Saturday, October 1, 2011

HCV-Listeria Outbreaks, Tainted wipes; Its Personal


Greetings folks, another wonderful weekend is upon us, time for relaxing and spending time with family. Most weekends you can find this blogger playing with my grandchild. I am one delighted grandma, that's an understatement.

The Good News
I am so excited that my daughter is about to give birth to my new grandchild, I could slap myself.

The Not So Good News
However, during this pregnancy my daughter has been screening her phone calls, why? I have no idea.

Well, it could be because she receives far too many unmanageable emotional phone calls from some woman who gave birth to her.

Just saying.

I can't help myself, each morning when I scan the health news for this blog, I frequently run across yet another recall or warning that my daughter needs to know about. Although I attempted to cut down the phone calls to listeria outbreaks only, its complicated. As any grandmother knows listeria can cause problems for both the mother and the baby. When a fetus is infected with listeria, it may be born prematurely or ... worse.

Pregnant women are more susceptible to it than non-pregnant healthy adults, and for certain vulnerable people, the illness could be fatal. Its become personal for me, not only is my daughter at risk but so are my friends with HCV, and friends who received a liver transplant. When it includes our friends and loved ones, it really hits home .

As reported at medpage the recent listeriosis outbreak from tainted cantaloupes shipped from July 29 to Sept. 10 to 25 states, sickened at least 72 individuals, killing 13 of them, according to the FDA and CDC. It s been reported that the outbreak was the most serious in over a decade.

Listeria can be potentially harmful for the elderly and individuals with the following medical problems; diabetes, immunocomprised adults , leukemia, kidney disease, hogkins disease, systemic lupus erythematosus, all our friends with AIDS, diseases of the liver, especially transplant recipients and my pregnant daughter.

The current public health advice to vulnerable groups on preventing listeria is to avoid the following:- Prepacked or delicatessen sliced meats- Soft cheeses - brie, camembert and chevre (goat's cheese)- Smoked fish- All kinds of pate including vegetable varieties- Pre-prepared cooked and chilled meals- Pre-prepared sandwiches- Unpasteurized milk, and now lets add cantaloupes to that list.

The Reality

From Medpage
CDC: 1,000 Food-Borne Disease Outbreaks in a Year
Matt McMillen-September 8, 2011

The latest numbers from the CDC show the U.S. had more than 1,000 outbreaks of food-borne disease in a single year.

The CDC study includes reports of illness from 2008, the most recent year that information is available.

The outbreaks caused 23,152 cases of illness, nearly 1,300 hospitalizations, and 22 deaths. But because most food-borne illnesses go unreported, the actual numbers are much higher. The CDC estimates that contaminated food causes as many as 48 million illnesses annually.
According to the CDC, a food-borne outbreak occurs when two or more cases of a similar illness are caused by a common food. An average of 24 such outbreaks were reported from each state or territory in 2008.

The total number of outbreaks was 10% less than the average number reported from 2003 to 2007. The number of outbreak-related illnesses in 2008 was also lower, by 5%.
Seventeen of the outbreaks crossed state lines, according to the CDC. Nine of those were caused by salmonella. Health officials identified the contaminated foods in six of those outbreaks: cantaloupe, cereal, ground turkey, ground white pepper, jalapeƱo and serrano peppers, and peanut butter.

Restaurant and deli food caused just over half of the 868 outbreaks that could be tied to a single location. Home cooking accounted for 15%...continue reading..

While I'm on my rant, those recalls on tainted wipes manufactured by Triads parent company H&P, really hit home. The recalls started around January of 2011, ending with the death of a child, which was reported this August, too much. The recall touched us all, and became personal for the millions of people infected with HCV.

The prep pads were packaged with pegasys in the U.S . and Pegintron outside the U.S. The wipes were contaminated with a rare bacteria, Bacillus cereus. As reported by MSNBC , there were eight reports of fatalities, 11 infections and nearly 250 other problems associated with the prep pads.

The Prep Pads and My Grandchild

For this grandma who often attends to my grandbabies boo-boo's, it should be noted that this spring I had those prep pads on hand, I still get chills. When my little angel ran a bit too fast and fell, because grandma tempted him with chocolate Ho Hos, me bad, I used good old soap and water to make it all better, not a prep pad.

To me it's evident that the dangers of using the tainted wipes to clean a wound on a child is low. My grandchild is healthy and has no underlying disease, however the risk is unacceptable. The loving parents of Harrison were not so fortunate.


The heartbreaking death of a child



January 2011
Parents blame toddler's death on tainted wipes

The parents of a 2-year-old Houston boy who died from a rare infection are suing makers of recalled alcohol prep products, claiming contaminated wipes and swabs transmitted bacteria that caused his fatal case of meningitis.

Sandra and Shanoop Kothari say their lively, dark-eyed toddler, Harrison, was recovering just fine from surgery to remove a benign cyst from near his brain and spinal cord last fall. But the day before he was set to be discharged after a week's stay, he developed a sudden and severe infection that worsened rapidly, causing multi-organ failure that led to Harrison’s death on Dec. 1, 2010.

Cultures showed he succumbed to acute bacterial meningitis caused by Bacillus cereus, bacteria typically found in rare food poisoning outbreaks, but not in hospital infections.

The wipes were contaminated with Bacillus cereus.
Continue Reading..

As reported by MSNBC in February 2011
"It also reported on a 55-year-old Tennessee man who contracted endomyocarditis, allegedly after using a Triad pad packaged with Genentech's peginterferon alfa-2a drug for hepatitis C. The man survived but required cardiac valve replacement surgery in December, the website indicated. He too has filed suit against Triad, with Genentech also named as a defendant".

Another Recall

Ground Beef In The News


Yesterday we heard of yet another recall on ground beef due to E. Coli.

From;The Food Poison Journal
Manning Beef, LLC, a Pico Rivera, Calif. establishment, is voluntarily recalling approximately 80,000 pounds of beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.


This weekend published @ Forbes

The 5 deadliest food-borne illnesses & how to prevent them
Oct 2 2011

With Listeria suddenly all over today's headlines thanks to the deaths of 21 people sickened by eating contaminated cantaloupes (as of Sept. 28th), you're probably asking yourself why you've heard so little about this deadly food-borne bacteria, and how to protect yourself from it.

Sadly, though, Listeria is just one of many types of bacteria that have been sneaking their way into the food supply in recent years, triggering fears of an epidemic of food poisoning.

Here, the 5 deadliest types of food-borne bacteria and how to keep yourself and your family members safe....continue reading..


Those Ugly Bacterial Toxins


Food Poisoning-Who's Most At Risk?

Infants and the elderly are at greater risk for food poisoning.
Other risk factors include:Having a pre-existing medical condition, such as chronic kidney failure, liver disease, or diabetes

Taking antibiotic, antihistamine, or steroid medicines
Having sickle cell anemia and other problems with red blood cells
Weakened immune system, pregnant women and people over age 65 are most at risk
Traveling in an area where contamination is more likely

Common bacterial toxins include:
Usually bacteria and algae cause food poisoning, but poisonous plants and animals may also be the cause.

Common bacterial toxins include:

E. coli in undercooked hamburger, unpasteurized apple juice or cider, raw milk, contaminated water (or ice), vegetables fertilized by cow manure, or spread from person to person.

Symptoms- Escherichia coli (E. coli): hemorrhagic colitis (diarrhea with very little stool and large amounts of blood), occurring up to 3 days after eating contaminated food

E. coli


What is E. coli?

Escherichia coli (E. coli) are gram-negative bacteria that can survive in an environment with or without air (facultative anaerobes) and, depending on the environment, may or may not produce thin hair-like structures (flagella or pili) that allow the bacteria to move and to attach to human cells. These bacteria commonly live in the intestines of people and animals worldwide. There are many strains (over 700 serotypes) of E. coli. Most of the E. coli are normal inhabitants of the small intestine and colon and do not cause disease in the intestines (non-pathogenic).

Nevertheless, these non-pathogenic E. coli can cause disease if they spread outside of the intestines, for example, into the urinary tract (where they cause bladder or kidney infections), or into the blood stream (sepsis). Other E. coli strains (enterovirulent E. coli strains or EEC) cause "poisoning" or diarrhea even though they usually remain within the intestine by producing toxins or intestinal inflammation..more information.

Listeria monocytogenes (L. monocytogenes) in cole slaw, dairy products (mostly soft cheeses from outside the United States), and cold, processed meats

Symptoms-For healthy adults listeria is generally not a significant risk – exposure to it might cause mild flu-like symptoms or stomach problems. More serious infections generally cause serious gastrointestinal and flu-like symptoms, often with muscle ache and a stiff neck, or sometimes confusion and loss of balance. This can then lead to a meningitis-like inflammation around the brain or septicaemia. Listeria is generally treated with antibiotics, which need to be administered quickly in serious cases.

Listeria


How can it be prevented?
Meats should be thoroughly cooked, and raw fruit and vegetables washed. Uncooked meat should be stored separately, and products containing unpasteurised milk avoided. Another key element is good kitchen hygiene, both keeping hands and equipment clean, and consuming even refrigerated leftovers within a few days.

Salmonella spp. in poultry, beef, eggs, or dairy products

From Medicine Net
Salmonella (S.) is the genus name for a large number (over 2,500) of types of bacteria. Each type is distinctly identifiable by its specific protein coating. The types are otherwise closely related. Salmonella bacteria are rod-shaped, flagellated, Gram stain-negative, and are known to cause disease in humans, animals, and birds (especially poultry) worldwide. The two major diseases caused by Salmonella spp. are gastroenteritis and typhoid fever (typhoid and paratyphoid fevers) in humans.

Salmonella


Potential direct sources of Salmonella are pets such as pet turtles, dogs, cats, most farm animals, and humans that are infected or are carriers of the organisms.

Symptons- Salmonellosis (gastroenteritis characterized by nausea, vomiting, and diarrhea) is the most common disease caused by the organisms. Abdominal cramping also may occur. Salmonellosis thus produces the symptoms that are commonly referred to as food poisoning. Although food poisoning is usually a mild disease, the nausea, vomiting, and diarrhea can lead to dehydration and even death (about 500 per year in the U.S.).

Salmonella Entering the Intestinal Tract





Shigella spp. from raw vegetables or cool, moist foods (such as potato and egg salads) that are handled after cooking

Symptoms- fever, chills, bloody diarrhea

Shigella


What is shigellosis?
Shigellosis is an infectious disease caused by a group of bacteria called Shigella. Most who are infected with Shigella develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacteria. The diarrhea is often bloody. Shigellosis usually resolves in 5 to 7 days. Persons with shigellosis in the United States rarely require hospitalization. A severe infection with high fever may be associated with seizures in children less than 2 years old. Some persons who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.

What sort of germ is Shigella?
The Shigella germ is actually a family of bacteria that can cause diarrhea in humans. They are microscopic living creatures that pass from person to person. Shigella were discovered over 100 years ago by a Japanese scientist named Shiga, for whom they are named. There are several different kinds of Shigella bacteria: Shigella sonnei, also known as "Group D" Shigella, accounts for over two-thirds of shigellosis in the United States. Shigella flexneri, or "group B" Shigella, accounts for almost all the rest. Other types of Shigella are rare in this country, though they continue to be important causes of disease in the developing world. One type found in the developing world, Shigella dysenteriae type 1, can cause deadly epidemics...more information

Staphylococcus aureus (S. aureus) in salad dressing, ham, eggs, custard filled pastries, mayonnaise, and potato salad (usually from the hands of food handlers)

Staphylococcus aureus is a common bacterium found on the skin and in the noses of up to 25% of healthy people and animals. Staphylococcus aureus is important because it has the ability to make seven different toxins that are frequently responsible for food poisoning.

Staphylococcus


What is staphylococcal food poisoning?
Staphylococcal food poisoning is a gastrointestinal illness. It is caused by eating foods contaminated with toxins produced by Staphylococcus aureus . The most common way for food to be contaminated with Staphylococcus is through contact with food workers who carry the bacteria or through contaminated milk and cheeses. Staphylococcus is salt tolerant and can grow in salty foods like ham. As the germ multiplies in food, it produces toxins that can cause illness. Staphylococcal toxins are resistant to heat and cannot be destroyed by cooking. Foods at highest risk of contamination with Staphylococcus aureus and subsequent toxin production are those that are made by hand and require no cooking. Some examples of foods that have caused staphylococcal food poisoning are sliced meat, puddings, some pastries and sandwiches.

What are the symptoms of staphylococcal food poisoning?
Staphylococcal toxins are fast acting, sometimes causing illness in as little as 30 minutes. Symptoms usually develop within one to six hours after eating contaminated food. Patients typically experience several of the following: nausea, vomiting, stomach cramps, and diarrhea. The illness is usually mild and most patients recover after one to three days. In a small minority of patients the illness may be more severe.
Click here for more information

C. jejuni in raw milk and chicken
Symptoms- Symptoms of food poisoning from Campylobacter usually occur 2 to 5 days after a person eats contaminated food, but may take up to 10 days to appear. The most common symptom of a Campylobacter infection is diarrhea, which is often bloody. Typical symptoms include:Diarrhea: Diarrhea ranges from mild to severe and is often bloody Fever Nausea Vomiting Abdominal pain Headache Muscle pain

C. jejuni



Campylobacter jejuni is the most common cause of bacterial foodborne illness in the United States. Over 6,000 cases of Campylobacter infection were reported in 2009 alone, but many cases are not reported to public health authorities. A 2011 report from the CDC estimates that Campylobacter causes approximately 845,000 illnesses in the United States each year.
Campylobacter is found most often in food, particularly in chicken. Food is contaminated when it comes into contact with animal feces. Any raw poultry may contain Campylobacter, including organic and “free range” products. In fact, studies have found Campylobacter contamination on up to 88 percent of chicken carcasses. Despite the commonness of Campylobacter, however, infections are usually isolated events, and widespread outbreaks are rare.
Two age groups are most commonly affected by Campylobacter: children under 5 years of age and young adults aged 15-29...more information

C. botulinum in improperly home canned foods (in children under 1 year of age, mostly from honey but also from corn syrup)

Symptoms weakness, blurred vision, sensitivity to light, double vision, paralyzed eye nerves,difficulty speaking and swallowing, paralysis that spreads downward, respiratory failure, death.
Click here for more information

Clostridium perfringens(C. perfringens) in meat and poultry dishes and gravies, mostly foods that were cooked more than 24 hours before eating and were not reheated well enough.

Symptoms of C. perfringens- Persons infected with C. perfringens develop watery diarrhea and abdominal cramps within 6 to 24 hours (typically 8-12). The illness usually begins suddenly and lasts for less than 24 hours. Persons infected with C. perfringens usually do not have fever or vomiting. The illness is not passed from one person to another.

Clostridium perfringens


What is Clostridium perfringens?
Clostridium perfringens (C. perfringens) is a spore-forming gram-positive bacterium that is found in many environmental sources as well as in the intestines of humans and animals. C. perfringens is commonly found on raw meat and poultry. It can survive in conditions with very little or no oxygen. C. perfringens produces a toxin that causes illness.

How common is C. perfringens food poisoning?
C. perfringens is one of the most common causes of foodborne illness in the United States. It is estimated that it causes nearly a million cases of foodborne illness each year...more information


Cirrhosis and Vibrio vulnificus Infection
Vibrio vulnificus Infection: Vibrio vulnificus is an organism that lives in salt-water, particularly in the Southeast Atlantic and the waters of the Gulf of Mexico. However, infections have been reported from all coastal areas in the United States. This infection can be acquired by eating raw or poorly cooked seafood (raw oysters, sushi) or by going in sea water with open skin sores. In patients with cirrhosis this infection can be lethal. Patients with cirrhosis should not eat raw seafood and should abstain from going in the ocean if open sores are present.

Download a PDF of this fact sheet
The Risk of Eating Raw Oysters or Clams Brochure

Fish poisoning causes nausea, vomiting, diarrhea, abdominal pain, dizziness, and headache.

Common types of fish poisoning include:
Scombroid poisoning from bacteria in dark meat fish (tuna, bonito, skipjack, mahi-mahi, mackerel) that are not refrigerated well

Specific types of fish poisoning can cause other signs and symptoms, such as:

Ciguatera poisoning in tropical fish (grouper, surgeonfish, snapper, barracuda, moray eel, shark) that have eaten toxic plankton

Symptoms;Ciguatera (caused by toxins in some fish, including grouper, snapper, mackerel, and barracuda): numbness or tingling around the mouth, feeling of loose teeth, impaired touch sensation of hot as cold and cold as hot, itching, muscle and joint pain, slow heart rate, low blood pressure

Puffer fish poisoning from the organs and flesh of puffer fish

Symptoms- Pufferfish poisoning: numbness or tingling around the mouth, trouble coordinating movement, difficulty swallowing, excess saliva, twitching, loss of ability to talk, convulsions, paralysis that spreads upward, respiratory failure, death

Poisoning from shellfish that feed on certain algae

Symptoms- Shellfish poisoning (caused by toxins in algae that are then eaten by shellfish): numbness or tingling around the mouth or in the arms and legs, trouble swallowing, difficulty speaking.

Mushroom Poisoning

Mushroom poisoning occurs from eating wild poisonous mushrooms, especially Amanita phalloides.

Symptoms -Mushroom poisoning: affects the liver, the neurological system (brain), or the gastrointestinal tract, including symptoms such as stomach upset, delirium (confusion), vision difficulties, heart muscle problems, kidney failure, death of liver tissue, and death if left untreated


CDC-Foodborne diseases in the United States


Data and Methodological Differences, 2011 and 1999

The 2011 estimates of illnesses, hospitalizations, and deaths from foodborne disease in the United States reflect improvements made since 1999 in data quality and methodology. Perhaps most importantly, these new estimates identify and rank the most important bacteria, viruses and parasites (“pathogens”) responsible for causing foodborne illness. Going forward, CDC will use the 2011 data to develop estimates of the proportion of illnesses that can be attributed to specific foods. These more specific estimates can further inform policy and regulatory priorities to prevent future illnesses.

The following table highlights the major differences in data and methodology between the new estimates and those published in 1999, and how they affect the estimates of illnesses, hospitalizations, and deaths from foodborne diseases in the United States.

1999 Estimate 2011 Estimates Effects of Differences
2011 estimate of acute gastroenteritis illnesses: more precise

Used 1996–1997 FoodNet Population Survey and data from US studies done before 1980 Used three most recent FoodNet surveys conducted in 2000–2001, 2002–2003, and 2006–2007

5 times larger = 2011 sample size (>48,000) compared with 1999 estimates. Larger sample size resulted in more precise data.

Stricter definition reduced rate of acute gastroenteritis.

Greater number of respondents excluded reduced rate of acute gastroenteritis.

Respondents reporting any vomiting included in definition of acute gastroenteritis Respondents reporting vomiting for <1 day or whose illness did not restrict activities excluded from definition of acute gastroenteritis.
25% = Proportion of respondents excluded from estimate of acute gastroenteritis because they reported cough or sore throat 38% = Proportion of respondents excluded from estimate of acute gastroenteritis because they reported cough or sore throat
0.79 = Rate of acute gastroenteritis per person per year 0.60 = Rate of acute gastroenteritis per person per year 211 million in 1999 reduced to 178.8 million in 2011 = Decline in the estimate of the total number of acute gastroenteritis illnesses

2011 estimate focused on foodborne illnesses acquired in the United States
Included international travel–related illnesses. Excluded international travel–related illnesses. Estimates were limited to foodborne illnesses that were domestically acquired, which reduced the number of foodborne illnesses in 2011 vs 1999.
2011 estimate showed decline in proportion of illnesses determined to be foodborne
40% = Proportion of norovirus illnesses estimated to be foodborne 26% = Proportion of norovirus illnesses estimated to be foodborne

Because norovirus causes a large number of illnesses, this reduction resulted in a big drop in the proportion of illnesses from all known gastroenteritis pathogens estimated to be foodborne, which in turn reduced the proportion of unspecified illnesses that were estimated to be foodborne.

76 million in 1999 to 47.8 million in 2011 = Decline in the overall estimate of foodborne illnesses (Also due to a lower estimate of acute gastroenteritis)

36% = Proportion of known gastroenteritis pathogens and the unspecified agents estimated to be foodborne 25% = Proportion of the known gastroenteritis pathogens and the unspecified agents estimated to be foodborne
2011 estimate of illnesses caused by known pathogens: more accurate
15% = Proportion of survey respondents with bloody diarrhea seeking medical care 35% = Proportion of survey respondents with bloody diarrhea seeking medical care Higher, more accurate estimate of medical care-seeking was used in multipliers to correct for under-diagnosis, resulting in lower illness estimates for known pathogens.
12% = Proportion of respondents with non-bloody diarrhea. 18% = Proportion of survey respondents with nonbloody diarrhea seeking medical care
2011 estimate used "adjustment” multipliers specific for each pathogen
Generic multipliers used to adjust for underreporting based on similarity of symptoms for known pathogens. Pathogen-specific multipliers used to adjust for under-reporting and under-diagnosis. Pathogen-specific multipliers resulted in more precise estimates.
2011 estimate modeled uncertainty for generation of estimates
Point estimates calculated without modeling of uncertainty. Modeled uncertainty for each estimate, resulting in credible intervals for each number. Credible intervals indicate a 90% probability that the actual numbers fall within the stated ranges.


The 10 riskiest foods in America

Leafy greens top the list of FDA-regulated foods that can make you ill

Source- MSNBC Published in 2009

  • U.S. consumers have been bombarded with reports of contaminated food in recent years, from salmonella in peanut butter and spinach to E. coli in cookie dough and ground beef. Individually, the outbreaks are alarming, but collectively, they represent what the consumers' group Center for Science in the Public Interest calls "a perfect storm of unsafe food." A new CSPI report finds that the top 10 riskiest foods regulated by the federal Food and Drug Administration accounted for nearly 40 percent of all foodborne outbreaks in the U.S. between 1990 and 2006, spawning nearly 50,000 illnesses with symptoms ranging from stomach cramps and diarrhea to kidney failure and death. Using data from the Centers for Disease Control and Prevention, researchers tracked more than 1,500 separate, definable outbreaks involving not only high-risk foods like meat and dairy, but staples of a healthy diet, such as fruits and vegetables. These outbreaks are only the tip of the iceberg of foodborne illness. For every case of salmonella poisoning reported, for instance, the CDC estimates that another 38 cases go unreported.

  • Leafy greens
    Image: salad

    Can salad really be bad for you?
    Although considered a healthy food, nutritious greens can also be coated in disease-causing germs. The Center for Science in the Public Interest identified 363 separate outbreaks linked to leafy greens, making them the No. 1 entry on the top 10 list of riskiest FDA-regulated foods. Salads and other food items containing leafy greens — iceberg lettuce, romaine lettuce, leaf lettuce, butter lettuce, baby leaf lettuce, escarole, endive, spring mix, spinach, cabbage, kale, arugula or chard — accounted for 24 percent of the outbreaks, which sickened at least 13,568 people. Another pathogen appearing frequently in leafy greens is norovirus, which was linked to 64 percent of the outbreaks in leafy greens. Salmonella was responsible for another 10 percent. Contamination may be present from production and processing or through improper handling, such as inadequate handwashing.


    Eggs

    Eggs, a popular high-protein breakfast food, have been linked to 352 outbreaks. The majority of illnesses from eggs are associated with salmonella, which sickened 11,163 people from 1990 to 2006. Salmonella lives in the intestinal tracts of animals and birds and is transmitted to humans when animal feces contaminate a food item of animal origin (such as eggs). Regulations implemented in the 1970s have reduced salmonellosis infections. However, salmonella enteritidis, the most prevalent type of salmonella in eggs today, infects the ovaries of otherwise healthy hens and contaminates the eggs before the shells are formed. New regulations issued in July 2009 require the adoption of controls aimed at minimizing salmonella enteriditis in egg production. While proper cooking should destroy most pathogens, serving eggs raw – or "runny" – or leaving egg dishes at improper holding temperatures (such as on a breakfast buffet) can allow the salmonella to multiply.


  • Tuna

    Image: tuna

    Many consumers are familiar with warnings about tuna and methylmercury, but the fish has also been implicated in 268 outbreaks and 2,341 reported cases of foodborne illness. Tuna has been linked to scombroid, the illness caused by scombrotoxin. Fresh fish decay quickly after being caught and, if stored improperly, begin to release natural toxins that are dangerous for humans. Adequate refrigeration and handling can slow this spoilage, but the toxin cannot be destroyed by cooking. Symptoms of scombroid poisoning can include skin flushing, headaches, abdominal cramps, nausea, diarrhea, palpitations and loss of vision. In addition to scombrotoxin, norovirus and salmonella can also be related to tuna consumption. More than 65 percent of outbreaks linked to tuna occurred in restaurants.

  • Oysters

    Image: Oysters

  • Contaminated oysters can ruin more than just a gourmet dinner. Oysters have been linked to 132 outbreaks, with 3,409 reported cases of illness. Not surprisingly, the majority of outbreaks from oysters occurred in restaurants. Illnesses from oysters occur primarily from two sources: norovirus and vibrio. Although norovirus in other foods is usually associated with improper handling, oysters actually can be harvested from waters contaminated with norovirus. When served raw or undercooked, those oysters can cause gastroenteritis, an inflammation of the stomach and small or large intestines. Vibrio, a type of bacterium in the same family as cholera, can cause a severe illness, particularly in those with a compromised immune system, characterized by fever and chills, septic shock and blistering skin lesions and can even be fatal.

    Potatoes

    Image: potatoes

    Potatoes, often in the form of potato salad, were linked to 108 outbreaks, with 3,659 consumers reported to have been sickened by spuds since 1990. Salmonella is the most common pathogen, associated with nearly 30 percent of outbreaks, followed by E. coli at 6 percent. The presence of salmonella and E. coli in potato dishes could indicate cross-contamination from raw or cooked ingredients or possibly from raw meat or poultry during handling and preparation. Shigella and listeria also appear in outbreaks associated with potatoes. More than 40 percent of potato outbreaks were linked to foods prepared in restaurants and food establishments (including grocery stores and delis).

    Cheese

    Image: brie

    Cheese has been linked to 83 outbreaks involving 2,761 reported cases of illness since 1990, with salmonella the most common hazard. Cheese can become contaminated with pathogens during production or processing. Most cheeses are now made with pasteurized milk, lowering the risk of contamination. In August, California officials warned consumers about eating Latin American-style cheeses such as queso fresco or queso Oaxaca, which may be made by unlicensed manufacturers using unpasteurized milk that could contain harmful bacteria. Pregnant women should be particularly cautious about consumption of soft cheeses such as feta, brie, camembert, blue-veined and Mexican-style cheese, which can carry listeria. Listeriosis infection can lead to miscarriage. For the elderly, listeria can cause severe illnesses, with high rates of hospitalization and death

    Ice cream

    Image: Ice cream cone

    Whether served in a cone or in a cup, America's favorite frozen treat occasionally can carry a load of dangerous bacteria. Ice cream has been linked to 74 outbreaks involving 2,594 reported cases of illness from pathogens such as salmonella and staphylcoccus since 1990. Soft ice cream can be particularly hazardous to pregnant women. Listeria can survive on metal surfaces — such as the interior of soft ice cream machines — and may contaminate batch after batch of products.


    Image: Tomatoes

    Although tomatoes were wrongly implicated in a sweeping 2008 outbreak later linked to fresh jalapeno and Serrano peppers, they have caused at least 31 identified outbreaks and sickened 3,292 since 1990. The most common hazard associated with tomatoes is salmonella, which accounted for more than half of the reported outbreaks. Salmonella can enter tomato plants through the roots or flowers and can enter the tomato fruit through small cracks in the skin, the stem scar or the plant itself. Restaurants were responsible for 70 percent of all illnesses associated with tomatoes.

    Sprouts

    Image: Sprouts

    Sprouts are a popular way to add crunch to salads and in Asian dishes. As the popularity of sprouts increases, however, so too does the potential for foodborne illnesses. Sprouts have been implicated in 31 outbreaks involving 2,022 reported cases of illness since 1990. The CDC and the FDA recommended in 1999 that people at high risk for complications from salmonella and E. coli — such as the elderly, young children, and those with compromised immune systems — not eat raw sprouts. The most likely source of sprout contamination is the seeds that are used to grow the sprouts. Seeds may become contaminated in the field or during storage, and the warm and humid conditions required to grow sprouts are ideal for the rapid growth of bacteria.

    • Berries
      Image: strawberries

      Strawberries, raspberries, blackberries and other berry products have caused 25 outbreaks and sickened 3,397 since 1990. In 1997, more than 2.6 million pounds of contaminated strawberries were recalled after thousands of students across several states reported illnesses from eating frozen strawberries in their school lunches. Hepatitis A was the culprit, and contamination may have occurred through an infected farm worker, according to the CSPI report. That same year, raspberries imported from Guatemala and Chile were implicated in a cyclospora outbreak across five states. The resulting infection is a parasitic illness of the intestines, which can cause severe diarrhea, dehydration and stomach cramps and requires treatment with antibiotics.

      — Center for Science in the Public Interest

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