A LEADING CAUSE OF FOOD POISONING IN OLDER ADULTS

If you have read The Safe Food Handbook (my book, not this blog) you will probably guess that one of my favorite agents of food poisoning is the tiny bacterium Listeria monocytogenes. It is believed to be the third leading cause of death from food poisoning in the United States.

Listeria turns up on a regular basis in our processed foods and in restaurant meals. Recently, it was suspected in Ruth's Pimento Spread, which is distributed in Virginia, Tennessee, North Carolina, South Carolina and Georgia.

This blog has often highlighted how dangerous the Listeria bacterium is for pregnant women, that is, for their unborn child (causing miscarriages and stillbirths). But today I want to touch on how dangerous it is for older adults and anyone else with a weakened immune system (such as those receiving cancer therapy).

As the Centers for Disease Control and Prevention (CDC) states, more than half of all Listeria infections occur in people age 65 and older. Why? The CDC points to the fact that as we age our immune system and organs aren’t as good at recognizing and ridding our body of harmful germs as they used to be. Chronic conditions such as diabetes and cancer also tend to occur more in people who are older and also weaken the immune system. Add to this the fact that as we age, our whole body, including our digestive system, tends to become more sluggish and ineffective, allowing pathogens such as Listeria monocytogenes to multiply and cause us more harm.

I suspect it also had something to do with the fact that older people who still live independently tend to eat more processed "easy" foods such as Ruth's Pimento Spread, which is a typical place for this nasty bacterium to hide.



TSF

MORE NOROVIRUS ILLNESSES ON CRUISE SHIPS

Well, we are off to a good start for cases of diarrhea, vomiting and stomach cramps on board cruise ships this year - and, it's only the beginning of February. In fact, there is a very good chance that we will easily pass the 2011 total number of illnesses (1971 reported cases).

By the last count I could find, we now have four cruise ships docking in the U.S. during the last few days with outbreaks of Norovirus on board: the two Princess Cruise Ships (Crown Princess and Ruby Princess) with a combined total of some 500 illnesses reported, a Carnival Corp. ship with about 100 reported so far, and an outbreak on Royal Caribbean Cruises “Voyager of the Seas” with maybe 200 illnesses on board (the numbers in this last case are still vague).

But let me tell you something else: the actual numbers are bound to be much larger. How much, I don't know. I would guess at least double or triple. Maybe even 10 times the above. After all, studies done on Norovirus have found that only about 10% of people affected by this virus seek medical care. And if they just decide to tough it out, and not see a doctor, they don't get counted.

Some passengers on a cruise ship don't go to see the medical staff because they discover that they have to pay extra for the consultation, or have to wait for a long time, when they are feeling awful and would rather be flat in bed (and, close to a bathroom). Others only become ill when they leave the ship (the incubation period for onset of symptoms can be as long as 72 hours), so they are unlikely to be included in the numbers reported to the CDC.

Of course, now with cruise travel reservations down, and less crowding on board, maybe even safer food, the incidence of Norovirus may start to decrease.....

To your good health,
TSF

WHY ARE CRUISE SHIPS RISKY PLACES TO EAT?

Alright, I still haven't really explained in recent blogs why cruise ships are among the riskiest places to eat. Mea culpa. So here goes.

Not every food borne illness originates on board a cruise ship. Some of the foods purchased for the cruise already carry contaminants (as was believed to be the case with contaminated shrimp served at the embarkation buffet on board one recent cruise). But the studies I have looked at suggest that most get into the food on board the vessel. Often people - crew or passengers - are involved in the spread of illness.

Here are some reasons:

• The mass preparation of food which is usually more prone to contamination ( whether done for catered events, nursing homes, schools, restaurants, conferences or cruise ships).

• The confined area and non-stop socializing among passengers, leading to close contact between people. This means that a crew member handling food can contaminate it, with several passengers (and maybe crew) becoming ill, and then these sick people will pass it on to others (as often happens in the case of Norovirus-caused illness), or, even contaminate more food (if crew members are involved, as they usually seem to be).

• The popularity of buffet service (often with passengers serving themselves): buffets are known to be especially risky type of food for a number of reasons (see future blog).

Investigation of on-board outbreaks has sometimes traced them back to just one ill crew member, which, by the end of the cruise, resulted in over a hundred, or several hundred, illnesses. The original carrier of an illness may also have been a passenger who came on board while ill (not wanting to miss a pre-paid cruise). He or she may then have passed it on to a crew member (cleaning up the mess) and from there to other crew members, including kitchen staff, and on to food and more passengers and crew.

Norovirus - the most common cause of gastrointestinal illness on board - is so very easy to pass on. Just a few viruses on a table surface, a fork or a lettuce leaf will do it. It is also extremely difficult to deep sanitize an infected ship if Norovirus is involved. I have looked at numerous cases in CDC records where the same ship was involved in repeated outbreaks in spite of all the efforts made.

TSF

HOW TO AVOID GETTING SICK ON A CRUISE

In the last blog, I talked about food borne illness on cruise ships. But, as one of my readers said,
"So, what's your advice?" Good point.

I am not going to advise you not to go on a cruise (much as
I personally hate them, though I love the sea, sailing, and love travelling on cargo ships). If it gives you pleasure, go ahead. But if you want to stay healthy and enjoy the trip, I suggest that you:

1) Check out the ship's outbreak record and inspection scores before you buy your ticket. The CDC's "green sheet" which is a "Summary of Sanitation Inspections of International Cruise Ships" and records from its inspection program are the best sources (available on: http://wwwn.cdc.gov/InspectionQueryTool/InspectionSearch.aspx. If there has been an outbreak on the cruise before yours, or, on several recent cruises, don't book on that ship. But two words of caution - the inspection scores are not completely up to date, and some ships score 100 or just below, and still have outbreaks - as in the case of the Royal Caribbean Ship "Radiance of the Seas" this year.

2) Try not to eat at the buffets, which are known to be the riskiest places, or, at least be in line first, which could reduce some of your food contamination risk.

3) Don't eat any on-shore catered food (It has been found to account for about the third of the foodborne illnesses on cruises - or, maybe just gets blamed). Buy your own - carefully - instead.

4)Try to avoid the shrimp and other seafood served on board, which often seems to be the source of illness.

5)Be on your best hygiene behavior throughout the cruise, so you don't catch Norovirus from someone else who may have got it from their food - or, pass it on if you yourself have it. Surveys comparing passengers who became ill with those who did not have found that hand washing made the difference.

TSF

NUTS TO YOU

Keeping up with frightening food events in our food supply is getting quite exhausting. One of the most annoying aspects is that just as you think you can forget about one of the outbreaks, you realize it is still out there. And contaminated products might still be out there too, waiting for us, innocent consumers, to pounce on them.

Take peanuts. The PCA incident that blanketed our country (and a few others) with salmonella-contaminated peanuts and peanut products should be well over by now. The plants have been shut down. More than 2,100 products in 17 categories have been voluntarily recalled by more than 200 companies, since January, 2009 (probably more, as the FDA information is at least a week or two out of date). Hundreds of people have become ill and some have died. But guess what, it's not over.

There have been more peanut product recalls in the last few days, including one yesterday. More or less ditto for pistachios. The most recent pistachio one - just four days ago. No wonder I could not get any at Trader Joe's on Wednesday when I wanted to make my usual favorite of herb cornish hen, stuffed with raisins and pistachios (I settled for pine nuts instead).

But back to peanuts. Yesterday's recall really illustrates the oddity of our so-called food safety system. Nuts for You of Preston ID is recalling Roasted and Salted Peanuts manufactured with peanuts bought from PCA. The product was distributed between March 15, 2008 and Jan 15, 2009.The sell-by date on the plastic bag of 'Nuts for You' was Feb 18, 2009 (more than four months ago) . Presumably the nuts were purchased sometime in 2007 from PCA's Texas plant to make these cute bags of salted peanuts sold at gift stores.

So here we are on June 25, asking consumers to send back products made of antique nuts (maybe two years old) that are well and truly expired and, are very likely to have also been well and truly eaten. The really bad news is that this type of pattern is not unusual.

Nuts to you, FDA. How are we supposed to escape bad food in America?

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