The number of food safety incidents that involved an international network more than doubled in January to March this year compared to the fourth quarter of 2019.

During the first quarter of 2020, the International Food Safety Authorities Network (INFOSAN) was part of 38 food safety events versus only 15 from October to December 2019.

Of 25 incidents involving a biological hazard, eight were due to Salmonella, five for Listeria monocytogenes, three because of norovirus, two each down to Shiga-toxin producing E. coli, Clostridium botulinum and Bacillus cereus and one each due to Cronobacter, Shigella sonnei and an unspecified hazard.

Common food types involved
Salmonella climbed back to being the main hazard since INFOSAN started quarterly summaries in January to March 2018. The two times it has not been first, Listeria has been in prime position.

Sharing of information through INFOSAN enables members to implement risk management measures to prevent illness in their respective countries. The network is run by the Food and Agriculture Organization (FAO) and World Health Organization (WHO).

Other issues in 2020 were undeclared allergens such as milk, peanut, egg and gluten. Physical hazards including undetermined foreign matter, glass, metal and plastic and one involving histamine.

Food categories mostly involved in incidents during 1Q 2020 were fish and other seafood, herbs and spices, legumes and pulses, milk and dairy products, nuts and oilseeds, snacks, desserts and other foods, cereals and cereal-based products, composite food, fruit products, meat products, vegetables and vegetable products, products of special nutritional use, and food for infants and small children.

Listeria and enoki mushrooms
In March, the INFOSAN secretariat was made aware by the U.S. Centers for Disease Control and Prevention (CDC) of an outbreak of listeriosis linked to enoki mushrooms, imported from the Republic of Korea. In total, 36 cases including four deaths have been reported.

Following investigations in Canada, the INFOSAN secretariat was informed of six Listeriosis cases between 2017 and 2019 potentially related by whole genome sequencing (WGS) to the outbreak in the U.S. Food isolates from enoki mushrooms from the Republic of Korea genetically associated with the cluster of cases were collected in 2019 by authorities in Canada.

Six people in Australia are also part of this international Listeria outbreak. Illnesses were reported between October 2017 and March this year but no-one has died.

Meanwhile, INFOSAN and the Canadian Food Inspection Agency (CFIA) will hold a workshop later this year to increase the human resources available to train members on a range of INFOSAN-related topics, online or in-person.

The hope is that understanding of the roles and responsibilities of INFOSAN members will be improved, resulting in greater participation that will enhance speed and efficiency during the response to global food safety emergencies.

Network’s five year plan
The network has also published a strategic plan covering 2020 to 2025. It has six main objectives. These include strengthening INFOSAN as the global network to detect and respond to international food safety emergencies to reduce their negative public health and trade impact, connecting food safety professionals across the world and boosting visibility of INFOSAN and identifying new funding opportunities.

Members from Africa and the Eastern Mediterranean have been the least responsive during food safety incidents, answering INFOSAN requests only 32 percent and 40 percent of the time compared to the global average of 70 percent. Members in the Pacific Island Countries are historically among the least active in INFOSAN.

There is a target to improve responsiveness of INFOSAN Emergency Contact Points to requests for information during international food safety incidents. The aim is 24 hours for acknowledgement and three days to provision of information compared to the historical average of 48 hours for acknowledgement and seven days for information.

The hope is to almost double the proportion of incidents identified because of a notification from an INFOSAN member instead of from a secondary source or the media from 26 percent to 50 percent.

INFOSAN is also looking at partnerships with the European Commission Food Fraud Network and initiatives of Europol and Interpol.

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Six people in Australia are part of an international Listeria outbreak traced to imported mushrooms that has also killed four in the United States.

The Listeria monocytogenes patients in Australia have been identified by whole genome sequencing as being related to the U.S. outbreak strain. Their illnesses were reported between October 2017 and March this year.

Food Standards Australia New Zealand (FSANZ) said the investigation was ongoing but no deaths have been attributed to listeriosis amongst cases.

Of the six infections in Australia related to the U.S. outbreak strain, four are thought to have been exposed in the country. Of these, three are residents of Queensland, and one is from New South Wales. The other two are thought to have been exposed while travelling overseas. The median age of cases is 75 years old, four are female and two are males, and all of them had underlying health conditions.

Listeria monocytogenes was detected in enoki mushrooms imported from South Korea that were recalled in the country earlier this month.

Choi’s Mushrooms recalled Green Co. Enoki Mushrooms in 200-gram and 300-gram packages. The products were sold at Asian supermarkets and grocers in New South Wales, the Australian Capital Territory, Victoria, Queensland and South Australia. Both products have date markings: April 22, May 5, May 12, May 19 and May 26, 2020.

Enoki mushrooms are a long thin white mushroom, usually sold in clusters. They are popular in East Asian cuisine and also known as enokitake, golden needle, futu or lily mushrooms.

Korean authorities and enoki mushroom suppliers are trying to ensure sanitary controls are being met and cooking instructions are put on packaging. In Korea, enoki mushrooms are cooked and not eaten raw in salads.

American and Canadian recalls
In the U.S., three enoki mushrooms recalls have been issued. They are H&C Food Inc., Guan’s Mushroom Co. and Sun Hong Foods, Inc. A total of 36 people infected with the outbreak strain of Listeria monocytogenes have been reported from 17 states and 30 needed hospital treatment. Listeria has been identified in ill people from November 2016 to mid-December 2019.

The Food and Drug Administration (FDA) sampled enoki mushrooms at import from Green Co. of the Republic of Korea. Results showed two samples yielded the outbreak strain. Green Co. was placed on import alert and H&C Foods Inc. recalled enoki mushrooms supplied by the company. This move flags imported shipments from this firm for potential detention without physical examinations.

In Canada, another make of enoki mushrooms was recalled in late March. Goldenway International Trade Co. Ltd. recalled Golden Mushroom brand Enoki Mushroom because of possible Listeria monocytogenes contamination.

The action was triggered by Canadian Food Inspection Agency (CFIA) test results but no reported illnesses have been associated with the product.

About Listeria infections
Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause serious and sometimes life-threatening infections. Anyone who has eaten any of the recalled products and developed symptoms of Listeria infection should seek medical treatment and tell their doctors about the possible Listeria exposure.

Also, anyone who has eaten any of the recalled product should monitor themselves for symptoms during the coming weeks because it can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop. 

Symptoms of Listeria infection can include vomiting, nausea, persistent fever, muscle aches, severe headache and neck stiffness. Specific laboratory tests are required to diagnose Listeria infections, which can mimic other illnesses. 

Pregnant women, the elderly, young children, and people such as cancer patients who have weakened immune systems are particularly at risk of serious illnesses, life-threatening infections and other complications. Although infected pregnant women may experience only mild, flu-like symptoms, their infections can lead to premature delivery, infection of the newborn or even stillbirth.

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Everyone who tracks food recalls knows they are an unpredictable and erratic occurrence. But even given that reality, food recalls during the past 30 days or so have been in a weird space.

Maybe the federal government’s “all hands on deck” response to the COVID-19 pandemic has not had anything to do with it, but the pace of food recalls seems to be a little off during the same period of time.

Consider for example that USDA’s Food Safety and Inspection Service (FSIS) did not recall any meat, poultry, egg products, or catfish between Feb. 8 and April 10.

The FSIS announced two recalls on April 10 — 130,763 pounds of ready-to-eat chicken bowl products and 42,587 pounds of raw pork trimmings. Some of the Conagra Brands chicken bowls had small rocks in them, The raw pork from Jowett Farms Corp. in Canada was not made available for import re-inspection.

But that’s been it for FSIS during the period when the federal government has been fixated on COVID-19, also referred to as coronavirus. And putting aside recalls for undeclared allergens, the other 80 percent of the food supply, which is regulated by the Food and Drug Administration has seen just eight pathogen-related food safety recalls during the fixation period.

And the timing on some of these is confusing. Since mid-March, the federal Centers for Disease Control and Prevention and the FDA have been tracking an outbreak of Listeria monocytogenes linked to enoki mushrooms grown in South Korea.

It’s a deadly outbreak involving 36 cases in 17 states. It’s killed four people and required hospitalization for 30, or 83 percent, of the victims. And just yesterday, three more recalls of enoki mushrooms from Korea were posted on the FDA recall website for Sun Hong Foods Inc., Guan’s Mushroom Co., and H&C Food Inc.

Here’s what was confusing. The FDA publish date for all three was April 14, 2020. Yet, the company announcement date for Sun Hong’s recall was March 9; for Guan’s Mushroom it was March 23, 2020; and for H&C Food it was April 7.

Maybe it’s a good thing because they are catching up, but delaying information about an outbreak involving a pathogen with a really high fatality rate seems more than a little off for the FDA.

Tuesday’s recalls by three different companies of the same imported mushrooms depicted the risk very differently. Sun Hong Foods Inc. made the link to the deadly outbreak. “We are aware that ill persons who may have consumed the product under investigation,” Sun Hong’s recall notice said. It said samples of its mushrooms taken by the State of Michigan tested positive for Listeria.

Guan’s Mushroom Co. said its product samples were found positive for Listeria by the State of California but said no illnesses have been reported to date “with this problem.”

H&C said: “No illnesses related to products distributed by H&C Foods have been reported to date” without making any connection to the outbreak.

FDA has posted five other pathogen-related during the period when “stay-at-home” orders have been in place. These included:

  • Whole Capelin Fish Pet Treats for possible Clostridium botulinum;
  • Organic Kudzu Root Herbal Supplement for Salmonella contamination;
  • Cooked butterfly Tail on Whiteleg for possible Vibrio contamination;
  • Red Clover Sprouts, Sprout Salad, Mixed Greens Spring Salad for E. coli O103; and
  • Frozen blackberries and frozen berry medley for Norovirus.

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Almost one-third of the year is in the rearview mirror at the federal Centers for Disease Control in Atlanta and only two new multistate outbreaks of foodborne illnesses are on the books.

A dangerous outbreak of Listeriosis bubbled up out of Michigan late February involving Enoki mushrooms grown in South Korea. In its latest report on April 8, the CDC reported 36 confirmed cases in 17 states that involve 30 hospitalizations and four deaths.

As of March 19, the second outbreak involving the rare E.coli O103 had sickened 39 people in six states with two hospitalizations and no deaths. Clover sprouts are blamed for the second active outbreak of 2020.

The two foodborne illnesses outbreaks are small potatoes when compared to the COVID-19 outbreak that by April 15 infected 641,315, resulting in 28,386 deaths. By this point in a more typical year, CDC usually is working on a half dozen or more multistate foodborne outbreaks.

The Listeria pathogen is the more serious of those involved in the two foodborne outbreaks that the CDC is currently combatting. The four deaths currently represent a fatality rate of just more than 11 percent. It has not been uncommon for Listeria outbreaks in North America to reach as high as 20 to 40 percent.

The Food and Drug Administration (FDA) and states including Michigan and California were successful in narrowing down the culprit to enoki mushrooms and connecting it to three companies, H&C Foods, Guan’s Mushrooms, and Sun Hong Foods, that recalled the Korean grown product from the marketplace.

CDC has a current warning out urging pregnant women, adults over 65 and others with a weakened immune system to avoid earing any enoki mushrooms imported from the Republic of Korea even if not part of the recalls.

Examples of people with weakened immune systems are those getting treatment for cancer or who are on dialysis.

Listeria can survive at refrigerated and freezing temperatures and can easily spread to other foods and food surfaces. Washing and sanitizing all food surfaces and containers is important for anyone who handled enoki mushrooms or any other food contaminated with Listeria.

CDC advises washing surfaces with hot, soapy water and washing containers in the dishwasher with hot soapy water. Food processors, restaurants and retailers who handled enoki mushrooms need to be extra vigilant in cleaning and sanitizing to avoid cross-contamination.

The Korean Ministry of Food and Drug Safety on March 18 reported finding Listeria monocytogenes in samples from two firms in Korea. Testing by Michigan and California identified the outbreak in enoki mushroom samples from the companies that announced recalls.

For the second recall, CDC warns against eating, serving or selling any sprouts from the Chicago Indoor Garden as they are “a known source of foodborne illness and outbreaks.”

Chicago Indoor Garden recalled various products with sprouts last March 12 including Red Clover 4-ounce clamshell; Red Clover 2-pound boxes, Sprout Sales 6-ounce clamshell; Mixed Greens 4-ounce clamshell; and Spring Salad 6-ounce clamshell.

CDC also warned children, older adults, pregnant women, and people with weakened immune systems not to consume raw or lightly cooked sprouts of any kind. Other examples of people with immune systems include those with diabetes, liver or kidney disease or HIV.AIDS.

The E. coli contaminated sprouts were first reported on Feb.26 and 25 additional people were added to the outbreak by March 19. There’s not been an update since.

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The FDA now warns against the third brand of imported enoki mushrooms under recall because of links to a Listeria outbreak that has sickened dozens.

“Consumers should not eat and should check their refrigerators and throw away any recalled enoki mushrooms from Sun Hong Foods, Inc., Guan’s Mushroom Co., and H&C Food, Inc. because they may be contaminated with Listeria monocytogenes,” according to an update this afternoon from the Food and Drug Administration.

“H&C Foods Inc. recalled 200 g/7.05 oz packages of enoki mushrooms imported from Green Co. LTD of the Republic of Korea. FDA import samples of enoki mushrooms from Green Co. LTD tested positive for Listeria monocytogenes and on April 6, 2020, whole genome sequencing analysis determined that the Listeria monocytogenes found in the positive samples matched the outbreak strain. As a result, On April 7, 2020, Green Co. LTD was placed on Import Alert 99-23, which flags imported shipments from this firm for potential detention without physical examination. The FDA is encouraging the international community to consult the Import Alert.”

As of today, 36 people across 17 states have been confirmed as outbreak victims. Thirty of the people have had to be admitted to hospitals. Company records show the implicated mushrooms were distributed in California, Florida, Illinois, New York, Maryland, Oregon, Pennsylvania, Texas, Virginia, and Washington. FDA officials report distribution to other states is being investigated.

The FDA is working with the federal Centers for Disease Control and Prevention, state and local partners on the outbreak investigation. 

Enoki mushrooms are a long thin white mushroom, usually sold in clusters. They are especially popular in East Asian cuisine and are also known as enokitake, golden needle, futu, or lily mushrooms.

Consumers can use the following information to determine whether they have recalled mushrooms in their homes. The FDA has posted photos of all of the recalled products on its update page.

Company Size UPC Code Confirmed Retailers
(others could be involved)
Confirmed
Distribution
Sun Hong Foods, Inc. 200 g/ 7.05 oz. 7 426852 625810 J&L Supermarket, Jusgo Supermarket, ZTao Market, New Sang Supermarket, Galleria Market, Distributors CA, FL, IL,
OR, TX, WA
Guan’s Mushroom Co. 200 g/ 7.05 oz. 859267007013 Sold to Distributors and Wholesalers CA, NY, PA
H&C Food Inc. 200 g/ 7.05 oz. 831211204181 Great Wall Supermarket NY, MD, VA

 

Four people are dead and at least 36 people across 17 states have been sickened in a three-year Listeria outbreak linked to mushrooms imported from Korea. The virulent strain has hospitalized at least 30 of the patients.

In the outbreak announcement today, the FDA reported that Sun Hong Foods Inc. has recalled all enoki mushrooms it imported from the Republic of Korea.  The company reported the mushrooms were sent to distributors in five states, but the product was sent along to an unknown number of other states and retailers, according to the company’s notice posted by the Food and Drug Administration.

“The firm recalled product after the Michigan Department of Agriculture and Rural Development found that a sample of these mushrooms was positive for Listeria monocytogenes,” according to the FDA’s outbreak announcement this afternoon.

“Additionally, the Listeria monocytogenes in the enoki mushrooms distributed by Sun Hong Foods Inc. was determined, by whole genome sequencing, to be a genetic match to the outbreak strain when tested by Michigan Department of Agriculture and Rural Development.”

The FDA’s public health officials are urging the certain people to avoid all enoki mushrooms from Korea, not just the product imported bu Sun Hong Foods.

“At this time, high risk groups, including the elderly, people with weakened immune systems or chronic diseases, pregnant women and their newborn babies, should not eat enoki mushrooms from Korea (Republic of Korea), even if they were not part of the Sun Hong Foods Inc. recall,” according to the FDA’s notice.

“Consumers, restaurants, retailers, and high risk groups should discard and not eat, sell, or serve enoki mushrooms if they cannot tell where they came from.”

The specific Sun Hong Foods mushrooms subject to the recall were sold in 7.05-ounce/200-gram clear plastic packaging with a green label. Sun Hong Foods Inc. is printed on the back of the packaging underneath the bar code. These products can be identified by the UPC number 7 426852 625810. Enoki mushrooms are a long thin white mushroom, usually sold in clusters. They are especially popular in East Asian cuisine and are also known as enokitake, golden needle, futu, or lily mushrooms.

New York has been hardest hit so far with 4 confirmed patients. Other states and the number of patients in them are: Arizona with 2, California with 9, Florida with 2, Hawaii with 3, Indiana with 1, Kentucky with 1, Massachusetts with 2, New Jersey with 1, Nevada with 1, Rhode Island with 1, Tennessee with 1), and Virginia with 3.

Illness onset dates confirmed as of today range from Nov. 23, 2016 through Dec. 13, 2019.

About Listeria infections

Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause serious and sometimes life-threatening infections. Anyone who has eaten any of the recalled product and developed symptoms of Listeria infection should seek medical treatment and tell their doctors about the possible Listeria exposure.

Also, anyone who has eaten any of the recalled product should monitor themselves for symptoms during the coming weeks because it can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop. 

Symptoms of Listeria infection can include vomiting, nausea, persistent fever, muscle aches, severe headache and neck stiffness. Specific laboratory tests are required to diagnose Listeria infections, which can mimic other illnesses. 

Pregnant women, the elderly, young children, and people such as cancer patients who have weakened immune systems are particularly at risk of serious illnesses, life-threatening infections and other complications. Although infected pregnant women may experience only mild, flu-like symptoms, their infections can lead to premature delivery, infection of the newborn or even stillbirth.

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