Food-borne infections endanger long-term health, especially for kids

Fair warning: Put down that salad or medium-rare cheeseburger you're eating, pitch the brie cheese you enjoy with a glass of wine, and clear the chicken and leafy greens from the plate in front of Junior. Because you're not going to want eat or serve any of them after you read what a pair of reports released Thursday by the Center for Foodborne Illness Research & Prevention, have to say:

Long after the painful stomach cramps and bloody diarrhea of a brush with tainted food is over, many of us suffer long-term health effects, mostly unrecognized, that are the result of food-borne pathogens. These lingering effects can be very bad -- as bad as premature death, paralysis, kidney failure and a lifetime of seizures or mental disability. Many researchers believe these persistent health consequences cause more disability, lost productivity, doctor-office visits and hospitalizations than the acute illnesses that follow exposure to a food-borne toxin.

And while high-profile cases of food-borne illness have been caught, publicized and probably brought to an early end in recent years (think spinach, alfalfa sprouts, ground beef, peanut butter and tomatoes), the incidence of poisoning by tainted food is probably vastly understated.

As if all that isn't bad enough, food-borne pathogens cut their widest swath of destruction among the youngest of us. Children under 4 are disproportionately the victims of poisoning by the food-borne pathogens Campylobacter, E coli O157:H7, Listeria monocytogenes and Salmonella. And roughly half of all reported cases of food-borne illness affect kids younger than 15. Because younger kids are smaller, it takes a smaller dose of harmful bacteria to sicken them, and their less-experienced immune systems don't combat food-borne pathogens as effectively as do those of adults. They're more vulnerable, too, because their stomachs don't produce the volume of acids that adult digestive systems do.

In addition to urging public health officials, physicians and researchers to do a better job of understanding and stopping outbreaks of food poisoning, the American Academy of Pediatrics, in a campaign called Make our Food Safe for the Holidays, urges the following steps for consumers:

• Cook meat thoroughly.
• Clean work surfaces, cutting boards and bowls thoroughly after using them on uncooked meats or eggs to prevent contamination of other foods.
• Wash produce before consuming it.
• When buying milk and juice, make sure they're pasteurized, and make sure that products made from milk are made with pasteurized milk.
• Report any food-borne illness to a local health department.

The Food & Drug Administration and the U.S. Department of Agriculture, which have shared responsibility for preventing, detecting, tracking and responding to food-borne illness, are exploring ways to improve their performance in tracking the sources of outbreaks. Meanwhile, here's a list of the chief culprits, the foods in which they're most commonly found and some of the possible long-term consequences of infection, all from the Center for Foodborne Illness Research & Prevention report:

Salmonella. The leading cause of food-borne illness in the United States, salmonella is harbored by foods with animal origins, including beef, poultry, milk and eggs. It causes 16,000 illnesses and 556 deaths per year. It can cause reactive arthritis -- painful and swollen joints mainly in the lower limbs -- from which patients generally recover in two to six months. Eye irritation and painful urination can also be long-term effects.

Campylobacter: Food-borne sources are raw and undercooked poultry, unpasteurized milk and contaminated water. It causes an estimated 2 million acute human illnesses (the vast majority in children under 4) and 124 deaths yearly. Long-term effects can include Guillain-Barre Syndrome, an acquired and sometimes permanent paralysis, reactive arthritis (like Guillain-Barre, an autoimmune reaction) and chronic arthritis.

E. Coli O157:H7: Disproportionately affecting children under 19, E. Coli can taint ground beef and other meats, green leafy vegetables, unpasteurized (or raw) milk and cheeses made from such milk. About 15% of children infected with E. coli O157:H7 develop hemolytic uremic syndrome, which can lead to kidney failure, chronic kidney problems, diabetes, high blood pressure, gallstones, irritable bowel syndrome, narrowed gastro-intestinal passages and neurological problems -- including seizures -- that can take as long four years to resolve.

Listeria monocytogenes: An estimated 2,500 in the U.S. are infected with Listeria each year, and roughly 500 of them die. Listeria monocytogenes taints vegetables grown in contaminated soil or fertilizer, contaminated meat or poultry products. Cold cuts, hot dogs, smoked seafood, raw milk and soft cheeses made from such milk are common sources. In pregnant women -- roughly one-third of those victims --  listeriosis can cause miscarriage, premature death or stillbirth. Surviving fetuses may have mental retardation, hearing loss or brain damage. Adults infected with listeriosis can suffer neurological effects, including seizures and impaired consciousness. About a third experience cardiorespiratory failure.

--Melissa Healy

Baby food and the potential for botulism poisoning, there and elsewhere

Any recall of baby food is worrisome, but toss in a reference to botulism -- as does the most recent recall notice -- and the worry can become alarm. But hold off. This action is quite limited in scope, affecting only one batch of one product, Plum Organics' 4.22-ounce apple and carrot portable pouch baby food.

The product has a best-by date of May 21, 2010, and a  UPC code of 890180001221. It was sold at Toys-R-Us and Babies-R-Us stores, and no illnesses have been reported 

Here's the recall notice, dated Monday, from Plum Organics.

It begins: "I wanted to let you know that, today, Plum Organics voluntarily recalled a small portion of our Apple & Carrot Baby Food in Portable Pouches after a routine test determined the formulation was incorrect. Plum Organics immediately investigated the matter and confirmed that a mixing error was to blame which resulted in an improper blend of carrots and apples."

That sounds benign enough, but keep going and you'll find this:

"The recall was undertaken as a precaution due to the risk of potential contamination with Clostridium botulinum, which can cause botulism, a serious and sometimes life-threatening condition."

Here's more on botulism and the organism that causes it, from the Food and Drug Administration.

Two key points:

"Onset of symptoms in foodborne botulism is usually 18 to 36 hours after ingestion of the food containing the toxin, although cases have varied from 4 hours to 8 days. Early signs of intoxication consist of marked lassitude, weakness and vertigo, usually followed by double vision and progressive difficulty in speaking and swallowing. Difficulty in breathing, weakness of other muscles, abdominal distention, and constipation may also be common symptoms."

And: "The incidence of the disease is low, but the mortality rate is high if not treated immediately and properly."

Here's some additional information from the federal Centers for Disease Control and Prevention, discussing common sources of botulism poisoning.

Home preparation is often the culprit. The CDC notes: "Foodborne botulism has often been from home-canned foods with low acid content, such as asparagus, green beans, beets and corn. However, outbreaks of botulism from more unusual sources such as chopped garlic in oil, chile peppers, tomatoes, carrot juice, improperly handled baked potatoes wrapped in aluminum foil, and home-canned or fermented fish. Persons who do home canning should follow strict hygienic procedures to reduce contamination of foods. Oils infused with garlic or herbs should be refrigerated."

-- Tami Dennis

Aquarium looks to the future of the oceans -- and seafood consumers

The nutrition experts say eat more fish. But then marine scientists say the oceans are being depleted and many species are increasingly threatened. What's a healthful eater who cares about the planet to do?

One answer is to eat from the Monterey Bay Aquarium's "Super Green" list of seafood that's good for people and the planet. It's part of the aquarium's "State of Seafood" report issued today. The report says that prospects for the oceans are improving with a growing consensus of how to manage wild and farm fishing.

The report sets out significant problems that remain for the oceans, and the primary factor in the oceans' decline is the human demand for seafood, the report says. Industrial-scale fishing has threatened commercial fisheries and threatened populations of animals including whales, tunas and sharks, it says. It notes that "bycatch," the unintentional capture of animals in fishing gear, is the single greatest threat for nearly 250 species of ocean animals.

"Ocean life is still in decline and we clearly need to take urgent action to turn things around," says Julie Packard, executive director of the aquarium. "The good news is that we know what it will take and that key players are working more closely than ever to solve the problems."

The report notes some positive developments: a consensus set of principles for restoring ecosystems and commercial fish populations; commitments from major seafood buyers to sustainable sources; and improved government policies to manage fisheries and fish farming. And, the report says, there is a growing public awareness of the need to take action.

The report says that the world seafood supply was 110 million tons in 2006 -- eight times what it was in 1950, with Asia accounting for more than half the global catch. And in the next year, people will eat more farmed seafood than wild for the first time.

Farmed fish, the report says, can help fight hunger, but aquaculture also can cause pollution and disease among other problems. It cited some success stories, including arctic char, eaten as an alternative to salmon and raised on land in tank systems that don't harm the oceans.

While the health benefits of seafood have been well documented, seafood also contains risky toxins such as mercury. The aquarium's report says no accepted methodology exists for quantifying the risks and benefits of eating seafood with high contaminant levels, though U.S. authorities have recommended that children, pregnant women and others avoid certain fish, including shark and swordfish.

The "Super Green" list was developed in conjunction with the Harvard School of Public Health and the Environmental Defense Fund.

This year is the 25th anniversary of the aquarium and the 10th anniversary of its Seafood Watch program, which advised people on what fish to buy and to avoid for their health and that of the oceans. The aquarium says it has distributed 32 million Seafood Watch pocket brochures.

-- Mary MacVean

Aquaculture photo courtesy of Monterey Bay Aquarium

Check the expiration date on foods

A study of Los Angeles food markets has found high numbers of products with expired freshness dates. The study was conducted primarily in markets in low-income neighborhoods in Los Angeles, but it's possible the sale of expired foods is a problem elsewhere, said author of the study LaVonna Lewis, a professor of Policy, Planning and Development at USC.

The study, which began in April 2008, and ended in February, enlisted 90 members of the community to keep checklists of what they encountered during their food shopping trips. A total of 657 checklists were submitted. The surveyed stores were primarily in the South Los Angeles area, but some checklists were submitted on stores in other communities. The stores included small markets and large supermarket chain stores.

The shoppers found at least one expired poultry, beef of dairy product in about one-third of the stores visits made over the study period. In 18% of the visits, residents found at least three expired poultry, beef or dairy items.

In an analysis of five stores that were heavily surveyed, the rates of expired poultry ranged from 19.2% to 39.5%. The range for expired beef was 20% to 41.8% and for dairy products, 26% to 45.4%.

The shoppers, however, found sufficient access to special diet foods, such as low-salt, low-sugar and lactose-free foods.

The study was sponsored by the Community Health Councils Inc., a project that addresses healthcare inadequacies in communities in a partnership with USC. Lewis presented the data last month at the 2009 California Reach Us Conference and is preparing her findings for publication in a scientific journal.

Future studies will try to determine if expired food products are found more often in low-income areas, Lewis said.

"It's a quality question," she said. "Shouldn't people have access to fresh, healthy foods no matter where they live? It's also a resource question. If you have limited resources, aren't those resources used less effectively if the food you purchase in your neighborhood is quickly out of date?"

-- Shari Roan

Photo credit: Tim Boyle  /  Getty Images

A risky-foods list probably isn't meant as a slam against vegetables

Alas, "good for you" doesn't mean "safe for you." Perhaps there's no way it could, not completely, but that doesn't stop the Center for Science in the Public Interest from trying to make the terms more similar...

Using data from the Centers for Disease Control and Prevention, the nutrition and health advocacy organization has released a report on what it calls the riskiest foods regulated by the Food and Drug Administration.

The top 10 foods, with the number of outbreaks and reported cases of illness (there were likely more, the organization says), between 1990 and 2006:

• Leafy greens, 363 outbreaks, 13,568 illnesses
• Eggs, 352 outbreaks, 11,163 illnesses
• Tuna, 268 outbreaks, 2,341 illnesses
• Oysters, 132 outbreaks, 3,409 illnesses
• Potatoes, 108 outbreaks, 3,659 illnesses
• Cheese, 83 outbreaks, 2,761 illnesses
• Ice cream, 74 outbreaks, 2,594 illnesses
• Tomatoes, 31 outbreaks, 3,292 illnesses
• Sprouts, 31 outbreaks, 2,022 illnesses
• Berries, 25 outbreaks, 3,397 illnesses
These 10 foods, the organization says, have been responsible for 40% of all food-borne outbreaks in that time frame -- for a total of 50,000 cases of reported illnesses.

Here's the full report. And its larger point, as stated in the group's press release: "The presence of so many healthy foods on such a list is exactly why the United States Senate should follow the House and pass legislation that reforms our fossilized food safety laws." 
 
And here are some tips on food safety as it relates to produce, courtesy the Chicago Tribune. As the tips deal only with produce, there's nothing about ice cream. Washing produce thoroughly, however, is likely to make it both good and safe for you.

-- Tami Dennis

Photo: The presence of leafy greens at the top of this list is personally painful.

Credit: Associated Press

 

'Do not consume raw cookie dough'? Please.

Two months after reports of E. coli contamination prompted its removal from supermarket shelves, Nestle Toll House refrigerated cookie dough is returning to a store near you. 
 
Here's the PR Newswire release.

It states: "To make it easy for both retail partners and consumers to identify the new batch of cookie dough, a blue "New Batch" label will appear on all new production cookie dough items. NESTLE TOLL HOUSE shipping cases also are marked in blue (rather than the previous black) to denote new production and will contain the statement: "Do not consume raw cookie dough." The adoption of this distinct labeling is the result of helpful discussions between Food and Drug Administration officials and Nestle, following reports of E. coli O157:H7 illnesses that appeared to be related to the consumption of raw cookie dough."

If you're not distracted by the delightfully tongue-in-cheek (as I read it) word "helpful," you might well wonder about the point of buying cookie dough if you can't eat it raw.  

-- Tami Dennis

Photo: Sure, cookie dough is just fine baked. But to appreciate the nuances of the ingredients, one must also sample the raw version.

Credit: File

Making sense of food safety legislation

If anything positive can be found in the recent salmonella outbreak in peanuts that caused at least nine deaths and prompted the recall of hundreds of foods, it’s that Congress appears poised to strengthen our food safety laws.

A bill that passed the House last month would give the U.S. Food and Drug Administration more authority to inspect food manufacturing plants and to authorize recalls when needed. It would also revamp the system to focus more on preventing outbreaks instead of tracing them after they occur. The Senate is considering a similar bill.

Of always, the devil is in the details. If you find yourself lacking the time it would take to read the bills yourself, check out this analysis by Marion Nestle, a professor of nutrition, food studies and public health at New York University and author of “Safe Food: Bacteria, Biotechnology, and Bioterrorism.” In large part, she writes on the Atlantic’s Nutrition blog, the House bill is modeled on a preventive approach called Hazard Analysis and Critical Control Points, or HACCP. This, she says, is a sensible way to go.

Bill Marler, a Seattle attorney who specializes in food safety cases, offers a more in-depth analysis on his blog. He ends with four suggestions to make the reform even more comprehensive. For instance, he advocates a system in which all food producers “play by the same food safety rules,” regardless of their size or whether they sell to manufacturers or directly to consumers.

He also views food safety as one step toward revamping our agricultural system so that larger issues of environmental sustainability, energy use and biodiversity are taken into account. “We need a food policy that helps create healthy humans,” he writes.

-- Karen Kaplan

Photo: Are these peanuts safe? Credit: Mark Boster/Los Angeles Times

Food dyes: an update

Ever since a study in England reported that a mix of six food colorings and one food preservative made kids hyperactive, the "Southampton Six" -- as these substances are rather sinisterly termed -- are being slowly, voluntarily phased out of use in the UK.

Not every manufacturer is playing the game over there, however -- tsk! According to an article at foodnavigator.com, a purveyor of a kind of seaside candy known as "rock" has just been caught with higher-than-even-legal levels of one of the six, Ponceau 4R, and fined 180 pounds sterling (about $295), plus 212 pounds sterling (about $348) in costs.

(In case you don't know what rock is, it's tubular candy that has a gaudy external color and the name of the seaside town it's bought at running all the way through it. Brighton Rock, by novelist Graham Greene, is named for candy rock, not geological rock.)

But the rock infraction is small-fry stuff. Other, larger food manufacturers -- Mars and Cadbury, for example -- have been criticized for being behind on their pledge to remove the colorants. As of March, sunset yellow (E110) was still showing up in Cadbury's creme eggs, for example. (You know: the dye that makes that delicious yolk center so ... intensely yellow.)

In the European Union, any products containing these six colorants will have to be labeled as of mid-2010.

The colorants are:
E102 Tartrazine
E104 Quinoline Yellow
E110 Sunset Yellow
E122 Carmoisine
E124 Ponceau 4R
E129 Allura Red

You can read about the issue in a 2008 Health section article by Melinda Fulmer. There's no planned phase-out in the U.S. Critics of the voluntary phase-out in Europe argue that food companies will drag their feet if they aren't forced to remove these items from foods. In New York City, trans fat content didn't change at restaurants until the phase-out was made mandatory.

Fulmer's article quotes Pete Maletto, a New Jersey-based food industry consultant and food scientist:

"Some U.S. companies, he says, have experimented with replacing artificial colors in certain products, but ultimately changed their minds when they knew they would have to charge more."It is more expensive. You have to use more [natural pigment]so it costs a little more," Maletto says. "But if you say 'no artificial colors' on the box, you could charge a customer 10 cents more and they would pay it," he adds.

Maletto and other scientists say the majority of food makers won't act unless the FDA moves to ban the colors, or they are required to put a warning label on the package."It will be the same as what's happened with trans fats," Maletto said. "Only then will they do it."

-- Rosie Mestel

Photo credit: Robert Lachman / Los Angeles Times

As for E. coli in cookie dough, that's still a puzzler

The strain of bacterium found recently at a Nestle's plant in Virginia is not actually the same as the strain blamed for an outbreak of illnesses in 30 states.

The FDA made the announcement today, and production at the plant is reportedly ramping back up. Here's a new AP story and a slightly fuller one from ABC News, the second of which brings a third strain of E. coli into the picture.

And perhaps more relevant considering the scarcity of facts, the list of recalled products, the Food and Drug Administration's basic page on the topic, plus one from the federal Centers for Disease Control and Prevention.

But if you're wondering how the investigators ended up pointing the finger at cookie dough in the first place, here's an informative blog post from a CDC officer investigating this outbreak. She writes: "There are no short cuts. We talk to the patients, we look at the combined information, and we generate hypotheses about the cause. Then we can refine our questions and go back to the patients again to see which hypothesis holds true." 

And, as a bonus, here's Michael Jacobson, executive director of the nutrition watchdog Center for Science in the Public Interest, expressing outrage over Nestle's alleged recalcitrance in cooperating with the FDA during inspections at the plant in question.

And in other food safety news this week: "Administration moves to bolster food safety net."

None of which explains the source of the E. coli blamed in the outbreak.

-- Tami Dennis

Photo: Some people actually eat cookie dough without cooking it first.

Credit: Justin Sullivan / Getty Images

Dry milk might keep for a while, but so might salmonella

The recalls are dwarfed by those recent, and now almost infamous, ones prompted by the Peanut Corp. of America. But they're starting to add up. Plainview Milk Products Cooperative of Plainview, Minn., has started another recall with ripple effects, this one of nonfat dried milk, whey protein and thickening agents sold over the last two years.

The reason? Possible salmonella contamination.

No illnesses have been linked to any of the products, which aren't sold directly to consumers but to companies with which the cooperative does business.

But because dry milk lasts a while, one of its main selling points after all, some could conceivably be in your cabinet.

Here's the news release from the company and the announcement on the FDA's website.

Bought any Turkey Gravy Mix from Gold Medal?

Popcorn Seasoning Movie Theater Butter Flavored from Kroger?

Hearty Traditions Maple & Brown Sugar Instant Oatmeal from Malt-O-Meal?

International Drinking Cocoa, Madagascar Vanilla, from Land O Lakes?
 
Nonfat dry milk products sold by Meijer and Giant, among others?

Or one of many products offered by Max Muscle Sports Nutrition?

It might be on the list. Even if not, you might want to check back. The number of products seems to be growing -- as such lists do.

-- Tami Dennis