Category Archives: outbreak

USA – Torero’s Mexican Restaurant in Renton linked to E. coli Outbreak

Food Poison Journal

Summary

Public Health is investigating an outbreak of Shiga toxin-producing E. coli (also known as STEC) associated with diarrhea and abdominal pain at Torero’s Mexican Restaurant in Renton.

The investigation is ongoing. At this time, we have not identified how STEC was spread within the restaurant. This is not uncommon for STEC outbreaks, because the bacteria can spread through contaminated food items, environmental surfaces, and from person to person.

Illnesses

Since September 5, 2022, 3 people from 3 separate meal parties reported becoming ill after eating food from Torero’s Mexican Restaurant in Renton on September 3, 2022 and September 7, 2022. All of the people developed one or more symptoms consistent with STEC, including diarrhea (often bloody), abdominal cramping, nausea, and vomiting. We have not identified any ill employees.

USA – CDC says outbreak linked to Wendy’s sandwiches is over with more than 100 sick

Food Safety News

Federal officials have declared that an outbreak of E. coli O157:H7 infections related to romaine lettuce on Wendy’s sandwiches has ended.

The Centers for Disease Control and Prevention is reporting that the total number of confirmed patients is 109, up from the 97 reported in its most recent update on Sept. 1. About half — 52 — of the patients have been so sick they had to be admitted to hospitals. Thirteen of the patients developed hemolytic uremic syndrome (HUS), a serious often life-threatening condition that can cause kidney failure. No one had died as of this evening.

As of the report tonight from the CDC the specific source of the E. coli could not be 100 percent confirmed. However, 83 percent of 82 patients for whom the information was available reported eating at Wendy’s before becoming ill.

“The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not have been limited to the states with known illnesses. This is because many people recover without medical care and are not tested for E. coli,” according to the CDC statement.

USA – More than 200 backpackers and rafters sickened in Grand Canyon National Park backcountry- Suspected Norovirus

Food Safety News

Between April 1 and June 17, 2022, at least 222 rafters and backpackers became infected with acute gastroenteritis, most likely norovirus, according to the Centers for Disease Control and Prevention (CDC). This is the largest outbreak of acute gastroenteritis documented in the Grand Canyon National Park backcountry.

Preliminary analysis of illness characteristics and portable toilet specimen test results suggested norovirus as the primary causative agent of illness. Norovirus spreads quickly through person-to-person contact and contaminated food or beverages and can persist in the environment. The bacteria can live for days to weeks on hard surfaces.

River outfitters and National Park staff members partnered to enable the implementation of prevention and control measures.

Norovirus-associated acute gastroenteritis is highly transmissible in settings with close person-to-person contact and decreased access to hand hygiene. Because many trips use the same campsites and place-portable toilets in the same locations, particles could have been transmitted to surfaces, beach sand or river water where new groups could have encountered them, and then transmitted the virus both from person-to-person and trip-to-trip.

USA – Outbreak Investigation of Listeria monocytogenes: Brie and Camembert Soft Cheese Products (September 2022)

FDA

Recalled brie and camembert cheese

The FDA, along with CDC and state and local partners, is investigating a multistate outbreak of Listeria monocytogenes infections linked to Brie and Camembert soft cheese products manufactured by Old Europe Cheese, Inc. of Benton Harbor, MI, and sold at various retailers under multiple labels and brands, including Reny Picot.

Based on epidemiologic information provided by CDC, of the five patients with information available, four (80%) report eating Brie or Camembert cheese prior to illness. FDA, with assistance from the Michigan Department of Agriculture and Rural Development, initiated an inspection at the Old Europe Cheese, Inc. facility in Michigan, which included sample collection and analysis. Analysis of environmental samples collected at the facility showed the presence of Listeria monocytogenesWhole Genome Sequencing (WGS) analysis determined that the Listeria strain found in the facility matches the Listeria strain causing illnesses in this outbreak.

Old Europe Cheese, Inc. has voluntarily recalled multiple brands of Brie and Camembert cheeses produced at their Michigan facility in response to investigation findings. The firm has also halted production and distribution of their Brie and Camembert products from the Michigan facility and is working with FDA on corrective actions. Consumers, restaurants, and retailers should not eat, sell, or serve recalled products and should throw them away; this includes Best By Dates ranging from September 28, 2022 to December 14, 2022, and all flavors and quantities. A full list of recalled products and stores that potentially sold these products is available below and on the firm’s recall.

FDA’s investigation is ongoing to determine if additional products are potentially contaminated. Updates to this advisory will be provided as they become available.

Recommendation

Consumers, restaurants, and retailers should not eat, sell, or serve recalled products and should throw them away; this includes Best By Dates ranging from September 28, 2022 to December 14, 2022, and all flavors and quantities. A full list of recalled products and stores that potentially sold these products is available below and on the firm’s recall.

Retailers may have repackaged bulk Old Europe Cheese items into smaller containers and sold this repackaged product to consumers. This repackaged product may not bear the original labeling and product information. If you are unsure where your Brie or Camembert cheese is from, ask your retailer or throw it away.

Listeria is most likely to sicken pregnant people and their newborns, adults aged 65 or older, and people with weakened immune systems. Other people can be infected with Listeria, but they rarely become seriously ill.

Call your healthcare provider right away if you have these symptoms after eating Old Europe Cheese Inc. or Reny Picot brand Brie and Camembert products:

  • Pregnant people typically experience only fever, fatigue, and muscle aches. However, Listeria infection during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn.
  • People who are not pregnant may experience headache, stiff neck, confusion, loss of balance, and convulsions, in addition to fever and muscle aches.

Follow FDA’s safe handling and cleaning advice and use extra vigilance in cleaning and sanitizing any surfaces and containers that may have come in contact with these products to reduce the risk of cross-contamination, including retailers who repackaged bulk recalled cheese. Listeria can survive in refrigerated temperatures and can easily spread to other foods and surfaces.

Case Count Map Provided by CDC

CDC Case Count Map of Listeria monocytogenes: Brie and Camembert Soft Cheese Products

Case Counts

Total Illnesses: 6
Hospitalizations: 5
Deaths: 0
Last illness onset: August 5, 2022
States with Cases: CA, GA, MA, MI, NJ, TX
Product Distribution: Nationwide

Research – Collective food poisoning (TIAC) ​​with E. coli O157 producing Shiga toxins, associated with the consumption of raw cucumbers

Sante Publique

On September 9, 2021, the Regional Health Agency (ARS) of Hauts-de-France was informed of a suspicion of collective food poisoning (TIAC) ​​affecting half-board students, educated in several schools in a municipality. of the Lille metropolis. On September 13, 2021, two cases of hemolytic and uremic syndrome (HUS) were diagnosed in two hospitalized children attending school in this town. Public Health France Hauts-de-France was asked by the Hauts-de-France ARS to provide support for the investigations and management of this TIAC. A total of 35 cases of gastroenteritis, with bloody diarrhea and fever (>38°C) in half of the cases, were identified. Ten cases were hospitalized and two children developed HUS. The cases identified were half-board students in four school groups (29 cases), a parent of a student and elderly people benefiting from the municipality’s home meal delivery service (5 cases). The case canteens were all supplied by the central municipal kitchen. The shape of the epidemic curve was in favor of a common and point source of contamination during meals on September 2 or 3, 2021. The case-control survey, carried out in schools, concluded that only the consumption of cucumbers in salad, served with the meal on September 2, was statistically and significantly associated with the occurrence of the disease. A strain of E. highly pathogenic Shiga toxin-producing (STEC) O157 coli was isolated from the stool cultures of eight cases, including the two children who developed HUS and in the offending cucumber salad. Genomic analysis of the strains confirmed the genetic clustering of clinical and food strains that belonged to the same genomic cluster. The veterinary investigation revealed that a failure in the decontamination process, associated with incomplete peeling of the contaminated cucumbers, contributed to the occurrence of this TIAC. The cucumbers in question came from Belgium and the Belgian health authorities were informed via the dedicated European alert circuits. No other episodes of clusters of STEC infection related to this TIAC have been reported to the ARS over the period while cucumbers from the same batch had been widely distributed in communities and commercial catering services in the Hauts-de-France region. The food vehicle, incriminated in this TIAC, is part of the plants at risk because of its raw mode of consumption. It is important to remind vulnerable populations and collective catering services that preventing the risk of STEC infection, linked to the consumption of raw vegetables, requires washing, disinfection and peeling.

Research – Spread of Hepatitis A virus strains of genotype IB in several EU countries and the United Kingdom – including foodborne spread

ECDC

As of 29 September 2022, 303 cases with identical or closely related HAV strains have been identified in Austria (7), Germany (8), Hungary (161), the Netherlands (8), Slovenia (35), Sweden (8), and the UK (76). Currently available epidemiological and microbiological data suggest that human-to-human transmission has occurred, and possibly also transmission through contaminated food.

On 15 February 2022, Hungary reported an outbreak of HAV genotype IB with the disease onset of the first case in early December 2021. To date, 161 cases (139 males, 22 females) have been confirmed with this strain in the National Hepatitis Reference Laboratory in Hungary. The weekly number of reported hepatitis A cases have been declining since June 2022. Several infected people identified themselves as men who have sex with men (MSM), suggesting possible transmission among sexual contacts. Several patients have been hospitalised.

In July 2022, a foodborne outbreak was suspected with a link to a restaurant in Hungary, where 16 people fell ill with HAV IB infection. Some of the patients reported consuming cold soup made with frozen berries. In the UK, no clear source of infection has been identified, but epidemiological investigations so far indicate possible foodborne infections in addition to person-to-person transmission. Germany, the Netherlands, and Sweden have reported a total of nine cases infected with strains matching the sequences of the UK strain. Investigations of these cases didn’t find any clear risk factors for infection such as a travel history or consumption of berries. Further investigations are ongoing.

HAV is highly transmissible through contaminated water, food, and via the faecal–oral route among close contacts (e.g. household contacts, sexual contacts, and contacts in day-care centres or schools), with an average incubation period of four weeks, ranging from two to six weeks. The virus is highly resistant to environmental conditions as well as to several preservation methods like acidification or freezing. Therefore, possible food-borne transmission should be investigated when several cases are reported within a short period.

Practising good hand hygiene – including thoroughly washing hands with soap after using the bathroom, changing nappies, and before preparing or eating food – plays an important role in preventing the spread of hepatitis A. Scaling up surveillance to detect and investigate sporadic and clusters of cases possibly associated with foodborne transmission in collaboration with food safety authorities is essential.

MSM are at risk of HAV infection when engaging in sexual practices that facilitate faecal-oral transmission of the virus. Hepatitis A vaccination, which is safe and highly effective, is the main option for response in the context of the current circulation of HAV genotype IB among MSM. The World Health Organisation and most EU/EEA countries recommend hepatitis A vaccination for MSM.

Besides vaccination, other options can contribute to the prevention of transmission among MSM: the use of condoms for anal sex, which have the additional benefit of offering protection against other sexually transmitted infections and good personal hygiene (e.g. washing hands and genital areas before and after sex). For the provision of primary prevention advice, authorities should consider engaging with civil society, social media, media outlets and dating apps to raise awareness among MSM about the risk of contracting HAV and the importance of vaccination. MSM who have already contracted the infection should be referred to sexual health services for further testing.

Research – Increase in food outbreaks by Escherichia coli. How to prevent them

ACSA

In recent months, outbreaks caused by Escherichia coli have increased (Ireland, Scotland, etc.). Recently, in France, pizzas contaminated by this bacterium affected 56 people─ including 55 small children─ and caused two deaths.

This bacterium is naturally present in our digestive microflora. Although most strains of E. coli  are harmless to humans, others can cause infections or carry antibiotic resistance genes. Among the pathogenic strains, shigatoxigenic E. coli is responsible for serious infections in children and the elderly.

Ruminants, especially cattle, are healthy carriers of these bacteria. Therefore, the bacteria present in their excrement can contaminate animal products (meat and dairy) and the environment (soil and water). Contamination occurs, for example, in the meat slaughterhouse (through the remains or after the evisceration of the animals) or at the time of milking the milk of cattle, sheep or goats.

With regard to plants, this contamination can occur during the spreading of manure or livestock effluents on farmland, or during the use of contaminated irrigation water.

The main foods implicated in outbreaks of shigatoxigenic E. coli infections are undercooked minced beef, non-pasteurized dairy products (raw milk and raw milk cheeses), raw vegetables (salad, young shoots, sprouts), unpasteurized fruits or vegetables and contaminated drinking water .

Throughout the food chain, the management of this risk is based on the application of effective self-controls and the verification of the effectiveness of the measures implemented.

With regard to the consumer, the prevention of infections through food is based on the application of the following measures:

  • Wash hands with soap and water when leaving the toilet, before preparing and eating food, and after handling raw or non-raw food.
  • Wash and peel the vegetables, if possible; and also fruits and aromatic herbs, especially those that are eaten raw.
  • For sensitive populations (young children and the elderly), thoroughly cook ground meat and ground meat products (70°C), avoid consumption of raw milk and raw milk products (except for cooked pressed cheeses), and of raw or undercooked flour.

Research-Sources and trends of human Salmonellosis in Europe, 2015-2019: an analysis of outbreak data

asca

Study published in the International Journal of Food Microbiology. The aim of this study was to determine the main food sources and recent trends of  Salmonella outbreaks in Europe. Data from outbreaks in 34 European countries during the 2015-2019 period are taken into account. 

In general, the most important food source of the salmonellosis outbreaks were eggs, pork series and meat products in general. While eggs were the most important source of infection in all regions, pork was the second most common source in Northern and Western Europe, and meat products (in general) in Eastern and Southern Europe. 

There were 939 outbreaks caused by Salmonella enteritidis , 130 by Salmonella typhimurium and its monophasic variant, 107 by other known serotypes, and 332 by other unknown types.

Complex food categories such as baked goods, buffet meals, mixed foods, sweets and chocolate, canned food products, and beverages were grouped as unknown sources in the analysis because it was not possible to identify the exact components responsible for the infection.

In total, 1,508 salmonella outbreaks were included in the analysis. Of these, 1,040 were caused by simple foods and 468 by unknown food sources. Most of the outbreaks were reported in Eastern Europe, followed by Southern, Western and Northern Europe.

Outbreaks caused by S. enteritidis (SE) and other known serotypes (other than SE and S. typhimurium and its monophasic variant [STM]) were attributed primarily to eggs, whereas outbreaks caused by STM were primarily attributed to the Pork Meat. In general, there was a significant increase in the number of reported outbreaks between 2015 and 2019, mainly due to the increase in outbreaks in Eastern Europe while, in Northern and Southern Europe, outbreaks caused by SE decreased significantly between the years 2015 and 2019. Outbreaks related to the consumption of cheese and fish are steadily declining.

Research – Summary of FDA’s Strategy to Help Prevent Salmonellosis Outbreaks Associated with Bulb Onions

FDA

Background

Onions are one of the most commonly consumed vegetables in the United States. Grown in more than 170 countries, they are also one of the most important horticultural crops worldwide. Bulb onions are characterized by having hollow, tubular, blue-green leaves and can be purchased fresh or frozen to use in cooked dishes or consumed raw as an ingredient or garnish. Bulb onions are typically dried or cured to reduce decay and increase shelf life.

In 2020 and 2021Salmonella outbreaks associated with the consumption of bulb onions produced in the U.S. and Mexico caused more than 2,100 confirmed cases of foodborne illness in the United States. The 2020 outbreak in the U.S. cost an estimated $203 million in consumer health-related losses. The 2021 outbreak in the U.S. cost an estimated $188 million in consumer health-related losses. [1]

Overview of Salmonellosis Outbreaks Associated with Bulb Onions

In 2020, the FDA’s Coordinated Outbreak Response & Evaluation (CORE) Network, in collaboration with the Centers for Disease Control and Prevention (CDC) and state and local partners, investigated a multistate outbreak of Salmonella Newport infections linked to the consumption of domestically grown red bulb onions. While no conclusive root cause could be identified, the agency’s investigation report identified several plausible opportunities for contamination including irrigation water, sheep grazing on adjacent land, and signs of animal intrusion, such as scat and large flocks of birds that may spread contamination.

In 2021, the FDA led investigations of a multistate outbreak of Salmonella Oranienberg infections linked to the consumption of red, white, and yellow bulb onions imported from the State of Chihuahua, Mexico. The FDA worked closely with Mexican competent authorities through the established Food Safety Partnership to investigate potential source(s) of contamination within the implicated region.  However, the agency was unable to conduct an on-farm investigation at the time, and no conclusive root-cause was determined.

Summary of FDA’s Strategy to Help Prevent Future Outbreaks of Salmonellosis linked to Bulb Onions[2]

Food safety is a shared responsibility. The bulb onion industry is responsible for meeting applicable food safety requirements. In addition, the FDA believes it is imperative that we share data, knowledge, and information and work collaboratively with industry and state regulators to enhance food safety and advance the goals and objectives of FDA’s Strategy for the Safety of Imported Food. Based on review of the outbreak investigational findings, historical data, and engagements with industry and other stakeholders, the agency has identified several measures that can be taken to reduce future incidences of foodborne illness related to bulb onions, including:

  • Engaging domestic and foreign industry and government partners to promote a broad understanding of the outbreak investigation findings, applicable Produce Safety Rule requirements, and the importance of root cause analysis after outbreaks.
  • Prioritizing inspections of bulb onion farms in the United States and Mexico that are covered by the FDA’s Produce Safety Rule.
  • Identifying and assessing practices and conditions associated with onion curing.
  • Supporting research efforts to better understand bulb onion production practices, including the impact of different soil conditions and curing practices on the safety of bulb onions.
  • Supporting industry-led efforts to develop and implement best practices for bulb onion production.

The agency has also identified the following additional actions specific to imported bulb onions:

  • Prioritizing Foreign Supplier Verification Program inspections of bulb onion importers to ensure that onion importers are verifying that foreign suppliers follow processes and procedures that provide the same level of public health protection as U.S. food safety requirements.
  • Increasing strategic and targeted sample collection and testing of imported bulb onions from the State of Chihuahua, Mexico.
  • Continuing to collaborate with Mexican competent authorities through the established Food Safety Partnership to help ensure the safe production of bulb onions in the State of Chihuahua, Mexico.

By implementing these activities, the FDA seeks to:

  • Encourage high rates of compliance with the applicable FDA food safety requirements across the bulb onion supply chain through education, outreach, and technical assistance to the growers, distributers, and importers of bulb onions.
  • Verify and measure the rate of industry compliance through inspections and sampling.
  • Broaden scientific knowledge about production methods that can reduce future incidences of foodborne illness related to bulb onions.

USA – Could the Wendy’s E. coli Outbreak have sickened over 2,600?

Food Poison Journal

According to the CDC, as of September 1, 2022, a total of 97 people infected with the outbreak strain of E. coli O157:H7 have been reported from six states – Indiana 11, Kentucky 1, Michigan 58, New York 1, Ohio 24, and Pennsylvania 2.  It is expected, according to the NCBI database, that the actual numbers of ill will be 115 or more shortly.  Interestingly, according to the CDC, for E. coli O157:H7, there is an underreporting rate of 26.1 – meaning for everyone 1 person counted by the CDC another 26.1 were actually sickened.