E Coli Lawyer & Attorney : Marler Clark Law Firm : E. coli Blog

E. coli O157:H7 was identified for the first time at the CDC in 1975, but it was not until seven years later, in 1982, that E. coli O157:H7 was conclusively determined to be a cause of enteric disease. Following outbreaks of foodborne illness that involved several cases of bloody diarrhea, E. coli O157:H7 was firmly associated with hemorrhagic colitis.

The Centers for Disease Control and Prevention (CDC) estimated in 1999 that 73,000 cases of E. coli O157:H7 occur each year in the United States. Approximately 2,000 people are hospitalized, and 60 people die as a direct result of E. coli O157:H7 infections and complications. The majority of infections are thought to be foodborne-related, although E. coli O157:H7 accounts for less than 1% of all foodborne illness.

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M.L. Johnson, writing in the Seattle Post Intelligencer, charts the rapid growth in Raw Milk dairies and she took time to speak with Bill Marler, the Seattle attorney representing children damaged by rural America's money making scheme.  She writes:

Seattle attorney Bill Marler is suing Organic Pastures, the nation's largest organic raw milk dairy, on behalf of two children who fell ill after consuming its products. Testing at the dairy farm near Fresno, Calif., did not detect the strain of E. coli that sickened the children, but a government report said the dairy was likely responsible.

Marler, who has sued other dairies as well, criticized states for bowing to pressure from farmers and allowing raw milk sales to go on - legally or not.

"My worry is that as it becomes more acceptable and becomes more commercialized, you know, it will reach a critical mass where all of the sudden you're going to get a whole bunch of little kids poisoned," Marler said. "And then everybody will throw up their arms and go, 'Whoa, we've got to stop this, we've got to pasteurize.'"

The rise in dairies that do not bother to pasteurize their milk is striking.  With claims of cure-all powers for Raw Milk,  Johnson reports that Washington State has seen the number of its Raw Milk operators grow to 22 , up from six in two years.   Raw Milkers in Massachusetts have more than doubled in five years, reaching 24.

And there is no doubt about the cure-all claims they are making as evidenced by this poster from Organic Pastures.   For the rest of Ms. Johnson's story, go here.

 

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Next week, the Food Safety & Inspection Service of the U.S. Department of Agriculture is  putting  reducing the Incidence of E. coli O157:H7 in Raw Beef on the menu in meetings with its many stakeholders.

The public sessions will be held on Wednesday, April 9, from 8 a.m. to 5 p.m., and Thursday, April 10, from 8:30 a.m. to 1 p.m. at the Holiday Inn Georgetown, 2101 Wisconsin Ave., NW, Washington, DC.

William Marler, managing partner at Marler Clark, L.L.P., speaks at 10:30 a.m., on Wednesday, April 9.   The entire two-day agenda can be found here.

Individuals are encouraged to pre-register to attend in person or via teleconference, and should visit www.fsis.usda.gov or contact Sheila Johnson at (202) 690-6498 or by e-mail at Sheila.Johnson@fsis.usda.gov.  There will be opportunities for public comment on both days.

Foodproductiondaily.com recently reported:

Dr. Richard Raymond, US under secretary for food safety, said that despite major advances in battling foodborne illnesses like E-coli in the country during the last decade, reduction levels have recently levelled out.

"It is time for another series of bold, strong moves based on knowledge and science to produce further significant reductions in illnesses attributed to the products we regulate," he stated. "We aim to prevent and not just respond to illnesses, and consumers, industry and our public health partners are critical partners in our long term strategy and we look forward to our continuing collaborative relationship to ensure food safety."

That story can be foundhere.

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We’ve been doing a lot of thinking about recalls lately. We know its not true, but by their combined actions, we sometimes cannot help but thinking the food industry and its regulators are in cahoots to drag out recalls and confuse the public.

When it became apparent that about one third of the 143 million pounds of beef recalled from the ill-fated Chino slaughterhouse was in the meat lockers of the nation’s public schools, we thought about local taxpayers getting stuck with the disposal costs.

It appears we were not alone in thinking about recall costs. David Mitchell, writing for www.ThePacker.com, says Wal-Mart has told its suppliers that they will, in the future, be charged by the giant discount chain for its costs to participate in a recall. The minimum charge would be $20 per store. Wal-Mart’s 2,500 stores would add up to a minimum charge of $50,000.

Mitchell writes that:

“It’s not a big surprise,” said one Wal-Mart supplier, who requested anonymity. “To be honest, other chains have things that are similar.”

The source said that retailers often have provisions in their supplier agreements that allow for such charges, but fees often go uncollected in the case of products recalled because of minor defects, such as labeling errors.

He said retailers do level assessments against suppliers in more damaging cases, such as the 2006 E. coli outbreak linked to spinach.

Go here for the rest of Mitchell's report.

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An isolated case in an isolated place where no one has had E coli in four years.   However, 8-year old Evie Hope Wray of Theodosia, MO was a confirmed E coli case; one that evolved into Hemolytic-uremic syndrome (HUS),   And HUS killed Evie, who was a soccer and cat-loving second-grader at Lutie Elementary School.

The farm, where she lived with her parents and brother, has well-water that was found to be clean and safe.   Ozark health officials are tying to find out where Evie was exposed to E. coli, but say its really difficult with an isolated case.

KSPR-TV, the ABC affiliate in Springfield, MO is telling the sad story.  They report that:

When this close-knit family's youngest daughter became horribly ill, it was devastating.
“Her vitals started dropping… they hooked her up to oxygen and when that didn’t work, they had her on all kinds of drips,” Evie’s dad Tom Wray remembers.

She was diagnosed with a serious strain of E. Coli, but it was HUS that caused her death.
With no way to treat the infection, doctors could merely provide dialysis to support her failing kidneys and sedatives to reduce her pain.

“She was on about seven different machines. I just touched her and said, ‘momma’s here.’” Evie passed away at a Columbia hospital, surrounded by people who loved her.
But those people are still haunted by how- how did this happen?

For more on Evie, go here.

 

 

Evie Hope Wray

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The United States Department of Agriculture's Food Safety & Inspection Service is hosting a public meeting on April 9, 2008 titled: E. coli O157:H7 - Addressing the Challenges, Moving Forward With Solutions.

FSIS will sponsor the public meeting focused on E. coli O157:H7.  "The purpose of the meeting is to have a discussion with stakeholders on recent spikes in recalls/illnesses related to E. coli O157:H7, provide updates on FSIS initiatives and build a foundation for establishing solutions to address the challenges this pathogen causes," the agency statement said.

More information on the meeting, including the agenda, will be made available in future issues of the FSIS Constituent Update. Also, be sure to check the Meetings and Events page of FSIS' Web site here for updates.

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Dr. Richard A. Raymond is Medical Doctor from Nebraska.  Since July 2005, he has been Undersecretary for Food Safety at the United States Department of Agriculture.  He was asked by the U.S. House Subcommittee on Oversight and Investigations why there's been an uptick in e coli-related recalls.

Dr. Raymond listed several reasons why e coli related recalls involved only a few thousand pounds in 2006 to 33 million pounds in 2007.   Among those reasons:

• More sensitive testing
• More use of Pulsenet by state and local/regional health officers, which can connect distant confirmed cases into a single outbreak.
• Changes he has made to Food Safety & Inspection Service policies to be more aggressive in using recalls.
• And finally, what the former rural medical doctor called "Raymond's theory."  He believes there has been "an increased load" of e coli in the hind  guts of cattle. 

Dr. Raymond, Nebraska's former chief medical officer, did not say what he thinks increased the load.

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We think the use of such phrases as "tipping point" and "perfect storm" are often over-used.  However, something may have happened this past week when comes to meaningful reform of the broken system for food safety.

After the cruel treatment of "downer" cows, the assault on the nation's school lunch program, and the nation's biggest beef recall in history,  Chairman John D. Dingell of the House Energy & Commerce Committee called a time out.  He had those who should know sharpen their pencils and raise their hands to testify about what's to be done.

One who came ready, ofcourse, was our own Bill Marler, who represents victims of  E coli and other food borne illnesses in the courts across the land.  Because there's been interest and because we think its important, we are going to publish what Bill had to say specifically about reforms before the House committee. Here goes:

Things are different from Sinclair’s critical view of packing plants of the 1900’s. We now face things Sinclair could not even begin to imagine. Those two things must drive food safety decisions now. The first is the threat of terrorist attacks via the food system. Just as too many could not imagine the horror of 9/11, too many cannot envision this kind of food disaster today. When a terrorist attacks our food system it will look eerily similar to any other outbreak of foodborne illness. Second, is the growth of food imports. Sinclair could not have imagined a world where the meat that may be in one hamburger could originate in Argentina, Canada and Colorado or that we would have fruits and vegetables year-round shipped in from South America, Asia and Africa. It is with these two enormous issues in mind, that I offer suggestions on how to put me out of business.

First, create a local, state and national public health system that catches outbreaks before they balloon into a personal and business catastrophe. Everyone believes that the Jack in the Box outbreak started in Seattle in January 1993. It did not. It actually began in November 1992 when young Lauren Rudolph died and another 30 people were sickened in and around southern California. However, because E. coli O157:H7 was not a reportable illness at the time, the death and illnesses were not recognized as an outbreak and the contaminated meat was shipped to Seattle. CDC’s PulseNet and Food Net were launched and are rightly credited with helping reduce the size of outbreaks by helping to more quickly conclude what suspect product is causing harm. But surveillance of human bacterial disease is lacking. For many foodborne illnesses, for everyone culture positive case, 20 to 50 other cases are missed because of lack of surveillance. Most people who become ill with a bacterial or viral disease are either seldom seen or never cultured. The more people are tested, the greater the likelihood that a source, accidental or not, will be found sooner.

Second, actually inspect and sample food before it is consumed. At present, Local and State authorities, along with the USDA and FDA, employ thousands of inspectors across the nation and world to inspect tens of thousands of plants that produce billions of pounds of food at farms, processing plants and retail outlets. The GAO has warned in the past that our food sampling and inspection is so scattered and infrequent that there is little chance of detecting microscopic E. coli or any other pathogen for that matter.

Third, consider mandatory recall authority on all food products. Recalls must be completely transparent. If a recall is ordered, consumers need to know what in fact is being recalled. Full disclosure must be the rule. Under the present system of voluntary recalls, last September we saw the disastrous Topps recall where the company knowingly left E. coli contaminated product on store shelves three weeks after being confronted with an ill customer and its product both testing positive for E. coli O157:H7. But recalls are not perfect. Although stunned by the video of animal abuse at Hallmark/Westland, I am more stunned that the recall has ballooned to 143 million pounds of meat and is quickly encompassing products that might contain trace amounts of the meat. No people have been sickened. I wonder if resources are better spent elsewhere.

Fourth, on a national level merge and then adequately fund the three federal agencies responsible for food safety. Right now, USDA's Food Safety and Inspection Service and the inspection arm of the Food and Drug Administration share this mission with the CDC. The system is trifurcated, which leads to turf wars and split responsibilities. We need one independent agency that deals with food-borne pathogens. You have a moral responsibility to consumers in your hometown or anywhere U.S. goods are sold. It is time to adequately fund our health and safety authorities to help business protect their customers.

Fifth, we cannot regulate ourselves out of this. Standards need to be set with the entire food chain at the table – from farmer, to manufacturer, to retailer and customer. Standards must also be based upon good science. We must invest in solid research at our land grant institutions to help producers manufacturer food that is safe, nutritious and the envy of the world.

None of this will stop bacterial and viral illnesses entirely. These invisible poisons have been around a long time. However, these five steps will enable us to help prevent it, help detect it far more quickly, to alert stores and families, and to keep our most vulnerable citizens - kids and seniors - out of harm's way. Thank you Mr. Chairman.

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We have seen some good work in the past from Philip Brasher, who works out of the Washington, D.C. bureau for the Des Moines Register.  On Sunday, Brasher took on the Chino slaughterhouse scandal, which led to the largest recall of beef in U.S. history.

We found it compelling reading.  Brasher seems to hit the nail on the head with the reasoning that what is really at stake is trust in the USDA brand worldwide.   We have suspected the Chino scandal coming just as USDA was on the verge of getting US beef back into Japan and South Korea could not have occurred at a worst time.

Brasher found a top US food executive delivering just that message.  Larry Pope, chief executive officer of Smithfield Foods, is quoted in the Register story saying:

"Every time an incident like this happens, it hurts everybody in this room," he warned a conference of agribusiness leaders. Consumers "trust that USDA stamp a little bit less. When we go overseas they trust the United States a little bit less."

Brasher goes on to report that USDA has not yet gone public with results of nation-wide audit of beef plants that it ordered after last year's "rash of E coli related recalls."  Purpose of the audit was to what controls meat packers have in place to combat E coli.

Go here to read all of the Brasher story.

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“The ban on non-ambulatory or ‘downer’ cattle is one of many steps in a robust system to produce safe beef, but it is not the only step taken to ensure the safety of the beef supply. The beef we eat is safe because there are multiple safety hurdles before it arrives at our grocery stores or restaurants.”

That was from the statement of the Denver-based National Cattlemen’s Beef Association after USDA announced that Hallmark/Westland Meat Packing Company was recalling 143.3 million pounds of beef because the Chino slaughterhouse was routinely processing “downer” cattle.

Here’s how Wayne Pacelle, chief executive officer of the Humane Society, sees it:

"There's no ambiguity in our mind that this plant was accepting downers, abusing downers and slaughtering downers."

While some audit evidence was raising doubts, we have been living under a five year old ban on “downer” cattle getting into the human food supply. The cruel practices the Chino slaughterhouse was using to get around the ban should not be the primary concern.

Our primary concern is that “downer” cattle are in the human food supply through one of USDA’s award-winning plants. Bill Marler explains the problem this way:

“Why is this all important? Federal regulations call for keeping downer cows out of the food supply because they pose a higher risk of E. coli, salmonella contamination, or mad cow disease since they typically wallow in feces and their immune systems are often weak. Yummy!”

Network news is reporting that 37 million pounds of the recalled beef went to America’s public schools. Unlike E. coli and salmonella, mad cow disease typically won’t show up for years.

The Secretary of Agriculture says chances anyone will get mad cow disease are “remote.”

However, he will be long gone before we find out if he was right or not.

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Marler Clark filed two E. coli lawsuits against Organic Pastures on February 7, 2008. The lawsuits were filed in Fresno County Superior Court on behalf of two children who developed hemolytic uremic syndrome (HUS) secondary to E. coli O157:H7 infection after consuming Organic Pastures raw milk.

The California Department of Health Services (CDHS) and California Department of Food and Agriculture (CDFA) conducted an investigation into the E. coli outbreak in September of 2006. CDHS and CDFA identified six children who had become ill with either E. coli O157:H7 or HUS and learned that all six had consumed Organic Pastures raw milk or colostrum in the days before becoming ill.

While investigating the cause of the children’s illness, pulsed field gel electrophoresis (PFGE), or “genetic fingerprinting” confirmed that five of the six children were infected with the same strain of E. coli; the sixth did not test positive for E. coli but had HUS. An investigation at Organic Pastures led to the discovery that several cows were infected with E. coli O157:H7, although the strain was different from the outbreak strain. CDHS determined that unpasteurized dairy products from Organic Pastures were the likely source of the outbreak.

Eleven-year-old Lauren Herzog and 9-year-old Chris Martin both consumed raw milk produced by Organic Pastures in early September of 2006. Lauren became ill with symptoms of E. coli infection on September 6. Her illness subsequently developed into HUS, a life-threatening complication of E. coli infection that can cause kidney failure and central nervous system impairment, and she was hospitalized on September 8. Lauren suffered acute renal failure and required approximately two weeks of daily kidney dialysis. She remained hospitalized until October 18, 2006, when she was discharged with over $250,000 in medical bills.

Chris became ill with symptoms of E. coli infection on September 5, 2006 and he was hospitalized on September 7. Like Lauren, Chris suffered HUS. His condition worsened and he was transported by helicopter to a Children’s hospital and was placed in pediatric intensive care. Chris’ kidneys failed and he required weeks of daily dialysis, as well as multiple blood transfusions. He was placed on a ventilator as a result of impending congestive heart failure, and remained on the ventilator for five days, was briefly taken off the ventilator, and later returned for several more days. Chris suffered a number of seizures as a result of his HUS. He also developed high blood pressure and pancreatitis. Chris was discharged from the hospital on November 2, 2006, nearly two months after he was admitted, with over $450,000 in medical bills.

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Powerful interests often find themselves in the position where they do not care--they don't have to. The nation's ethanol industry may be in just such a position when it comes to concerns that the distiller's grains it produces increases e coli O157H7 in cattle.

At least that's the impression one gets from reading "Distillers grain link to E coli disputed" in the Council Bluffs, Iowa Daily Nonpareil.  The article sought the ethanol industry's response to research by Kansas State University and the University of Nebraska that concluded cattle that were fed distillers grain, an ethanol byproduct, had increased levels of E coli 0157H7 bacteria in their hindgut over cattle fed regular corn.

Doug Archer, general manager of Green Plains Renewable Energy, first said ethanol producers haven't received the studies.   The Nonpareil reports:

"We're in a fairly young industry. At this point there's only concern. I'm sure the appropriate agencies will investigate and determine if there is a link between E coli and distillers grain," said Archer.

As far as the distillers grains manufactured at GPRE, Archer said they do a fair amount of testing and meet all the regulated guidelines.

"We've gone through the right processes and have worked with scientists and animal nutritionists. I don't see how there is any kind of health threat."

Archer continued to say until a link is found, there's no cause for alarm.

"When it is found out, it'll certainly be dealt with."

Check out the complete story here.

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The e coli-tained lettuce that Taco Johns served to its customers in 2006 continues to be thrown about like a hot potato among those who were involved.   Taco Johns sued Bix Produce , Roma, Pacific Marketing and the Wegis Family Limited Partnership in federal court.

The Sioux Falls Argus Leader yesterday (Jan. 31) reported that the St. Paul-based Bix Produce has asked a federal judge to dismiss it from the litigation. The A-L report said:

Bix’s motion to dismiss filed Wednesday describes the allegations publicly for the first time. It says the Taco John’s corporations are suing because they lost business due to “negative media publicity surrounding an E. coli outbreak at certain Taco John’s restaurants in Iowa and Minnesota.”

The suit asked that a jury award $5 million in damages.
Taco John’s dropped Bix as a supplier in 2006 after contaminated
lettuce showed up at restaurants in Albert Lea and Austin, Minn. and Cedar Falls and Waterloo, Iowa.

You can get the A-L story here.

 

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Marti Davis of the Knoxville News Sentinel spoke with the McDonald family, whose two children became ill with E. coli infections last fall after eating Cargill ground beef patties.  Davis noted that only John McDonald, the children's father, has eaten ground beef since his children's illness.  The rest of the family has not reintroduced ground beef into their diet since September.  She wrote:

That's when preschoolers John and Michaela McDonald shared a burger that led to a prolonged stay in intensive care and cost 4-year-old John part of his bowel and colon. Jim and Georgia McDonald, parents of four, purchased the frozen hamburgers at Sam's Club near their West Knoxville home a few days before the patties were recalled.

Surgery to bypass John's digestive tract was reversed in December, and both children are well for now, Jim McDonald said, but no members of his family, other than himself, have eaten ground beef since the illness.

His children were hospitalized a few days after the family prepared the beef at a cookout, unaware of the recall. They were among victims nationwide who became ill from tainted burgers prepared by the Cargill Co., an international agribusiness giant based in Minnesota.

Davis is following claims brought by the McDonald family, who is represented by Marler Clark.  The family filed a lawsuit against Cargill last year, but has withdrawn the lawsuit in the hopes that Cargill will compensate the children for injuries they sustained through mediation instead of a jury trial.

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Health officials in "The Big D" city of Dallas now say they confiscated beef sold off the street to owners of the Chicken Shack, which is located in the 6000 block of Lamar Street, before it could be cooked or sold to anyone else.

The suspected source of the beef is the stolen trailer, which was taken from the parking lot of  the Texas American Food Service on Dec. 19.   The trailer contained nearly 15,000 pounds of beef that was contaminated with e coli.  The beef has been missing since the mostly empty trailer was recovered on Dec. 27.

Since Monday, when the City of Dallas issued this press release, local health officials and inspectors from USDA's Food Service & Inspection Service have been fanning out over north Dallas in hopes of recovering the stolen beef before it makes anyone sick.  They are talking to businesses and inspecting restaurants.

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Have you ever been approached in a Barber Shop by someone offering to sell you some beef-on-the cheap?  It happened in North Dallas, according to a Texas health department division manager.

Dallas Business Journal is reporting that the health department has fanned out across North Dallas to speak with businesses and inspect restaurants in the aftermath of the still missing 14,800 pounds of e coli-contaminated beef that was stolen from a Texas American Food Service truck.

The beef was in a Texas American Food Services trailer that went missing Dec. 19, and was found mostly empty on Dec. 27 near Lake June Road and U.S. 175 in Dallas.

Since then, here's what the Dallas Business Journal says is happening:

"Ahsan Khan, division manager of the food protection and education division of the Dallas Health Department, said an employee of a barber shop in northeast Dallas reported that a suspicious person attempted to sell him ground beef last week. Seven other businesses -- mostly restaurants -- also said they had been solicited by a suspicious individual peddling ground beef, Khan said.

"The DHD made the findings during a Monday survey of 80 Dallas businesses.

"Inspectors from both the city of Dallas and the U.S. Department of Agriculture are increasing their site visits to area restaurants, according to a news release the city issued Tuesday. Dallas restaurant inspectors are also handing out fliers warning against the threat of the tainted meat. "

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This week's Food Safety Infosheet from the International Food Safety Network (iFSN) out of Kansas State University and the University of Guelph addresses concerns about E. coli O157:H7 - a potentially deadly foodborne pathogen.  From the infosheet:

E. coli O157:H7 can cause vomiting, diarrhea and can lead to kidney damage and is most dangerous for children and the elderly.

Foods that have been associated with E. coli O157:H7 include ground beef, fruits and vegetables, sprouts and unpasteurized juices.

When meat is ground, E. coli O157:H7 can be mixed from the surface into the middle of a patty or meatball. The only way to ensure that the dangerous
bacterium is killed is to use a digital tip-sensitive thermometer.

All three E. coli victims in the infosheet were hospitalized with Hemolytic Uremic Syndrome (HUS), a severe, life-threatening complication of an E. coli O157:H7 infection. Although most people recover from the symptoms of E. coli O157:H7 infection, about 5-10% of infected individuals develop (HUS).  The essence of the syndrome is described by its three central features: destruction of red blood cells (hemolytic anemia), destruction of platelets (those blood cells responsible for clotting, resulting in low platelet counts, or thrombocytopenia), and acute renal failure.

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20-year-old Stephanie Smith awoke from nine weeks in a medically-induced coma shortly before Christmas.  Smith became ill with an E. coli infection in September after eating a contaminated hamburger, and has since been hospitalized with hemolytic uremic syndrome.  Britt Johnsen from the St. Cloud Times wrote about the girl's illness:

Doctors aren’t sure if she’ll ever make a full recovery. But next week they hope to move her from the intensive care unit to a neurology recovery unit, said her mother, Sharon Smith.

“I’m a little scared. I just hope her mind’s OK, for her sake,” she said.

Smith, who was a Just For Kix dance instructor, got sick after she ate ground beef that was part of a Sam’s Club recall. She was diagnosed with hemolytic uremic syndrome, which happens when E. coli toxins enter the bloodstream.

WCCO's John Lauritsen also covered Stephanie's story:

"The last time I was there, which was a couple days ago, she cried when I left. She's moving her fingers and she winks now," said Sharon Smith [Stephanie's mom].

Every little movement Stephanie Smith makes is a step in the right direction. Especially considering that during the Thanksgiving holiday doctors told Sharon Smith they couldn't do any more for her daughter. Until recently, every time they would try and take her out of her coma Stephanie Smith would have a seizure.

On October 6, 2007, Cargill Meat Solutions Corporation announced that it was recalling approximately 845,000 pounds of frozen ground beef patties for possible E. coli O157:H7 contamination. The recall was initiated after three people in Minnesota tested positive for E. coli and a joint investigation by the Minnesota Department of Health and Minnesota Department of Agriculture identified the Cargill hamburger patties as the source of the illnesses.

The Cargill products were sold at retail establishments and to restaurants and other institutions. Sam’s Club announced that it was pulling the potentially E. coli-contaminated ground beef patties produced by Cargill from its store shelves nationwide on October 5th.

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The year 2007 is going to be remembered for the big beef recalls due to E. coli returning with a vengeance. All totaled meat producers were forced to recall over 33.3 million pounds of beef products.

Topping the list was the 21.7 million pound recall due to E. coli that sent the New Jersey-based Topps Foods into bankruptcy. When United Food Group in June was forced to recall 5.7 million pounds of E. coli-laced ground beef, no one would have guessed it was going to lead to a second half of 2007 that found E. coli in beef just like the bad old days.

E. coli forced the recall of 3.3 million pounds of Totino’s and Jeno’s frozen meat pizzas. In two separate recalls, Cargill had to recall over 1.9 million pounds of beef they had contaminated with the deadly E. coli pathogen.

Most of the big recalls of 2007 remain on the active case list of the Food Safety and Inspection Service (FSIS) of the U.S. Department of Agriculture. The percentage of recalled products actually returned to manufacturers is often pretty low.

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The safety of our leafy green food supply - mainly lettuce and spinach - has received significant attention since the USDA's Agricultural Marketing Service published a request for comments regarding proposed national leafy greens handling regulations in October.  According to Michael Durando, branch chief of USDA's marketing order administrative branch, who was interviewed for an article in the Washington Post that was published yesterday, this request generated over 3,500 comments - considerably higher than the average 2-3 responses for an average issue or 100 or so comments for a "hot-button" issue. 

The Washington Post article, written by Bloomberg News reporter Cindy Skryzcki, is titled, "In a Pickle Over Self-Regulation for Produce Growers".  For the article, Ms. Skryzcki interviewed various stakeholders who will be impacted by decisions made regarding whether government or industry should regulate the growth and distribution of fresh produce.  Stakeholders include leafy greens marketing groups, farmers, and the USDA. 

Ms. Skryzcki wrote about differences of opinion in the comments that have thus far been submitted, which include viewpoints on whether all farms and processors should be required to follow the same standards and whether industry should be able to regulate itself with such agreements as marketing agreements instituted by California and Arizona leafy greens growers and handlers after the 2006 spinach E. coli outbreak instead of facing formal government regulation. 

From the article: 

The Western Growers Association said there should be no exemptions from uniform steps that growers and handlers should have to follow to certify the safety of lettuce, spinach, endive, kale, cabbage and other greens.

At a congressional hearing in May, Joseph Pezzini, an executive with Ocean Mist Farms in Castroville, Calif., and the chairman overseeing California's Leafy Green Handlers Marketing Agreement, said industry is best suited to define best practices for handling the covered vegetables.

The Consumers Union's Odabashian opposed the marketing-agreement plan in comments, saying the Agriculture Department idea isn't appropriate for addressing safety concerns. She said in an interview that the California agreement, which went into effect in July, didn't prevent two recent recalls.

While we all share the goal of reducing the incidence of foodborne illness outbreaks traced to contaminated produce, USDA faces a tough decision.

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Researchers from Kansas State University have concluded that feedlots containing cattle that are fed distiller's grain, a byproduct of ethanol production, have an increased incidence of E. coli O157:H7 - a toxic form of E. coli that causes human illness.  T.G. Nagaraja, a professor of diagnostic medicine and pathobiology at Kansas State's College of Veterinary Medicine, and Jim Drouillard, a professor of animal sciences at Kansas State, conducted research to determine whether diet influences the number of bacteria in an animal's gut.

An Associated Press article regarding the new research focused on the need for further research now that the increase has been identified:

Research in the next few years will focus on finding out the reasons for the prevalence of the bacteria in cattle fed a distiller's grain diet. Nagaraja said it could be related to changes in the animal's gut from the diet. The byproduct may also provide a nutrient for the E. coli bacteria.

Domer said more work needs to be done to see if the prevalence of E. coli contamination can be controlled by providing cattle that are fed distiller's grain with other feed sources.

"The research is still early and probably needs more work so we can know how to control the situation," Domer said.

Feeding cattle distiller's grain is a big economic advantage for ethanol plants," Nagaraja said. "We realize we can't tell cattle producers, 'Don't feed distiller's grain.' What we want to do is not only understand the reasons why 0157 increases, but also find a way to prevent that from happening."

E. coli O157:H7 bacteria is believed to mostly live in the intestines of cattle, but has also been found in the intestines of chickens, deer, sheep, and pigs. E. coli O157:H7 does not make the animals that carry it ill; the animals are merely the reservoir for the bacteria.

Meat typically becomes contaminated with E. coli O157:H7 during the slaughtering process, when the contents of an animal's intestines and feces are allowed to come into contact with the carcass. Unless the carcass is sanitized, the E. coli bacteria are eventually mixed into the meat as it is ground. Because the bacteria is mixed into the meat during the grinding process, and is not just on the surface, thorough cooking (to160 degrees) is required to prevent E. coli O157:H7 poisoning from consumption of ground beef. Contaminated meat looks and smells normal, and although the number of organisms required to cause an infection is not known, it is suspected to be very small.

A 2003 study on the prevalence of E. coli O157:H7 in livestock at 29 county and 3 large state agricultural fairs in the United States found that E. coli O157:H7 could be isolated from 13.8% of beef cattle, 5.9% of dairy cattle, 3.6% of pigs, 5.2% of sheep, and 2.8% of goats. Over seven percent of pest fly pools also tested positive for E. coli O157:H7.

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A five-year-old from Hutchinson, Kansas, was released from Wesley Medical Center after being hospitalized for a month with hemolytic uremic syndrome.  Aubrey Anderson's kidneys failed after she became ill with an E. coli infection in October. 

According to the Hutchinson News, Aubrey was released from the hospital to recover at home because her mother is a registered nurse.  Public health officials have yet to identify the source of Aubrey's illness, and she will continue medical follow-up for months to years.  As the Hutchinson News reported:

It will be weeks, and perhaps months, before the family knows how much the illness damaged her kidneys, and whether she'll face a lifetime of treatment or be in the clear, said her father, Bill Anderson.

"We won't know until we get at least six or seven weeks out if there's any residual scarring as a result of the E. coli," Anderson said. "If there is scarring, it may mean anywhere from a range of a kidney transplant to her maybe having to take oral medication for the rest of her life to keep her body in balance."

Initial indications were that her kidneys were functioning, so the family is optimistic she'll make a full recovery.

All persons who have experienced HUS should be formally evaluated by a nephrologist—a kidney specialist—at a year following their acute illness. Kidneys injured by HUS may slowly recover function over at least a six month period following the acute episode and perhaps longer. Even persons with “mild” HUS who did not require dialysis should be formally evaluated. Such an evaluation should include a routine physical, blood pressure measurement, and blood and urine analyses from which kidney filtration rate can be calculated.

Physicians doing follow-up on HUS patients will carefully look for indications of kidney injury. These will include whether there is an abnormal amount of protein in the urine that may signal a significant injury to the kidneys or blood in the urine which also can reflect kidney injury. As assessment of the HUS patient’s glomerular filtration rate—“GFR”—is essential to determining whether the kidneys are functioning in the range of normal for that person age, sex, and size. It is also important to establish a baseline GFR so that future assessment of kidney function can reflect any potential loss of filtering capacity over time.

Studies done to date on HUS outcomes have largely confirmed a positive correlation between more severe kidney involvement acutely, particularly the need for extended dialysis, an increased incidence of future renal complications. However, it has been shown in multiple studies that even moderate kidney compromise in the acute phase of HUS can result in long-term complications due to damage to the filtering units in the kidneys.

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The Times-Tribune reported over the weekend that Vickie Shelton, a Knox County resident, passed away on Monday, November 26th at Central Baptist Hospital in Lexington after being admitted.  According to the story, Ms. Shelton had eaten ground beef before becoming ill, and public health officials are conducting tests to determine whether that ground beef was contaminated with E. coli.

As reported by the Times-Tribune:

Officials at the U.S. Department of Heath in Fayette County are testing samples of ground beef Shelton had reportedly consumed prior to becoming sick. American Foods Group of Green Bay, Wisc. issued the recall on products produced in October and reportedly shipped to retailers and distributors in seven states including Kentucky, Indiana, Maryland, Ohio, Tennessee, Wisconsin and Virginia.

The recall, issued Nov. 24, is a class 1 recall with health risks listed as “high.” American Foods Group voluntarily recalled approximately 95,927 pounds of various coarse and fine ground beef products because they may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service stated in a news release.

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Jane Liaw from the Santa Cruz Sentinel reported today on USDA's proposal to ask the public about whether the leafy green industry should be further regulated.  More regulation would be USDA's response to several E. coli outbreaks that have been the result of consumption of contaminated produce.  Liaw wrote:

One option on the table is a national version of the industry-developed standards that followed the E. coli outbreak and now govern California farmers and leafy green handlers. Though some farmers in Santa Cruz County are unhappy about the regulations, most support national standards.

"We'd get a uniform set of food safety standards. Nothing wrong with that," said Michael Dobler of Dobler & Sons in Watsonville, who believes that everyone should be held to the standards he already embraces.

The USDA is considering both voluntary and mandatory standards, officials say, but favors a voluntary program that allows flexibility.

Much controversy has come from last year's spinach E. coli outbreak - but so have changes.  California and Arizona leafy greens producers have signed marketing agreements that were designed to encourage good manufacturing practices across their industry, and the United Fresh Produce Association asked the government to step in and regulate farming and processing practices for leafy greens. 

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Sharon Smith, the mother of Stephanie Smith, a Minnesota resident who has been hospitalized for months after eating a hamburger and becoming ill with E. coli poisoning, spoke with Kirsti Marohn of the St. Cloud Times for an article that appeared in today's paper.  She shared the story of the few days before Stephanie became ill with symptoms of E. coli infection, and of her hospitalization. 

The 20-year-old dance instructor has undergone intensive medical treatment while doctors work to support her body.  Five days after becoming ill, Stephanie was hospitalized with hemolytic uremic syndrome and was placed in a coma when she began having seizures.  As Kristi Marohn wrote:

Two months later, she remains in critical condition at St. Marys Hospital in Rochester, fighting for her life against a severe case of E. coli poisoning.

Doctors have told Sharon that Stephanie remains extremely critical. She was diagnosed with hemolytic uremic syndrome, caused when E. coli toxins enter the bloodstream.

The severity of her case is very rare, similar to only a handful of others worldwide. Still, Sharon hasn’t given up hope that her only daughter, with her wide smile and warm personality, will pull through.

There are hopeful signs. Stephanie’s kidneys have started functioning again, and she no longer needs dialysis. But there are setbacks, too. Her tongue has swelled so doctors have had to prop her mouth open and put an oxygen mask on her. So far, attempts to lower the coma-inducing drugs have resulted in more seizures. She continues to breathe with the help of a respirator.

Stephanie's is one of the most severe E. coli cases reported on in recent years, but she is not alone.  Other E. coli victims from outbreaks this fall have also been hospitalized for lengthy periods - at least one other in a coma. 

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In September, an E. coli outbreak among students at Galena Elementary School perplexed health officials.  Several children became ill with E. coli and a source of the outbreak was elusive.  The sibling of two students at Galena Elementary battled an E. coli infection during the outbreak, and continues to recover after being on dialysis.  His mother has been hospitalized since she became ill with E. coli over 52 days ago. 

WAVE3 TV out of St. Louis, Missouri, reported the story of Amelia Seraiah's E. coli illness and hospitalization last night:

A Floyd County woman watched her son battle a deadly strain of E. coli back in September. Now she's hospitalized with the same illness. But her health isn't the only problem the single mother of five is facing.

It was 52 days ago -- on September 30th -- when Amelia Seraiah came down with the deadly bacteria. Her children are now staying with family members, who say they just pray she makes a full recovery.

Sharon Peltier has a lot to be thankful for this week. Her 3-year-old grandson, William, is off dialysis and doing better. He spent 17 days last month in Kosair Children's Hospital. Now Peltier's daughter (William's mother) is in Norton Hospital, fighting the same illness: E. coli.

Amelia isn't the only person battling an E. coli infection who will spend Thanksgiving in the hospital.  7-year-old Jayden Moss, of Willard, Utah, is expected to remain hospitalized until February.  He became ill with an E. coli infection earlier this fall and has suffered brain damage due to neurological involvement of HUS.  According to KSL.com:

Jayden is now at the learning level of an infant after developing Hemalitic Uremic Syndrome (HUS) from E. coli.

"He started throwing up and diarrhea," his mother, Rachael, said.

It eventually shut down his kidneys, and blood vessels in his body began bursting, causing severe brain damage. "Right now he doesn't walk, doesn't talk, he doesn't eat on his own, he's fed by a machine," Jayden's father, Jeremiah, explained.

According to the KSL story, Jayden's first-grade classmates have raised $6,500 to help his family pay their medical bills.

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A Mattoon High School senior from Mattoon, Illinois, who became ill with an E. coli infection last September shared his story with the Herald & Review. 

Matt Roberts became ill with an E. coli infection last September - just before an E. coli outbreak was traced to El Rancherito restaurant in Effingham.  His E. coli infection progressed to hemolytic uremic syndrome (HUS) and he was hospitalized for over a month.  While hospitalized, Matt was placed in a medically-induced coma for ten days, and underwent dialysis and blood and plasma transfusions.  Even after he was released from the hospital, Matt continued to receive plasma transfusions.

While Matt was ill, the Coles County Health Department worked to identify the source of his E. coli infection but has thus far been unable to determine the source of his illness.  According to the Herald & Review:

Coles County Health Department officials confirmed in early October they did not suspect any area restaurants as the source of Matt's infection or the E. coli contracted by another unidentified Coles County resident, who recovered from the illness relatively quickly.

Nor was Matt anywhere near the Effingham El Vaquero restaurant, to which seven E. coli cases were linked in late September.

And Matt was showing symptoms well before the Effingham outbreak.

A 20-year-old woman from Wisconsin was also hospitalized and in a drug-induced coma.  Stephanie Smith became ill this fall after eating ground beef contaminated with E. coli and developed HUS.

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In an editorial titled, "Is the meat you buy safe enough?" that appears online at the Eco-Logic Powerhouse website, Henry Lamb evaluates the state of the meat industry and USDA's role in it.  He reviews the recent E. coli outbreaks linked to meat produced at Topps and Cargill, and poses the question, "Every package of this contaminated meat contained a USDA inspection seal. Why did the USDA inspection fail to discover this contamination before it was shipped to stores across the nation?"

Mr. Lamb analyzes what in his view is the inadequacy of the current USDA inspection system and discusses USDA's current efforts to implement an animal tracking system - which he believes is completely unnecessary:

How can this inspection deficiency be corrected? Will it take more inspectors? Will it take new procedures? Whatever it takes, American consumers expect the USDA Food Safety and Inspection Service to do whatever is necessary to assure that the meat that reaches the grocery store is safe.

In view of these two most recent recalls, it would seem that the USDA would be extremely embarrassed, and working on a crash program to improve their food safety procedures. Apparently, the USDA has higher priorities.

There is far more interest and effort at the USDA to get every property where any one of 29 species of livestock animals reside, registered into a federally controlled database. What does this effort have to do with preventing contamination in the meat processing plant?

Mr. Lamb addresses the argument that irradiation will make food safer, and counters with the argument that if food irradiation is implemented there will be less pressure on slaughterhouses to prevent contamination.

And as to the question of why the average American should care about meat safety, Mr. Lamb concludes, "It matters not how safe the USDA system might be, if you are among those who fall ill as the result of inadequate USDA inspection procedures. To these people, the system is obviously not safe enough."

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The Hutchinson News from Hutchinson, Kansas, reported today that five-year-old Aubrey Anderson is undergoing dialysis treatments at a Wichita hospital to combat the effects of hemolytic uremic syndrome (HUS) secondary to E. coli infection.  The child has been hospitalized for 18 days. 

From About-HUS.com:

The essence of Hemolytic Uremic Syndrome is described by its three central features: destruction of red blood cells (hemolytic anemia), destruction of platelets (those blood cells responsible for clotting, resulting in low platelet counts, or thrombocytopenia), and acute renal failure. In HUS, renal failure is caused when the nephrons, or filtering units, become occluded (blocked) by micro-thrombi, which are tiny blood clots. In almost all cases, the filtering ability of the kidneys recovers as the body of the patient slowly dissolves the micro-thrombi within the microvessels.

A typical person is born with about one million filtering units, called nephrons, in each kidney. The core of the nephron is a bundle of tiny blood vessels, called a glomerulus, where osmotic exchange allows for the filtration of wastes that eventually collect in the urine and are excreted. During Hemolytic Uremic Syndrome, the lack of blood flow to the nephrons can cause them to die or be damaged, just as heart muscle can die as the result of coronary vessel occlusion during a heart attack. Dead nephrons do not regenerate.

In general, the longer a patient suffers kidney failure, the greater the loss of filtering units as a result. At some point, the damage to the kidneys’ filtering units can be so severe that the patient will, over a period of years, lose kidney function and suffer end-stage renal disease (ESRD), which requires chronic dialysis or transplantation.

HUS can also cause transient or permanent damage to other organs, which include the pancreas, liver, brain, and heart. The essential pathogenic process is the same regardless of the organ affected: microthrombi inhibit necessary blood flow and cause tissue death or damage. During the acute stage of Hemolytic Uremic Syndrome, patients must be carefully monitored for these extra-renal complications. It is very difficult to predict the severity and course of HUS once it initiates.

The active stage of Hemolytic Uremic Syndrome may be defined as that period of time during which there is evidence of hemolysis and the platelet count is less than 100,000. In HUS, the active stage usually lasts an average of six days (range, 2-16 days). It is during the active stage that the complications of HUS per se usually occur.

In the Hutchinson News article, Aubrey's father discussed her condition:

"Aubrey's hemoglobin was down a little today, which is not good," Anderson said in an e-mail. "Her platelets, however, have reached a 'normal' level and the doctor feels that they will not decrease again, and that is encouraging. Her toxicity level is down from yesterday, but they would like to see it come down farther."

Aubrey remains on a feeding tube, which goes down through her nose and bypasses her stomach into her intestines. She continues to frequently vomit, however, which displaces the feeding tube.

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The Des Moines Register reported this morning that an Iowa E. coli case might be connected to the E. coli outbreak that was traced back to consumption of Totino's and Jeno's pizzas earlier this month.  According to the story, testing is still being conducted, and the epidemiologic investigation has not yet concluded that the pizza was the source of the Iowan's illness; however, the investigation is ongoing.  Nigel Duara wrote:

Dr. Patricia Quinlisk of the Iowa Department of Public Health said Tuesday that either a person in western Iowa contracted a strain of E. coli that matches the DNA "fingerprint" of the E. coli bacterium involved in a national frozen pizza recall, or the person's history involves consumption of the tainted product.

The bacterium in the recall is blamed for sickening 23 people in 12 other states, including bordering states South Dakota, Nebraska, Missouri, Illinois and Wisconsin.

Quinlisk said the department has investigated three cases. Two did not match the strain found in the pepperoni in Totino's and Jeno's pizzas, but one case is still under investigation.

"We're still waiting for some further information," Quinlisk said Tuesday. "We don't know it's definitely here. Two (cases) were proved not to be here."

General Mills announced on November 1, 2007, that the company was recalling its Totino’s Crisp Crust Party pizzas and Jeno’s Crisp ‘N Tasty pizzas for possible E. coli O157:H7 contamination. The recall was initiated after over 20 people became ill with E. coli infections after eating the pizzas.

The pizzas were produced on or before October 30, and were distributed nationwide. Each package is marked with “EST. 7750” inside the USDA seal of inspection, and has a “best if used by” date on or before April 2, 2008.

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Steve Hedges of the Chicago Tribune wrote yesterday about a loophole in the food safety system that allows E. coli-contaminated ground beef to become part of pre-cooked products destined for the frozen foods section at grocery stores and school lunches through the USDA's National School Lunch Program.  Hedges wrote that when ground beef tests positive for E. coli, it can be diverted from processing to be sold as a fresh product and put into processing to become a pre-cooked meal. 

Food Safety and Inspection Service inspectors interviewed for Hedges' story believe that the amount of E. coli contamination in ground beef products has not declined nearly as much as has been touted in the last several years.  Their argument is that if a company tests ground beef, and it is positive for E. coli and shifted to a "cook only" line, USDA testing is not performed on the product.  That means that ground beef already known to be positive for E. coli is never tested by the government.  As Hedges wrote:

But some USDA inspectors say the "cook only" practice means that higher-than-appropriate levels of E. coli are tolerated in packing plants, raising the chance that clean meat will become contaminated. They say the "cook only" practice is part of the reason for this year's sudden rise in incidents of E. coli contamination.

"All the product that is E. coli positive, they put a 'cooking only' tag on it," said one inspector, who like other federal inspectors interviewed asked to remain anonymous for fear of losing their jobs. "They [companies] will test, and everything that's positive, they slap that label on."

There is no evidence that "cook only" meat has directly sickened consumers. But some inspectors contend that the practice conceals significantly higher levels of E. coli bacteria in packing plants than the companies admit to. That's because companies that find E. coli are allowed to shift that meat immediately into "cook only" lines, without reporting it to the USDA.

After ConAgra recalled 19 million pounds of ground beef for E. coli contamination in 2002, the company planned to "recycle" the ground beef it recovered by using it in canned chili products and pet food.  Consumers became aware of the plan when Dave Migoya of the Denver Post wrote about ConAgra's plan in a story titled, "CONAGRA CO. WILL LIKELY RECYCLE RECALLED E-COLI-TAINTED BEEF INTO COMPANY’S CONSUMER PRODUCTS 'AND NO ONE HAS TO TELL YOU IT'S THERE'".  The company ultimately announced that it was destroying the ground beef instead of re-using it.

One would speculate that Hedges' article could cause quite a stir if consumers read it and begin to understand that the "pre-cooked" products they purchase in freezer sections could contain pre-cooked E. coli and cow poop.

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