Some types of E. coli cause disease by making a toxin called Shiga toxin. The bacteria that make these toxins are called “Shiga toxin-producing” E. coli or STEC for short. They are also sometimes called verocytotoxic E. coli (VTEC) or enterohemorrhagic E. coli (EHEC); however, these all generally refer to the same group of bacteria. The most commonly identified STEC in the U.S. is E. coli O157:H7. When you hear news about outbreaks of E. coli infections, they are usually talking about E. coli O157:H7.

In addition to E. coli O157:H7, many other serogroups of STEC cause disease. These other serogroups are sometimes called “non-O157 STEC”. In the United States, E. coli serogroups O26, O111, and O103 are the non-O157 serogroups that are most likely to cause illness in people. All STEC can cause hemolytic uremic syndrome (HUS), a severe blood disease that is the leading cause of acute kidney failure in children in the U.S.

Antibiotic resistant bacteria have been called one of the world’s most pressing public health problems. Almost every type of bacteria has become stronger and less responsive to antibiotic treatment. These antibiotic-resistant bacteria can quickly spread. They threaten the community with new strains of infectious disease that are more difficult to cure and more expensive to treat.

Antibiotic resistance can cause significant danger and suffering for children and adults who have common infections, once easily treatable with antibiotics. Bacteria like Salmonella and E. coli O157:H7 can develop resistance to specific medicines. A common misconception is that a person’s body becomes resistant to specific antibiotics; however, it is the bacteria, which become resistant to the drugs.

If a bacterium is resistant to many drugs, treating the subsequent infections it causes can become difficult or even impossible. Someone with an infection that is resistant to a certain medicine can easily pass that resistant infection to another person. A difficult illness can be spread from person to person. In some cases, the illness can be very serious and have terrible complications like sepsis or hemolytic uremic syndrome (HUS) which can lead to acute kidney failure or even death.

With the recent King Soopers and Beef Packers, Inc. ground beef recalls related to contamination with antibiotic resist Salmonella, the public is at a risk of being exposed to these resistant microbes. It is critical that food manufacturers take absolutely every precaution to eliminate these antibiotic resistant food pathogens from ever entering our food supply.

The Beef Packers, Inc. 400 ton Salmonella contaminated beef recall has expanded to 11 states with the number of alleged victims climbing into the high twenties. As the investigation deepens those numbers may go higher. The FSIS has a list of retailers that have acknowledged selling the potentially contaminated ground beef. The list is not yet a complete list and there probably will be further updates. For a link to the list click on the picture or click here.

Aside from the typical complications from Salmonella poisoning, such as severe dehydration and debilitating nausea and vomiting, there are rare complications that also pose a serious threat to a victim’s health and well being, such as hemolytic uremic syndrome (HUS), septicemia, Reiter’s syndrome and even death. The strain of Salmonella involved in this ground beef recall is resistant to many commonly prescribed drugs. Because of the resistant properties, this strain of Salmonella can be especially difficult to treat.

The CDC estimates that every year in the U.S. there are about 1.4 million cases of salmonellosis, an infection caused by Salmonella bacteria. 95 % of those cases are related to foodborne sources. Out of every 1000 cases of Salmonella poisoning, approximately 220 result in hospitalization and 8 result in death. In fact, 31 % of all deaths from food poisoning can be attributed to Salmonella.

As of Friday, July 31, 2009, 80 persons infected with a strain of E. coli O157:H7 with a particular DNA fingerprint have been reported from 31 states. Of these, 70 have been confirmed by an advanced DNA test as having the outbreak strain; these confirmatory test results are pending on the others. The number of ill persons identified in each state is as follows: Arizona (2), California (5), Colorado (6), Connecticut (1), Delaware (1), Georgia (2), Iowa (2), Idaho (1), Illinois (7), Kentucky (2), Massachusetts (4), Maryland (2), Maine (3), Minnesota (8), Missouri (1), Montana (1), North Carolina (2), New Hampshire (2), New Jersey (1), Nevada (2), New York (1), Ohio (3), Oklahoma (1), Oregon (1), Pennsylvania (2), South Carolina (1), Texas (3), Utah (4), Virginia (2), Washington (6), and Wisconsin (1).

Most persons became ill during May and June. Ill persons range in age from 2 to 65 years; however, 66% are less than 19 years old; 69% are female. Thirty-five persons have been hospitalized, 10 developed hemolytic uremic syndrome (HUS); none have died.

Investigation of the Outbreak

In an epidemiologic study, ill persons answered questions about foods consumed during the days before becoming ill and investigators compared their responses to those of persons of similar age and gender previously reported to State Health Departments with other illnesses. Preliminary results of this investigation indicate a strong association with eating raw prepackaged cookie dough. Most patients reported eating refrigerated prepackaged Nestle Toll House cookie dough products raw.

On June 29, 2009, the U.S. Food and Drug Administration announced that a culture of a sample of prepackaged Nestle Toll House refrigerated cookie dough currently under recall yielded E. coli O157:H7. The contaminated sample was collected at the firm on June 25, 2009. Further laboratory testing showed that the strain in the sample was not the outbreak strain.

E. coli O157:H7 has not been previously associated with eating raw cookie dough. CDC, the state health departments, and federal regulatory partners are working together in this ongoing investigation.

Clinical Features

Most people infected with E. coli O157:H7 develop diarrhea (often bloody) and abdominal cramps 2-8 days (average of 3-4 days) after swallowing the organism, but some illnesses last longer and are more severe. Infection is usually diagnosed by culture of a stool sample. Most people recover within a week, but some develop a severe infection. A type of kidney failure called hemolytic uremic syndrome (HUS) can begin as the diarrhea is improving; this can occur in people of any age but is most common in children under 5 years old and the elderly.

Advice to Consumers

The Food and Drug Administration and the Centers for Disease Control and Prevention continue to warn consumers not to eat any varieties of the recalled Nestle Toll House refrigerated cookie dough due to the risk of contamination with E. coli O157:H7. This includes Nestlé Toll House cookie dough that does not say “new batch” on the labeling.  Consumers who have the recalled prepackaged, refrigerated Nestle Toll House cookie dough products in their homes should throw it away.  Cooking the dough is not recommended because consumers might get the bacteria on their hands or on surfaces. The recall does not include Nestle Toll House morsels, which are used as an ingredient in many home-made baked goods and other baked cookie products.  The recall also does not include newly made Nestle refrigerated cookie dough products; these products can be identified by labels with shields that say “new batch” on them.

According to microbiologists, Salmonella is a distant cousin to the E. coli bacterium. About 100 million years ago Salmonella branched off from E. coli forming over 2500 different strains of Salmonella. The bacteria are so pervasive in the animal kingdom scientists say that there is no hope of fully eliminating or controlling the bacteria. 

The Centers for Disease Control and Prevention says there are 40,000 reported cases of salmonellosis, an infection of Salmonella, in the U.S. each year. That’s just the tip of the iceberg. Epidemiologists estimate that for each case reported, there are about 40 additional people who become ill but never report their illness to the medical system.

The CDC estimates that every year in the U.S. there are about 1.4 million cases of salmonellosis, an infection caused by Salmonella bacteria. 95 % of those cases are related to foodborne sources. Out of every 1000 cases of Salmonella poisoning, approximately 220 result in hospitalization and 8 result in death. In fact, 31 % of all deaths from food poisoning can be attributed to Salmonella.

I have again been invited to serve as a faculty member for LSU Law Center’s Trial Advocacy Program, which will be taking place this week in Baton Rouge.  Nearly 200 senior law students will participate in this intensive and unique, three-day program.  The law students will role play and receive critiques from some of the nation’s leading experts in courtroom practices. I am excited about the opportunity to again serve as part of this select faculty, comprised of federal and state court judges, professors and prominent attorneys. 

The program will present a rigorous schedule that challenges the students to develop trial skills and practice methods pioneered by the famed National Institute for Trial Advocacy. This is a great opportunity for students to get a taste of what to expect as trial lawyers.  They are in their final year of law school and getting close to the point where they will be employing these skills in real cases. I have been fortunate enough to be a part of this program since its inception over 15 years ago, and I’m proud to have positively impacted the careers of thousands of attorneys from across the country. Who knows, maybe some of these law students will someday join our efforts to improve the food system as food safety advocates.

Rodent-infested conditions, violations of the seafood HACCP regulation prompt action

At the request of the U.S. Food and Drug Administration, U.S. Marshals today seized tuna salad sandwiches and other food products from Bearden Sandwich Company Inc., doing business as Southern Belle Sandwich Company, in Baton Rouge, La.

The seized products, totaling more than $72,000, violate the Federal Food, Drug, and Cosmetic Act because the products have been prepared, packed, and held under unsanitary conditions whereby they may have become contaminated with filth or rendered injurious to the public’s health (the Act uses the term “insanitary” to describe such conditions). In addition, the tuna fish salad sandwiches were processed under conditions that violate Seafood Hazard Analysis Critical Control Point (HACCP) regulations.

“When FDA investigators find violations inside a company’s facility, we will do what is necessary to keep insanitary and potentially harmful products out of consumers’ hands,” said Michael Chappell, the FDA’s acting associate commissioner for regulatory affairs. “Companies that are not complying with our laws will be subject to enforcement actions.”

Recent FDA inspections found evidence of widespread and active rodent and insect infestation, filthy conditions, and poor employee practices, such as allowing food-processing utensils to lie on the floor near live insects.

The company distributes products to convenience and retail stores in southern Louisiana; Mobile, Ala.; Montgomery, Ala.; and Crestview, Fla.

The FDA has not received reports of foodborne illnesses associated with consumption of the products. The FDA urges consumers who may have purchased the products to dispose of them in a safe manner and wash their hands thoroughly after handling the products. “Safe disposal” means avoiding bare-hand contact with the recalled products, discarding them in a way that will not allow people and pets to retrieve them, and washing items that came in contact with the products, including hands, with warm, soapy water.

John Dingell, a U.S. representative for Michigan, was one of the big proponents of the recently passed HR 2749 food safety bill.  When the bill failed to get the votes required to fast track it through the House, Rep. Dingell made a powerful speech to help to inform and organize the other members of congress about this important and necessary legislation. Holding nothing back in his speech Dingell stated, “Americans are dying because the Food and Drug Administration does not have authority to protect them and American producers and agriculture are being hurt. This [HR2749] will fundamentally change the way in which we ensure the safety of our food supply.” His impassioned plea worked as the House passed the bill one day after failing to fast track. For his hard work and effort to protect Americans from foodborne illnesses like Salmonella and E. coli and their respective complications like hemolytic uremic syndrome (HUS) and death, NBA Food Advocate salutes Rep. John Dingell as a “Food Safety Warrior”.

Adams Extract and Spice, LLC. is announcing a voluntary recall of products because they have the potential to be contaminated with Salmonella.  The products contain a specific lot of ground red pepper supplied by Van de Vries Spice Corporation, 9 Elkins Road, East Brunswick, New Jersey 08816.  This lot of ground red pepper initially tested negative for Salmonella.  Subsequently, Adams Extract and Spice, LLC. has been informed that another sample drawn from the same lot has been confirmed positive for Salmonella. 

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

The following lots of specific products were distributed in Texas, Louisiana, and New Mexico through retail stores, mail order, internet sales and direct delivery.

The items listed below are in clear plastic (PET) bottles with yellow caps:

Adams Cayenne Pepper 2.61 oz Best by date 060311-060711, 062711-070111, 071811-072211, 080111-080511

Adams Brisket Rub 13.47 oz Best by date 062111-062511, 062711-070711

Adams Brisket Rub 8.5lbs Best by date 062811-070211

Adams Multi-Season Seasoned Salt 14.46 oz Best by date 070511-070911

Adams Multi-Seasoning 30 oz Best by date 071111-071511

REX Cayenne Pepper Ground 6.98 oz Best by Date 072111-072511, 071111-071511

REX Cayenne Pepper 16 oz Best by Date 071111-071511

The item listed below is in French square glass bottles with silver-tone caps:

Adams Reserve Cajun Seasoning 4.93 oz Best by date 061011-061711, 071311-071711

The items listed below are in translucent polypropylene jars with translucent caps:

Carniceria Texas Red All Purpose Seasoning Adams 14.25oz Best by date 061711-062111

Carniceria B-B-Q Seasoning Adams 15.07oz Best by date 061611-062011

The item listed below is in red trimmed “cello” packages:

REX Crab Boil Ready Mix 64 oz

The item listed below is in green trimmed “cello” packages:

REX Fish Fry 10 oz

No illnesses have been reported to date.

Consumers who have purchased these products are urged to return them to the place of purchase.