NUMBERS OF E.COLI ILLNESSES COULD BE TEN TIMES GREATER

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, has said that the actual number of infections resulting from the very toxic E.coli outbreak centered in Germany, could be 10 or more times higher than those officially announced.

So let's say the official numbers are 2,000 illnesses from this very unusual bacteria (that's probably close to what they will be tomorrow). That would mean that it's really closer to 20,000. Is this possible?

Yes, not only possible, but probable. That is what I have been suggesting in previous posts, so I am glad someone agrees. In all outbreaks there are large numbers of affected people who are not included in the reporting system: because they don't go to the doctor, because laboratory tests are not performed, because the tests don't turn up the bacteria (numbers present in the stool will decrease after the first few days), because the cause is not correctly identified, because the doctor or hospital doesn't have time to send in a report.

In addition, there are reporting delays: not just a few days, but sometimes weeks, while the information works its way through the system. This means that the reported statistics are always behind the real ones. And, much lower than the real ones.

Based on a review of the U.S. experience, The Safe Food Handbook suggests that probably as few as 3% of actual cases of food borne illness actually enter the official reporting system. I would guess that it is better in Europe, where the regulatory agencies are not as underfinanced and overworked as they are here. But it is still only a fraction.

To your good health!

TSF

NOROVIRUS FROM CONTAMINATED ICE

The problem is that Norovirus is very infectious. You only need to be exposed to about 100 particles to catch it, whereas in the case of seasonal flu it's around 10,000 - quite a difference. It's also a survivor. Norovirus can live outside the body much better and longer than many other viruses.

Virus-contaminated food is only one of the vehicles for catching it, but an important one. You can also inhale the virus from the air where someone has vomited, or

get sick from touching an infected surface, or a sick person. You can even catch Norovirus from contaminated ice, as occurred a few decades ago at a football game between University of Pennsylvania (where I went to graduate school) and Cornell, or, at a museum fundraiser for that matter.

Here's what happened (my source is the Centers for Disease Control - CDC report on the incidents). Within 48 hours of the University of Pennsylvania-Cornell football game in Philadelphia in 1987, a large number of band members from both universities, Cornell football players, and spectators, including visiting students and university staff and faculty, all started having symptoms of gastrointestinal illness, especially projectile vomiting and nausea. A smaller percentage had diarrhea, headaches, chills and additional symptoms. These were typical of Norovirus. Almost all had bought soda with ice from the stadium vendor.

Oddly, many of the Pennsylvania football team members became ill several days later. Apparently this team had used ice from a different source at the September 19 game, but had used the contaminated ice at practice a few days later.

Just a couple of days later there was an outbreak of gastroenteritis among 750 people who attended a museum fund-raiser in Wilmington, Delaware, not far away. The ice was traced to the same Pennsylvania ice supplier. It turned out that its wells had been flooded by a creek (obviously contaminated) following a torrential downpour of rain. Probably, in all, about 5,000 people became ill from this Norovirus contaminated ice.

There is no reason why this kind of outbreak can't happen again anytime, anywhere. And there's no way to know that ice is contaminated. Opt for a warm soda?

TSF

E.COLI CONTAMINATED HAZELNUTS

E.coli 0157:H 7 contaminated hazelnuts (and, I bet, a growing list of hazelnut-containing processed foods). Yes, you read correctly.

DeFranco & Sons of Los Angeles, California, is recalling in-shell hazelnuts and mixed-nut products in bulk and bags. They were distributed nationwide in the US and to Canada. (I wonder where they were grown? California or imported? I'll find out and let you know). These nuts have already been linked to seven cases of E.coli 0157:H7 illness in Michigan, Minnesota and Wisconsin. There will be more.

E.coli 0157 contamination of nuts is very uncommon. Usually it's Salmonella bacteria (as it was in the case of past peanut and pistachio outbreaks we had). And, we all know by now that this nasty bacteria can cause very serious illness, especially in young children and the elderly who could develop hemolytic uremic syndrome (HUS) just as they think they are getting over the diarrhea.

If you have eaten hazelnuts recently, or, any product containing hazelnuts (such as peanut butter, chocolates, baked goods, ice creams) watch out for symptoms of bloody diarrhea, in case you were unlucky. Onset of symptoms is usually 3-4 days (but can be 2-8) after eating the nuts. Get yourself (or your child) to a doctor if that happens.

And my advice - avoid any brand hazelnuts or hazelnut containing product for the moment, until we find out where this outbreak ends up.

TSF

MY GUIDE ON SAFE FOOD AND DRINK FOR TRAVELERS

I just took a look at the World Health Organization's "Guide on Safe Food for Travelers." I don't like it. Apparently it was adopted by China for the Beijing Olympics. No wonder several members of the US track team came down with food poisoning.

As you gather from several recent posts, travel has been on my mind lately (is it spring coming?) and I have certainly done enough of it in my life - mainly for international assignments. Anyway, here's my own guide, which I now always follow except in Europe and certain Asian cities:

• Eat only cooked food, except in the case of fruit which has been grown high on a tree and you can peel (such as bananas, mangos, oranges).
• As far as possible, avoid large catered affairs and buffets.
• Avoid street vendor food, and food sold by small roadside places or in markets, unless it is simple food, cooked in front of you (such as a roasted corn cob, roasted chestnuts).
• Only eat cheese or other dairy if you are certain it is pasteurized.
• Avoid shellfish, unless you are certain that it comes from safe waters and never eat fish or shellfish on a plane.
• Drink only bottled water and drinks, or hot coffee, tea, and avoid ice in anything you drink unless you are sure it is made from bottled water.

And, of course, always wash your hands before you touch food.

TSF

E. coli O157:H7 in Costco Cheese

E. coli O157:H7 is a particularly nasty bacterium. Only a few in your food can be enough to give you a totally miserable week or so of diarrhea and stomach cramps. For people who are more vulnerable, and especially young children (under age 5), and sometimes, older adults, it can even be much worse. Just as they seem to be improving, they develop a type of kidney failure called hemolytic uremic syndrome (HUS). HUS can be fatal.

We tend to associate E. coli O157:H7 with meat, particularly consumption of undercooked hamburgers. True, it turns up there fairly regularly, including in the past few months. But vegans - don't think you are safe. It can be on your fruit and vegetables too. And, for those who eat dairy - it can be right in the cheese.
That is where it has been turning up in the past ten days. On November 4, the FDA informed us that E. coli O157:H7 had been found in Bravo Farms Dutch Style Gouda cheese. Ugh - offered at in-store tastings by Costco in Arizona, California, Colorado, New Mexico and Nevada and sold in Costco stores. ("Would you like a little taste of deadly bacteria?") People in the Southwest are getting very sick...although no one has died yet.

Then today I found another cheese recall, this time for Mauri Gorgonzola cheese with sell-by dates of 01/31/11 and 01/14/11. It has also tested positive for E. coli O157:H7. And, again Costco is selling it. DPI Specialty Foods of Tualatin, Ore., cut, packaged and distributed the cheese to Costco stores in Colorado. According to the FDA, the strain of E. coli O157:H7 in this cheese is different from the one in the earlier alert. So what is happening? Who knows. Once the investigation is completed - and this could take weeks, or even months - we may be told the cause. But - and this is an update(11/15) further investigation shows Costco is blameless. It wasn't one of their workers, contaminating it while cutting it up. The cheese came from DPI Specialty Foods already carrying the E.coli (proven through its presence in an unopened package).

In the meantime, I continue to suggest a preventive approach. If you would just as soon not spend the next week or more in misery, don't buy or eat any kind of cheese distributed by DPI Specialty Foods or bought at Costco, until we find out more (contaminated equipment? sick workers with poor sanitation? ). It could well be that other cheese products will be implicated as well. If you want to be even safer, cut out all cheese for a while, as the problem or problems may turn out to be earlier in the food chain - and, could be an ingredient problem.

TSF

POISON PEPPER

It is always nice to be proven right, although I know I should really not be pleased since people are becoming seriously ill all over America. But I did predict that the next big outbreak would be caused by Salmonella bacteria. And I did warn that spices are much more deadly than those innocent little pinches of taste suggest.

It is a long story, but basically what has been going on for the last few weeks is an outbreak of Salmonella montevideo bacteria in black and/or red pepper. Yes, Salmonella has proven itself quite able to live for months in dry environments, such as spices. And of course, it may soon move to a much pleasanter home when such spices are used as ingredient in many processed and ready-to-eat foods - or, in our homes.

In this case it started with people becoming ill from eating a variety of ready-to-eat Italian-style meats distributed by Daniele International Inc.in Rhode Island(see earlier post). A trace-back of ingredients by the FDA eventually pinpointed pepper as the suspect ingredient, and the likely source as two companies - Overseas Spice Company, Dayton, N.J.; and Wholesome Spice Company, Brooklyn, N.Y. (some irony in the 'wholesome' name, right?). Both of these companies had supplied pepper to Daniele International. Of course, both also sold to other commercial companies as well, who incorporated them into their own products, or packaged and sold them under other labels.

As a result we now have a spreading outbreak and multiplying number of food product recalls - not just spicy sausage, but also recalls of black and red pepper - whole black pepper, crushed red pepper, and ground red pepper and of dips mixes and a variety of seasonings- too many to list. Two of the distributor are Dutch Valley Food Distributors, Inc. and Frontier Natural Products Co-Op. Frontier not only sold under the Frontier brand but also under the Whole Foods Market brands (poor Whole Foods - here's another recall for you). This is just the tip of the iceberg, or the beginning of the landslide.

In the meantime, illnesses caused by such Salmonella contaminated pepper have occurred in 44 states. So far there have been at least 249 confirmed cases, with many more winding their way through the reporting system, and more still to come.

The FDA is continuing its investigation of the original source of these pepper products. It isn't saying at the moment. My guess would be China, where a lot of such spices come from these days. I'll see what I can find out.

Bon appetit (but take it easy on the peppers and spicy sausages and hope your retailer is keeping up with the recalls).

TSF

ANOTHER BAD NUT

I suppose it was simply a matter of time before we had another nut-related outbreak.

Remember the peanut-linked one last year that seemed to go on for ever, then followed by a smaller one associated with pistachios? Well, the holiday season brought with it an outbreak in hazelnuts. True, hazelnuts are nowhere near as popular in the US as they are in Europe, but a lot of us do tend to eat them at least this time of the year. Otherwise, we just love them in chocolates and certain other baked goods.

Anyway, another outbreak of salmonella contamination in nuts was not what we wanted. The first recalls came out about mid December. It was only associated with hazelnuts that had been shelled (not those in shells), both organic and non-organic, and seems to have started at a large company that shells the nuts and then supplies other companies and retailers. My guess - another case of contaminated equipment.

And don't think this was just some small incident. In the end some of the higher-end retailers such as Whole Foods, and Harry and David, as well as several others, had to conduct product recalls at their busiest and most lucrative time of year.

Which reminds me, I ordered several Harry and David products to be sent to people such as my doctor and her staff. I hope they didn't contain hazelnuts. I had better check the FDA -Harry and David product recall list. How does one notify one's doctor that you may have sent her contaminated goodies as a thank you gift?

Bon appetit!

TSF

SWINE FLU IN FOOD

Well, it happened before I got down to writing on it. 'Swine Flu,' which is really not really the pure porcine variety, but a 'novel' type of Influenza A (H1N1) has been declared a pandemic by the World Health Organization. Americans are anticipating a huge immunization campaign in late September and traders are happily buying shares of all the companies promising to have masses of the vaccine ready by then. At least 3 companies are at the field trial stage with their vaccines. Meanwhile, there are some great scam vaccines being sold over the Internet.

Many schools are still shut down, people are nervous, and the number of illnesses keeps growing. From April 15, 2009 to July 24, 2009, a total of 43,771 confirmed and probable cases of infection were reported in 53 states, DC and Puerto Rico. Of these cases reported, 5,011 people were hospitalized and 302 people died. On July 24, 2009, the CDC gave up counting. According to one model it developed, which takes underreporting, lack of testing and other such factors into account, there have most likely been around a million cases of this flu in the U.S. between April and June.

I was one of them. No, it wasn't much fun. But frankly, not that bad either. I've had worse. And while it is reputed to be very contagious, my husband did not get it. Nor did my friends.

To the main issue: the question in many peoples’ minds has been whether one could get this unpleasant flu from eating pork or pork products. The answer is 'NO' - well, at least, not from pork.

The markets certainly have seemed to think so. Because there had been a number of cases of ‘swine flu’ in the U.S., and more were expected, U.S. hog prices and even the value of shares in meat companies fell as a result. Several countries banned U.S. pork and there was fear that more would join in.

The FDA ,the CDC and other government and private organizations with vested interests, have busily telling consumers - and reassuring our trading partners - that our pork is perfectly safe to eat. This flu virus is spread person-to-person like any other ‘flu virus, usually when an infected person sneezes or coughs or when the virus lands on a surface that you then touch and later touch your food, bite your fingernails or suck your thumb. Naturally, we don’t normally go around licking door knobs or stairway banisters, and hopefully, not sucking our thumb too often either. Although, certainly, this is a very 'fingernail-biting' time in our economy and many of us are taking up the habit every time we check our bank account or credit card statement.

But what about restaurants? The same situation applies, but of course, if a restaurant worker sneezes on your fresh tomato or lettuce – or, your fork - and you then put it in your mouth ….well…..Although the FDA and CDC are not admitting it, it is quite possible for people to catch swine flu from their food – but maybe from their salad instead of the pork chop.

Bon appetit!

TSF