak strain of E. coli O157:H7 have been reported from10 states. The number of ill persons identified in each state is as follows: Arizona (1), Arkansas (2), Georgia (1), Illinois (9), Indiana (2), Kansas (3), Kentucky (1), Minnesota (3), Missouri (37), and Nebraska (1).

Among persons for whom information is available, illnesses began from October 10, 2011 to November 4, 2011. Ill persons ranged in age from 1 to 94 years, with a median age of 29 years old. Sixty-three percent were female. Among the 45 ill persons with available information, 30 (67%) were hospitalized, and 2 developed hemolytic uremic syndrome (HUS). No deaths have been reported.

Collaborative investigative efforts of state, local, and federal public health agencies indicate that romaine lettuce sold primarily at several locations of a single grocery store chain (Chain A) was the likely source of illnesses in this outbreak. Contamination likely occurred before the product reached grocery store Chain A locations.

Ill persons reported purchasing salads from salad bars at grocery store Chain A between October 5 and October 24, 2011. A total of 9 locations of grocery store Chain A were identified where more than one ill person reported purchasing a salad from the salad bar in the week before becoming ill. This included 2 separate locations where 4 ill persons reported purchasing a salad at each location. For locations where more than one ill person reported purchasing a salad from the salad bar and the date of purchase was known, dates of purchase were all within 4 days of other ill persons purchasing a salad at that same location. Chain A fully cooperated with the investigation and voluntarily removed suspected food items from the salad bar on October 26, 2011, out of an abundance of caution. Romaine lettuce served on salad bars at all locations of grocery store Chain A had come from a single lettuce processing facility via a single distributor. This indicates that contamination of romaine lettuce likely occurred before the product reached grocery store Chain A locations.

The FDA and several state agencies conducted traceback investigations for romaine lettuce to try to identify the source of contamination. Traceback investigations focused on ill persons who had eaten at salad bars at several locations of grocery store Chain A and ill persons at university campuses in Minnesota (1 ill person) and Missouri (2 ill persons). Traceback analysis determined that a single common lot of romaine lettuce harvested from Farm A was used to supply the grocery store Chain A locations as well as the university campus in Minnesota during the time of the illnesses. This lot was also provided to a distributor that supplied lettuce to the university campus in Missouri, but records were not sufficient to determine if this lot was sent to this university campus. Preliminary findings of investigation at Farm A did not identify the source of the contamination. Farm A was no longer in production during the time of the investigation.

Officials at Magnolia Regional Health Center in Corinth, Miss. say the hospital has received 11 positive salmonella cultures since Nov. 28 and some cases have been hospitalized.

A definitive source is yet to be determined.

State health officials have interviewed the patients to find out what foods they'd eaten. They also are taking food samples from local restaurants. No restaurants have been closed by the state.

Australia has an egg problem.

Health types have said as much in the past, but once again, salmonella in a raw egg dish has sickened a bunch of Australians, with restaurant owners claiming ignorance, no evaluation of whether people are doing what they say they are doing, and an opaque version of public health transparency with the consuming public.

The co-owner of the Canberra business at the center of a Salmonella outbreak says she is working with ACT (Australian Capital Territory, sorta like Washington, D.C., and home to the federal capital, Canberra) health authorities to ensure the safety of its food.

It is believed raw egg in mayonnaise made at the Silo bakery in Kingston is to blame for the outbreak.

ACT Health has confirmed 13 people have been affected by Salmonella bacteria.
Five were hospitalised with dehydration after suffering severe vomiting and diarrhoea.

The bakery has been closed by health authorities until the source is confirmed.

Co-owner of Silo Leanne Gray says she is scrupulous about food hygiene and is perplexed by the outbreak.

"Until those sub-species [lab] results come back the information is not conclusive," she said.

"But I do understand the Health Department have to take actions if they have suspicions and we have nothing to hide."

"We've decided as of Friday, no more mayonnaise and that's forever."

But the information about the bakery was provided by ABC News. The ACT Health Directorate would only say it is currently investigating an outbreak of Salmonella gastroenteritis linked to a Canberra food business.

ACT Chief Health Officer, Dr Paul Kelly said, “Salmonella has been identified in mayonnaise containing raw egg, with further tests of food and environmental samples pending."

Ms. Gray, the bakery owner with “scrupulous food hygiene” has apparently never heard of raw eggs as a source of salmonella – although she did point out her eggs were free-range.

Hundreds of people have been sickened in Australia in the past five years from consuming undercooked eggs or dishes containing raw eggs, including 111 sick with salmonella from home-made aioli -- a garlic mayonnaise that includes raw egg – at the Burger Barn in Albury, Australia last year. Other Australian outbreaks are available at these links.

http://bites.ksu.edu/blog/139189/10/01/25/it-was-aioli-australian-salmonella-toll-albury-rises-111-linked-raw-egg
http://barfblog.foodsafety.ksu.edu/blog/137965/07/12/25/raw-eggs-sicken-50-aussies
http://barfblog.foodsafety.ksu.edu/blog/139946/08/12/29/136-hospitalized-australian-bakery-fined-40000
http://barfblog.foodsafety.ksu.edu/blog/139553/08/02/17/tasmania-rest-australia-wake-raw-egg-risks
http://barfblog.foodsafety.ksu.edu/blog/140014/09/02/08/raw-egg-hollandaise-sickens-20-upscale-retirement-home

In May 2011, the Sydney Morning Herald reported the number of Australians sickened by egg-related salmonella outbreaks rose from 96 to a staggering 753 per year between 2001 and 2008. The rate fell to 358 in 2009, but eggs are still responsible for more than a third of all foodborne outbreaks linked to salmonella in Australia.

Martyn Kirk, a senior lecturer in epidemiology at the Australian National University, said eggs had become the most common cause of food-related disease outbreaks.

Restaurants are responsible for the bulk of poisonings: 40 per cent. And while cooking will kill salmonella, restaurants are allowed to serve foods containing raw eggs.

''Most of the vehicles we see associated with outbreaks are foods where the eggs are completely uncooked; things like chocolate mousse, tiramisu, hollandaise sauce and aolis,'' Mr Kirk said.

While egg producers in NSW are now required to be licensed with the NSW Food Authority, no government body conducts regular bacterial tests on eggs, or monitors the presence of salmonella on farms.

A risk assessment commissioned by the Australian Egg Corporation in 2004 found refrigerating eggs could reduce outbreaks of salmonella. The lead author of the report, the microbiologist Connor Thomas, told the Herald salmonella cannot grow in temperatures below seven degrees, and refrigeration reduces the breakdown of protective membranes inside the egg that stop the bacteria's growth.

But in April 2011, Food Standards Australia New Zealand (FSANZ) introduced changes to the food standards code, omitting any regulations related to temperature control.

A spokeswoman for FSANZ said it chose to exclude refrigeration requirements from the standard, in part, because of ''the substantial cost of implementing such an option.''

Ms. Gray, you can still serve mayonnaise. Use pasteurized liquid eggs, or pasteurize eggs yourself, or buy it commercially.

The captain of the New Zealand men's netball team has died after choking on a piece of food while eating dinner with his wife.

Mike Siave, 35, was at the dinner table in his Canterbury home with his wife of 10 years, Amanda, on Friday when he collapsed to the ground unable to breathe.

He died at the scene from what the coroner later ruled was asphyxiation caused by a food blockage.

Ms Siave told the New Zealand Herald she'd lost "the love of my life" and the "wonderful" father of their two sons, Jackson, seven, and Cooper, five.

Mr Siave was also a senior salesman at Telecom and a long-term member of the Canterbury men's netball team, which has pledged to dedicate its 2012 season to him.

Netball is similar to basketball and was first developed in England in the 1890s.

ABC News (the Australian one) reports four people have been treated in hospital after an outbreak of salmonella poisoning in Canberra.

The majority of victims presented to hospital on Friday.

ACT health authorities are investigating the source of the outbreak.

Cultures are being checked to determine if the salmonella cases are linked. No other details were available.

Traditional media is starting to pick up on the food safety nonsense coming out of the Fat Duck, Heston Blumenthal’s signature restaurant that sickened 529 with norovirus from raw oysters – and staff – in 2009.

The Guardian reports today the Fat Duck fiasco was the largest restaurant-related norovirus outbreak, ever.

The latest report published in the journal, Epidemiology and Infection, reports that at least 240 people had gastroenteritis

The fun part is the delusional deconstruction offered by a Fat Duck spokesthingy to the Guardian:

"The reported illness in February 2009 at the Fat Duck was confirmed as oysters contaminated at source by norovirus. At the time we voluntarily closed the restaurant and called in the authorities. We co-operated with all parties fully and transparently and received a clean bill of health to reopen after a 10-day investigation.”

The paper says the outbreak was reported to health types six weeks after the putative index case, and only after the restaurant had hired private consultants and only after the restaurant had already closed. By this time the restaurant had received 66 complaints of illness, but not bothered to tell anyone.

"We also received full support by our insurers who found no fault in our practices following a report from a leading UK independent specialist.”

Insurers tend not to publish peer-reviewed papers; no one knows who this independent specialist is. But anyone can know what the health types found. It’s in the paper.

“There is still no guaranteed safety measure in place today to protect the general public with regards to shellfish and viral contamination. For this reason we still do not serve oysters or razor clams at the Fat Duck."

There never was a guaranteed safety measure to protect the public from norovirus in raw shellfish, yet the restaurant knowingly chose to serve them anyway – until they got caught and made a lot of people barf.

Keep blaming others, Heston and crew, the Brits will swallow anything. Guess that’s why the Duck was attracting tens of thousands of calls a day from prospective diners earlier this year.

In May, 2011, five people were killed – including two children -- and over 180 sickened with E. coli O111 after eating raw beef dishes at restaurants in Japan.

After initially blaming the Australian supplier, Yasuhiro Kanzaka, president of Foods Forus Co., which runs the Yakiniku-zakaya Ebisu chain, said the company had not conducted microbial tests at any of its outlets since July 2009, adding, "We'd never had a positive result [from a bacteria test], not once. So we assumed our meat would always be bacteria-free.”

The Japanese health ministry subsequently stated it planed to begin imposing new penalties for food safety violations as early as October, as current guidelines were nonbinding.

The agriculture ministry urged restaurants to ensure the trimming of all raw meat and to remind customers of the higher risks of food poisoning for children and the elderly.

It’s now December, and according to a report released last week, 59 of the 4,490 restaurants and meat suppliers inspected were providing raw beef cuts, including "yukke," to customers, despite new regulations requiring beef to be heated for at least two minutes in 60-degree water. Restaurants were also required to set up special sanitized workspaces to prevent bacterial infections.

The Tokyo metropolitan government report also revealed that none of the 59 locations serving the shredded raw meat met the new food safety standards issued in October.

"We have ordered the facilities that do not meet the standards to stop providing the dishes, and all of them have discontinued providing raw meat at this point," the metropolitan government said.

While the crackdown in Tokyo has ostensibly stopped yakiniku restaurants from serving yukke, some claim the strict regulation has only led restaurants to serve the dish under the table.

Although violations of the new safety rule can result in a fine of 2 million Yen or imprisonment of up to two years, the metropolitan government has only ordered the restaurants to stop providing raw meat.

Which is as effective as me telling my 3-year-old, “no” or “don’t do that.”

Stepping in dog poop is annoying, but the health hazard is unknowingly ingesting or contact with the poop.

While walking around Chicago, I came across this sign that is unique in its clarity: Pet waste transmits disease (right, exactly as shown).

It goes straight to the point and informs the public of the real reason behind the need to clean after our pets in public places.

Dog poop can spread hookworms and roundworms, both of which can infect humans and have severe consequences: ocular larva migraines from roundworms; cutaneous larva migraines from hookworms.

The camp of former President and now Pampanga Rep. Gloria Macapagal-Arroyo suspects that her diarrhea could be part of the alleged plot to "put her to sleep."

A radio report said that according to lawyer Ferdinand Topacio, they are now investigating the possibility that contaminated food was deliberately given to Mrs. Arroyo at the St. Luke's Medical Center (SLMC) in Taguig City as part of the alleged "Oplan: Put The Little Girl To Sleep".

Topacio cited the statement of Dr. Juliet Gopez-Cervantes, the main attending physician of Mrs. Arroyo, that the former president was suffering from diarrhea likely caused by salmonella, which can be passed on to a patient through contaminated food.

Meanwhile, the lawyer said that according to Mrs. Arroyo's doctors, it was also possible that the former president already had the salmonella bacteria inside her intestines and that it could have just been aggravated by certain factors.

The report said that Topacio reminded reporters during an ambush interview this afternoon that part of the kill plot was to serve poisoned food to Mrs. Arroyo at the hospital.

Topacio reiterated that their source on the kill plot is very reliable. He repeated earlier claims by Mrs. Arroyo's spokesperson, Elena Bautista-Horn, that the source is currently connected in government.