Salmonella Blog - Surveillance & analysis on salmonella news & outbreaks

Regulators said consumers should avoid eating "Ziyad" brand plain tahini after routine testing by the Minnesota Department of Agriculture found the sesame seed paste tainted with potentially dangerous salmonella bacteria.

The Associated Press reports that the USDA had issued the warning for the Middle Eastern food found in specialty stores and some major grocery store chains.

The product is sold in glass jars and labeled "Tahini" in green letters on a yellow background. The product was distributed by Ziyad Brothers Importing of Cicero, Illinois.

Agriculture officials said no illnesses have been reported in connection with the tahini, but the Minnesota Health Department is monitoring the situation.
 

Salmonella is one of the most common enteric (intestinal) infections in the U.S. In some states (e.g. Georgia, Maryland) it is the most common, and overall it is the second most common foodborne illness (usually slightly less frequent than a Campylobacter infection). The reported incidence of Salmonella illnesses are about 17 cases per each 100,000 persons.1

Salmonella is a type of bacteria that causes typhoid fever and many other infections of intestinal origin. Typhoid fever, rare in the U.S., is caused by a particular strain designated Salmonella typhi. But illness due to other Salmonella strains, called "salmonellosis," is common in the U.S. Today, the number of known strains (technically termed "serotypes" or "serovars") of this bacterium total over 2,300.

These days, eating healthy foods is a top priority for most families. "But there are some hidden dangers in some of the healthiest foods," warns Debra Holtzman, JD, MA, a nationally recognized safety and health expert. According to the CDC, about 76 million Americans will suffer from food-borne illness and at least 5,000 will die this year. Children, the elderly and the immunocompromised are at the greatest risk.

Follow Debra Holtzman's simple tips for safer eating:

1. Lettuce: Because it is grown so close to the ground, it can come into contact with manure or irrigation runoff. Holtzman recommends that when you buy lettuce that you first discard the outer leaves. Then separate the inner leaves and thoroughly wash. Holtzman warns that all raw fruits and vegetables can harbor disease-causing bacteria, She recommends before eating any raw produce, that it be thoroughly washed under running cold water. If appropriate, use a small scrub brush. This is true even for organic fruits and vegetables.

2. Water: Contaminated water can be a major source of trouble, especially for those drinking from private wells or streams. The EPA recommends that private water supplies be tested at least once a year for: nitrates, total dissolved solids and coliform bacteria, the presence of which may indicate other contamination. You may need to test more frequently and for more potential contaminants if a problem is suspected. People who are on a public water utility receive a consumer confidence report once a year that analyzes the water.

3. Raw sprouts: Alfalfa sprouts, clover sprouts and radish sprouts have all been associated with salmonella and E. coli. Cook sprouts thoroughly to kill off the bacteria.

4. Unpasteurized juices, milks or cheeses: Make sure you always purchase the pasteurized versions of your favorite products. Pasteurization kills bacteria. When you go to a juice bar, make sure the juices being served are pasteurized. Unpasteurized products have been linked to salmonella, E. coli and listeria -- all can lead to death.

5. Moldy Peanuts: Aflatoxins are by-products of common, naturally occurring mold growth on certain agricultural products such as peanuts, wheat, cereals and corn. Alfatoxins have been found to cause liver cancer in animal species. Check carefully for any sign of discoloration or mold.

6. Raw or undercooked shellfish: Shellfish, such as clams, and oysters must be cooked thoroughly. Any animal protein consumed raw or undercooked has an increased potential for causing illness.

7. Swordfish, Shark, King Mackerel and Tilefish: The Food and Drug Administration (FDA) advises children, women who are planning to become pregnant and pregnant or nursing women not to eat these fish. Swordfish, shark, king mackerel and tilefish have much higher levels of methyl mercury than other commonly consumed fish. Mercury is most harmful to the developing brains of unborn children and young children, affecting cognitive, motor and sensory functions.
8. Caesar salad: Many restaurants or home made recipes call for raw eggs in Caesar salad. Always ask if the salad is served with raw eggs in the dressing.

9. Honey: Never give honey to a baby under the age of one. Honey may contain bacterial spores that can cause infant botulism, a rare but serious disease that affects the nervous system of young babies.

10. Wild mushrooms: Some common species of mushrooms are capable of causing poisoning or even death. Only an expert with specialized training can distinguish the edible kinds from the others. Only eat mushrooms you've purchased in the grocery store or the ones you've raised at home from cultures bought from reputable sources.
 

State agriculture officials have dispatched a team of veterinarians and inspectors to test farm animals that may be linked to life- threatening cases of kidney failure among children and at least one adult who attended recent fairs in Orange and Hillsborough counties.

First stop was Ag-Venture, a Plant City-based farm show that operated petting zoos this month at the Florida Strawberry Festival and the Central Florida Fair.

All the patients with the potentially deadly syndrome had contact with livestock at the fairs.

The state Department of Health on has issued an alert along the Interstate 4 and Interstate 75 corridors, warning of the potential for children who had visited petting zoos at the fairs to develop hemolytic uremic syndrome.

The condition begins with diarrhea and can progress to kidney failure.
 

Robin Elise Weiss, LCCE, has written a comprehensive guide for foods to avoid during pregnancy:

Salmonella
This is usually traceable to eggs and chicken meat. This means no more licking the cake batter spoon! You should always ensure that your eggs and meats are cooked thoroughly. When using a cutting board for chicken be sure to wash it prior to using it for another food, particularly things like raw vegetables.

Symptoms can include: headache, abdominal pain, nausea, diarrhea, shivering or fever. Usually symptoms occur within 12-48 hours after infection and lasts about 2-3 days. Only if it is severe will treatment usually be necessary. Though if you're vomiting and become dehydrated IV therapy may be beneficial.

Listeriosis
Food most likely to be infected by listeria are unpasteurized milk products, improperly cooked meats, cooked chilled food, soft cheese are some of the major players. Normally this bacteria is killed at the pasteurizing temperature, but if the food is refrigerated after being infected the bacteria is still present. Rarely, but still possible for some, is transmission through direct contact with live stock.

General aches and pains accompanied by a fever are the main symptoms. Usually people think that they have the flu. Reports of miscarriage and stillbirths have been linked to listeriosis infections spread by the mother to the unborn baby.
 

Additional tips:

• Never eat raw meat or eggs
• Always wash your hands after preparing food, between foods, and after the restroom
• Avoid contaminating foods with each other
• Always use clean utensils and cooking equipment
• Avoid dented cans
• Eat or drink only pasteurized products, including apple juice
• Completely defrost foods, especially meats, prior to cooking
• Do not refreeze anything that has been defrosted
• Reheat food only once, then toss it
   

Yanni's, The Greek-American restaurant loved for its voluptuous pancakes and traditional Greek food, closed Sunday afternoon.

The popular pancake spot went through a troubled period in 2003, when St. Louis County Health Department inspectors closed the restaurant for a month after a salmonella outbreak. Thirty-five people became ill and seven were hospitalized, though the cause was never pinpointed.

The property that the restaurant is on was sold to make way for an expansion at the nearby Lakewalk Surgery Center. Florida resident Fred Paine owns the property. The building will be bulldozed sometime this summer.
 

Dyeing eggs has become a tradition for many families, but through the years food safety has become a big concern. Salmonella has become a buzzword related to the handling of eggs, reports Christy Walter for the Sentinel.

During this time of year, eggs are handled more than usual, and each handling provides the opportunity for bacteria to come into contact with the egg. It is important, therefore, that you always wash your hands (with soap and warm water) before handling eggs at every step. This includes cooking, cooling, dyeing and hiding. The following are some safety tips on how you can keep your family safe while having fun decorating your Easter eggs:

• When dyeing your eggs, you do not want to dye eggs that have cracked during the cooking process. You may eat them without dyeing or use them in an egg dish. Make sure that they and all other hard-boiled eggs are stored in the refrigerator and consumed within one week. If you will not be dyeing your eggs right after cooking, place them in their original carton and store them in the refrigerator until dyeing time, this will decrease the chance for any bacteria to have the opportunity to grow.
• When you are ready to dye your eggs, remove them from the refrigerator and have fun. Use food coloring or a food-grade dye to color your eggs. After dyeing, you should place the eggs into the refrigerator again until time to hide them. Consider safe hiding areas for your eggs; you want to avoid any areas where the egg might come in contact with bacteria. Once the eggs are found, if they are not to be eaten right away, they need to be put back in the refrigerator.
• You should never eat an egg that has been out of the refrigerator for more than two hours. Also, if the egg has become cracked during hiding, do not eat it. To be safe, the time it takes to hide and find the eggs should be less than two hours. As a safe alternative, you may want to choose to hide plastic eggs that contain prizes in them and save the hard-boiled eggs to eat after the egg hunt.
• If you plan to use your decorated eggs as a centerpiece or other decoration where they will be out of refrigeration for more than two hours, do not consume those eggs and discard them once you are finished.
• Many recipes for bunny-shaped cakes or other Easter treats may call for raw egg white frosting. However, anytime raw eggs are eaten, there is a risk of salmonella food poisoning. Therefore, it would be wise to find a frosting recipe that uses a hot syrup and egg white. If the egg white mixture reaches 160 degrees, if should be safe. Other alternatives include using a pasteurized powdered meringue available where cake-decorating supplies are sold.
   

County health officials said a study shows food-borne diseases have been reduced 13.1 percent because of the restaurant inspection and letter grading system imposed in 1998.

Dr. Jonathan Fielding, the county's public health director and an author of the study, said it was the first scientific proof that the grading system resulted in a "demonstrable public health benefit."

"What's really important here is we were able to show a reduction in hospitalizations due to food-borne illnesses, compared to state trends," Fielding said.
 

Salmonella is one of the most common enteric (intestinal) infections in the United States. Salmonellosis (the disease caused by Salmonella) is the second most common foodborne illness after Campylobacter infection. It is estimated that 1.4 million cases of salmonellosis occur each year in the U.S.; 95% of those cases are foodborne-related. Approximately 220 of each 1000 cases result in hospitalization and eight of every 1000 cases result in death. About 500 to 1,000 or 31% of all food-related deaths are caused by Salmonella infections each year. Salmonellosis is more common in the warmer months of the year.

Salmonella infection occurs when the bacteria are ingested, typically from food derived from infected food-animals, but it can also occur by ingesting the feces of an infected animal or person. Food sources include raw or undercooked eggs/egg products, raw milk or raw milk products, contaminated water, meat and meat products, and poultry. Raw fruits and vegetables contaminated during slicing have been implicated in several foodborne outbreaks.

Symptoms of Salmonella infection

The acute symptoms of Salmonella gastroenteritis include the sudden onset of nausea, abdominal cramping, and bloody diarrhea with mucous. Fever is almost always present. Vomiting is less common than diarrhea. Headaches, myalgias (muscle pain), and arthralgias (joint pain) are often reported as well. The onset of symptoms usually occurs within 6 to 72 hours after the ingestion of the bacteria. The infectious dose is small, probably from 15 to 20 cells.

Reiter's Syndrome, which includes and is sometimes referred to as "reactive arthritis," is an uncommon, but debilitating, result of a Salmonella infection. The symptoms of Reiter's Syndrome usually occur between one and three weeks after the infection. Reiter's Syndrome is a disorder that causes at least two of three seemingly unrelated symptoms: reactive arthritis, conjunctivitis (eye irritation), and urinary tract infection. The arthritis associated with Reiter's Syndrome typically affects the knees, ankles, and feet, causing pain and swelling. Wrists, fingers and other joints can be affected, though with less frequency. With Reiter's Syndrome, the affected person commonly develops inflammation where the tendon attaches to the bone, a condition called enthesopathy. Some people also develop heel spurs, bony growths in the heel that cause chronic or long-lasting foot pain. Arthritis from Reiter's Syndrome can also affect the joints of the back and cause spondylitis, inflammation of the vertebrae in the spinal column. The duration of reactive arthritis symptoms can vary greatly. Most of the literature suggests that the majority of affected persons recover within a year. The condition, can, however, be permanent. For more information, visit the Marler Clark sponsored Web site about Reiter's Syndrome.

Detection and treatment of Salmonella infection

Salmonella bacteria are discovered in stool cultures. Although blood cultures are rarely positive, bacteremia (bacteria in the blood stream) does occur in 5% of adults with Salmonella gastroenteritis and can result in spread to the heart (endocarditis), spleen, bone (osteomyelitis), and joints (Reiter's Syndrome or reactive arthritis). However, blood cultures are often not performed and in most cases the blood stream is not infected. In the stool, the laboratory is challenged to pick out Salmonella from many other similar bacteria that are normally present. In addition, many persons submit cultures after they have started antibiotics, which may make it even more difficult for a microbiology lab to grow Salmonella. So, the diagnosis of salmonellosis may be problematic and many mild cases are culture negative.

Salmonella infections usually resolve in five to seven days, and many times require no treatment, unless the affected person becomes severely dehydrated or the infection spreads from the intestines. Persons with severe diarrhea may require rehydration, often with intravenous fluids. Treatment with antibiotics is not usually necessary, unless the infection spreads from the intestines, or otherwise persists, in which case the infection can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Some Salmonella bacteria have become resistant to antibiotics, possibly as a result of the use of antibiotics to promote the growth of feed animals.

For those persons who develop Reiter's Syndrome, symptomatic treatment with high doses of a nonsteroidal anti-inflammatory drug and steroid injections into affected joints can be helpful in reactive arthritis. For people with severe joint inflammation, injections of corticosteroids directly into the affected joint may reduce inflammation. A small percentage of patients with reactive arthritis have severe symptoms that cannot be controlled with these treatments, in which case medicine that suppresses the immune system, such as sulfasalazine or methotrexate, may be effective. Exercise, when introduced gradually, may help improve joint function. Topical corticosteroids can be applied directly on the skin lesions associated with reactive arthritis.

Preventing Salmonella infection

To prevent salmonellosis, cook poultry, ground beef, and eggs thoroughly before eating. In order to insure that eggs do not contain viable Salmonella they must be cooked at least until the yoke is solid, and meat and poultry must reach 160?F or greater throughout. Be particularly careful with foods prepared for infants, the elderly, and those with a compromised immune system.

Do not eat or drink foods containing raw eggs, such as homemade eggnog and hollandaise sauce. Avoid drinking raw (unpasteurized) milk or products made from raw milk.

Wash hands, kitchen work surfaces, and utensils with soap and water immediately after they have been in contact with foods of animal origin. Also, wash hands with soap after handling reptiles, amphibians or birds, or after contact with pet feces. Infants and immunocompromised persons should have no direct or indirect contact with such pets.

Even though California's fresh produce industries have a good record in voluntary compliance, federal regulations for microbial food-safety are still on their way.

Trevor Suslow, a University of California, Davis postharvest specialist, said he is "trying to build awareness of coming mandatory GAPs," or good agricultural practices, for microbial food-safety in fresh-market fruits and vegetables, just like those now required for chemical or physical safety.

Many growers and shippers of fresh-market fruits and vegetables are already using GAPs as means of promoting label reputations and high standards of quality. According to officials of the GAPs Program at Cornell University, one case of E.coli contamination was blamed on improperly handled mesclun lettuce mix that caused illnesses in Illinois and Connecticut. The lettuce was grown near a cattle operation and a free-range chicken farm, a situation in violation of sound practices.

To assist in developing GAP programs in the field and in packinghouses, Suslow and other UC Davis experts, collaborating with counterparts across the nation, have compiled an array of recommendations, guides and other resources, written and on videos, in English and Spanish versions.
 

Nutritionist Helga Meyer cautions us on how easy it is to contract illnesses. She recently witnessed a cashier started sneezing and then, due to the lack of a Kleenex tissue, used the hand with which he was scanning each item, to sneeze in. All items were again handled by another person bagging the produce.

Before an item is purchased, she says, it goes through several hands, which may be in dubious stages of cleanliness. Besides the common cold, many other diseases such as influenza are transmitted by touching your nose, eyes , mouth or eating with unwashed hands. Food poisoning can also be caused by unwashed or unclean food, and food that has spoiled – and can be passed from person to person.

She recommends these “Good Habits to Cultivate”:

• Always wash your hands after using the bathroom.
• When using a public restroom and having washed your hands, always use a paper towel to open the door, where other unwashed hands have touched.
• Wash your hands before handling food to prepare, or to eat.
• Do not use the same cutting board for raw chicken and to prepare any other food , whether raw or to be cooked.
• Thoroughly disinfect the dishcloth you use to wipe the countertop after preparing chicken or raw meat. It would be safest to use disposable paper towels to do the dirty work.
• Be careful to clean out containers where you have used raw eggs, before using it for something else.
• Wash packages which you bought, before storage, where possible.
• Always wash vegetables and fruit before preparing them to use raw or cooked.
   

“The most important thing to do is what our mothers told us from the moment we could help ourselves: Wash your hands whenever necessary,” she says. “Cleanliness is the main way to keep yourself and your family healthy.”

In November, ABC Action News reports, Alessi Bakery failed several state inspection reports, racking up over 75 critical violations. That same month, dozens of customers got sick after eating food at parties catered by Alessi.

Now, the county Health Department and the state have both issued their final reports on the incidents.

The Hillsborough County Health Department investigated that incident and found 26 people came down with salmonella after eating Alessi's meat-stuffed potato. Then, the county received word of a second food-borne illness outbreak a company appreciation luncheon also catered by Alessi. Inspectors say 15 of 26 people fell ill there, and the cause was salmonella linked to Alessi's stuffed potato.

Then a third case of food poisoning was reported, this time in Pinellas County. The Health Department says it happened at a birthday party in St. Petersburg catered by Alessi. Thirteen of 36 people got sick with salmonella poisoning; again, the culprit was Alessi's mini-stuffed potato.

The bakery's owner, Phil Alessi, has fired his general manager and brought back a former Alessi manager, who was working at his bakery plant to restructure the catering business.