The Center for Science in the Public Interest (CSPI) is urging the Food and Drug Administration to protect consumers from unprocessed poppy seeds, which are often contaminated with the plant’s naturally occurring opiate residues.

The nonprofit nutrition and food safety watchdog group on Feb. 5  filed a regulatory petition with the FDA on behalf of six families injured by contaminated poppy seeds and medical experts. They’re asking regulators to clean up America’s poppy seed supply by setting a maximum threshold for opiate contamination and establishing controls on imported seeds.

Steve and Betty Hacala of Rogers, AR, lost their 24-year-old son Stephen in 2016 to a poppy seed tea overdose.

“It was hard for us to believe that something as innocent and common as poppy seeds could be lethal,” said Steve Hacala, one of the petitioners. “Now we want to make sure the poppy seeds brought into this country are cleaned, to spare other families this kind of loss.”

Poppy seeds used in baking come from the same plant that produces opiates, including morphine and codeine. The poppy plant cannot be legally grown in the United States, meaning all poppy seeds sold in this country are imported from countries where cultivation is permitted. While the seeds themselves contain negligible amounts of opiates, they can be contaminated with plant debris and require washing and processing to reduce opiate contamination to safe levels.

Not all importers adequately process their seeds, and some sellers even market poppy seeds as “unwashed” or “unprocessed” to convey that they have high levels of opiates to consumers who may purchase the seeds to brew poppy seed tea. This tea is typically used for medicinal, therapeutic, or recreational purposes and can concentrate the opiates from a batch of seeds. Consumers of these seeds may not be aware that the effects from the consumption of the seeds may be because of opiates. In addition, opiate contamination levels can vary widely from batch to batch, putting those who drink the tea at increased risk of accidental overdose or other health consequences.

Other signatories of the petition include Linda Golden of South Carolina and Jeffery Folds of Georgia, the mother and cousin of Todd Shirley, who died at age 48 in 2019 because of poppy seed tea overdose; and Bob and Lori Morales, and Kristen Harris, all of Nevada, the parents, and wife of Kendall Harris, who died at age 38 because of overdose from unwashed poppy seeds purchased on Amazon. Paul Lancia of St. Louis, MO, joined the petition after his wife suffered multiple strokes which her doctor suspected were caused by heavy poppy seed tea consumption.

Some signatories to the petition were shocked to find they tested positive for drugs after unwittingly consuming contaminated poppy seeds. Neither Elizabeth Dominguez of Tonawanda, NY, nor Jamie Silakowski of Depew, NY, used any opioids during their pregnancy, but both tested positive after eating baked goods with poppy seeds.

“I’m devastated that a simple poppy seed bagel could cause this much distress,” said Dominguez, who tested positive for opioids during routine drug testing given to mothers prior to delivery in some hospitals. She was temporarily separated from her newborn and visited at home multiple times by Child Protective Services because of the test triggered by poppy seeds.

The petition was also joined by Dr. Irving Haber, a pain medicine specialist, and Dr. Madeleine Swortwood, a researcher at Sam Houston State University, who have published studies documenting the risks of poppy seed tea.

The petition follows the publication this past month of a study co-authored by CSPI scientists in Clinical Toxicology showing that adverse events from the consumption of opiate-contaminated poppy seeds may be on the rise. Medical and government publications have documented more than 600 reported adverse events including 20 overdoses and 19 total fatalities attributed to poppy in the U.S., with most fatalities have occurred since 2015.

CSPI previously called on the FDA and the Drug Enforcement Agency to address the risks of contaminated poppy seeds in April of 2019. In December 2019, the DEA clarified that selling opiate-contaminated poppy seeds can be illegal under the Controlled Substances Act.

The Center for Science in the Public Interest is a nonprofit  food and health organization that serves as a watchdog group for public interests.

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In a letter to the country’s top medical official, the Center for Science in the Public Interest asked U.S. Surgeon General Jerome Adams to issue an advisory warning people of the dangers of contaminated, unwashed poppy seeds and poppy seed pods.

Opium and other chemicals in the unwashed seeds and seed pods have caused numerous deaths and serious overdoses, some of which caused permanent brain damage, according to the letter from leaders for the Center for Science in the Public Interest (CSPI). The poppy seeds and seed pods are sold as so-called natural food, usually intended to be eaten or brewed into tea.

Online sales of the seeds and seed pods are of particular concern, according to the letter signed by CSPI leaders Peter Lurie, president, Laura MacCleery policy director, and Sarah Sorscher, deputy director of regulatory affairs. They say the products are easily obtained from websites such as amazon.com and ebay.com. They also told the surgeon general that other websites offer “recipes” for brewing tea that concentrate the opium from pounds of the seeds or pods into relatively small amounts of liquid.

Some websites and blogs also offer tips on how to determine which unwashed poppy seeds and pods to buy to obtain the highest concentrations of morphine, codeine, thebaine, and other opiate alkaloids, according to the CSPI letter.

The group sent a similar letter to the Food and Drug Administration’s leadership in April. In Monday’s letter to Surgeon General Adams, the CSPI leadership repeated several points included in the letter to the FDA. 

“Typically, the fact that the seeds may be contaminated with opiates is not clearly indicated in the labeling or advertising materials, and users seeking contaminated seeds instead utilize coded language in product reviews, sometimes offered on third-party blogs, to signal which seeds are most likely to contain high concentrations of opiates,” the CSPI told the surgeon general. 

“The contaminated seeds thus remain widely available, including through the online shopping platform Amazon.com, despite the fact that the retailer has been informed multiple times of the risks of these products, including on April 25, 2018, by Sen. Tom Cotton, on July 13, 2018, by Arkansas Attorney General Leslie Rutledge, and most recently on Feb. 27 in a letter sent by the family of a victim who died from poppy seeds purchased on the platform.”

Some people who have opioid use disorder use these products as substitutes for other opioids, according to the CSPI letter and statements from the FDA and U.S. Drug Enforcement Agency. Other people have begun using the products believing they were harmless natural herbal remedies, not fully realizing the potential for dependence and abuse.

The CSPI letter to the surgeon general included a chart with information about people who have suffered severe consequences of using unwashed poppy seeds and or pods. The letter also provided history and international context for regulating such products.

“The opium poppy, Papaver somniferum, naturally produces opiate alkaloids, including morphine, codeine, and thebaine, which are concentrated in the seed pod and milky sap of the plant. The opiates found in the Papaver somniferum plant are highly addictive, leading the Drug Enforcement Administration (DEA) of the U.S. Department of Justice (DOJ) to list ‘poppy straw,’ which is defined as parts of the poppy plant other than the seeds, as a controlled substance under Schedule II of the Controlled Substances Act (CSA). As a result of this listing, and under the provisions of several international agreements, Papaver somniferum cannot be legally cultivated in the United States, and therefore raw materials must be imported to produce opioids for pharmaceutical use as well as poppy seeds sold as foods. . . 

“Poppy seeds may become contaminated with poppy straw and sap in the fields or during harvest, necessitating washing and processing to remove the alkaloids. 

“The European Commission has developed guidance on good practices to prevent and reduce the presence of opium alkaloids in poppy seeds and poppy seed products. These practices begin with selecting seeds from varieties cultivated for food use, which are bred to contain a low level of opium alkaloids. Appropriate processing can be highly effective; the combination of washing and drying can reduce morphine concentrations in highly contaminated batches of raw poppy seeds (original concentrations vary from 50 to 220 mg morphine/kg) down to concentrations below 4 mg morphine/kg without loss of quality and organoleptic properties.

“The United Kingdom has issued guidance setting a target level of 10 mg morphine/kg for the presence in poppy seeds placed on the market destined for the final consumer. . . 

“One research team at Sam Houston State University recently analyzed samples of poppy seeds purchased online and found that morphine concentrations in some samples were high enough to yield 2788 mg of morphine from 1 kilogram (2.2 lbs) of seeds, in addition to codeine and thebaine. 

“Assuming a batch of seeds with up to 2788 mg/kg of morphine, brewing 0.44 lbs. of seeds per the Mercola recipe instructions could produce up to 557 mg morphine, and 3 lbs of seeds (the maximum suggested by Chewworld.com) could yield up to 3801 mg of morphine. These amounts are well above the dose of 50 morphine mg equivalents per day demonstrated to increase the risk of overdose among patients prescribed morphine for pain treatment.

The CPSI’s letter includes links to source material documenting numerous cases of overdose, dependence, and death, “and these cases appear to be more common over time.” CSPI has identified 5 cases of non-fatal overdose, 7 cases of opioid dependence, and 13 confirmed deaths associated with the use of poppy seeds or seed pods from the medical literature, a 2010 DOJ Drug Alert, and case reports in the FDA Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS) database.

“All but four of these 25 cases involved men — 84 percent — and the median age was 26 years (with a range of) 6 weeks-82 years; age was unavailable for six cases,” the letter states. “Typically, the product was administered as a tea, usually made from about 1-2 pounds of poppy seeds, but occasionally from the poppy pod. Eighteen of the cases took place in the United States, including all 13 deaths. 

“. . . Based on our review, the problem appears to be worsening in recent years.”

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The Center for Science in the Public Interest (CSPI), on Wednesday, called on the Food and Drug Administration (FDA) and the Drug Enforcement Administration (DEA) to crack down on the sale of contaminated poppy seeds and seed pods in the wake of at least 12 American deaths.

CSPI asked officials at the agencies to jointly clarify that it is illegal to import and distribute contaminated poppy seeds and that those who do are subject to federal prosecution. At the same time, Senator Tom Cotton (R-AR) said he intends to introduce new legislation, the Stephen Hacala Poppy Seed Safety Act, to amend the law to ensure that contaminated poppy seeds may not be sold to consumers.

Opiates such as morphine and codeine occur naturally in the opium poppy, which is why its cultivation is prohibited in the United States. The DEA lists “poppy straw”—all parts of the poppy plant other than the seeds—as a Schedule II controlled substance.

While the sale and importation of poppy seeds are legal, seeds can become contaminated by poppy straw and sap in the fields and during processing.

Importation of contaminated poppy seeds is illegal. Opiate contamination can be brought down to safe levels by washing and drying the seeds. Nevertheless, potentially contaminated poppy seeds are widely available at several online retailers, including Amazon and eBay. Recipes for poppy seed “teas” abound on web sites such as Mercola.com and Chewworld.com.

“Poppy seed teas are responsible for numerous cases of addiction, overdose, and death,” said CSPI president Dr. Peter G. Lurie. “This little-known aspect of the opioid epidemic does appear to be worsening in terms of its toll. The FDA and the Department of Justice are aware of the problem but have failed to exercise their authorities fully.”

Stephen P. Hacala, a 24-year-old Arkansas man, died after drinking tea made from contaminated poppy seeds purchased on Amazon.com in 2016, prompting Arkansas Attorney General Leslie Rutledge (R) to contact the FDA and prompting Senator Cotton to ask then-Attorney General Jeff Sessions and DEA Acting Administrator Uttam Dhillon to stop the products’ sale. Hacala’s parents, Steve and Betty Hacala, are in Washington today meeting officials at FDA for the second time.

“Our family is still in shock over the death of our son Stephen from consuming morphine-laced poppy seeds,” said Betty Hacala. “We have been working tirelessly since his death to raise awareness and drive change so that other families don’t have to suffer as we have. We implore the FDA and DEA to act now.”

Mr. Hacala’s death is among at least 12 deaths from poppy tea reported in the United States since 2010. Ten of these deaths, including Mr. Hacala’s, were published in the medical literature, a 2010 Department of Justice Alert, or the FDA’s adverse event reporting database.

Two new deaths occurred within the past few months: In December, a 44-year-old Utah woman passed away with poppy seeds ordered online found at the scene. And just last month a 46-year-old man died after brewing a concoction of poppy seeds and concentrated lemon juice. Shipping packages and phone records showed that he had ordered several bags of poppy seeds online.

“Stephen Hacala Jr. died from an opioid overdose because of a dangerous gap in our nation’s drug laws,” said Senator Cotton. “Despite government warnings, unwashed poppy seeds, which can contain lethal doses of morphine, are still available for sale online. As our country continues to fight the opioid crisis, it’s time to end sales of unwashed seeds so that no other families experience the pain the Hacala family has endured.”

Besides asking the FDA and DOJ to jointly clarify to industry and retailers that unwashed poppy seeds are illegal, CSPI is urging the FDA and DEA to conduct random sampling and testing of poppy seeds offered for sale by online retailers and at border posts, and to prioritize inspections of poppy seed distributors. CSPI is also asking the FDA to issue guidance to industry advising of good manufacturing practices to reduce opiate contamination in poppy seeds

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A man who has been seeking changes to U.S. law since his son died from morphine intoxication in 2016 expects to see bills filed in April. His son wasn’t using drugs. It was unwashed poppy seeds, bought on Amazon.com and brewed as tea, that killed him.

The draft legislation expected to be introduced in the U.S. House of Representatives and Senate in early April. It would establish the definition of unwashed poppy seeds as “poppy seeds that have not been processed to adequately remove poppy straw, latex, or other contaminants that may contribute to levels of morphine, codeine, or other compounds that pose a potential risk to health.”   

If approved by Congress and signed into law by the president, the Act will make unwashed poppy seeds an adulterant, meaning it would be illegal to sell them or any foods or beverages that contain them.

Steve Hacala is pleased about the movement on Capitol Hill. He was similarly pleased when Walmart pulled unwashed poppy seeds from it’s shelves after his son’s death. He’s not pleased that online entities such as Amazon continue to sell various brands of unwashed poppy seeds. The seeds’ labels make a variety unfounded claims about health benefits.

Investigators determined those labeling claims were behind the death of Stephen Patrick Hacala Jr.  

“Law enforcement authorities were confounded by the cause of death. There was no evidence of trauma and no evidence of drugs in Stephen’s apartment. The presence, however, of a partially used five-pound bag of poppy seeds and a water bottle containing some of the wet seeds raised suspicion,” according to a letter U.S. Sen. Tom Cotton sent to FDA Commissioner Scott Gottlieb in Aug. 2018.

“Upon further review and research of Stephen’s Amazon.com purchases of poppy seeds, it was later determined that the unwashed poppy seeds killed Stephen. Stephen had purchased the seeds in order to make so-called poppy seed tea, presumably to achieve the calming effect that Amazon.com online reviews explain to online consumers. An autopsy revealed that Stephen in fact died from morphine intoxication.” 

The timing of the action in the U.S. capital coincidently comes as French officials are warning the public there to not consume baguettes and ready-made sandwiches made with poppy seed bread.  

The officials issued the alert after employees at French companies tested positive for opiates. The workers were adamant that they hadn’t taken any drugs, according to news reports. Tests confirmed poppy seeds in bread they had eaten contained particularly high amounts of alkaloids. 

The road to the rule of law

In April 2018 the elder Hacala and his wife Betty traveled to Washington D.C. to meet with FDA officials. The couple urged the officials to crackdown on poppy seed sales. 

In July 2018 Arkansas Attorney General Leslie Rutledge wrote to executives of several online sales operations, including Amazon’s Jeff Bezos, urging them to remove unwashed poppy seeds from their offerings. As of March 15 this year, unwashed poppy seeds continue to be available on Amazon and other websites. 

In August 2018 Rutledge wrote to the commissioner of the Food and Drug Administration asking that the agency adopt regulations requiring poppy seeds to be labeled according to their “potentially harmful contents and to prohibit the sale of poppy seeds that contain controlled substances.”

“Poppy seeds are sometimes used as an ingredient in baking products in the United States. Washed and prepared in the proper way, they are appropriate for consumption,” Rutledge said in the letter to FDA Commissioner Scott Gottlieb.

“If sold ‘unwashed,’ however, the seeds have the potential to cause unexpected intoxication, illness, and death. This is because the opium poppy plant contains a latex at the point where poppy seeds are extracted. This latex also contains morphine, codeine, and thebaine — all deadly controlled substances. When prepared for consumption, poppy seeds are washed and processed in order to remove trace amounts of these substances from the seeds. But in the unwashed, natural, or raw state, the poppy seeds are dangerous.”

The variable toxicity of unwashed poppy seeds combined with the internet have made for a dangerous situation for consumers around the world, Bill Marler said. One pot of tea made from the seeds might not have any negative effect, but the next one could kill you.

“Amazon is still selling this stuff. Essentially a Schedule 1 drug is being sold over the counter,” said Marler, who has specialized in representing victims of food poisoning since the deadly 1993 E. coli outbreak traced to Jack in the Box hamburgers.

Editor’s note: Seattle attorney Bill Marler is a founding member of Marler Clark LLP and publisher of Food Safety News.

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The number of food recalls in Australia has gone up while several food safety projects and regulations are being worked on, according to FSANZ’s annual report.

Food Standards Australia New Zealand (FSANZ) published 93 food recalls in 2022–23, up from 79 in 2021–22 and above the 10-year average of 79. The most significant portion was attributed to undeclared allergens and microbial issues. A total of 79 post-recall reports were received.

The agency coordinated national responses to food incidents related to thebaine toxicity linked to poppy seeds and toxic weed contamination in spinach.

In late 2022, almost 40 illnesses were reported nationwide in people who consumed poppy seeds. The problem was seeds not intended for food use and containing high levels of thebaine, a naturally occurring plant chemical, had entered the supply chain. Nearly 200 people fell sick after eating a brand of spinach contaminated with a weed called thornapple. The scientific name is Datura stramonium, also known as jimsonweed.

Sampling surveys
In 2022–23, FSANZ reported 25 events to the International Food Safety Authorities Network (INFOSAN), including recalls of products imported into Australia and exported to other countries. These included curry powder, enoki mushrooms, and tahini recalled because of microbial contamination.

FSANZ reported 16 incidents to states and territories following the European Commission’s Rapid Alert System for Food and Feed (RASFF) notifications. They included unauthorized substances, foreign material in foods and biotoxin contamination.

FSANZ is involved in a national survey investigating the prevalence and levels of Listeria in enoki mushrooms. Food sampling was undertaken from April to June 2023 in all states and territories where the product is available. Results are expected by early 2024.

Other work includes heavy metals and patulin in apple juice and other apple products, antimicrobial-resistant bacteria in food, and pyrrolizidine alkaloids in 60 honeys and teas/herbal infusions.

In June 2022, FSANZ organized a training exercise to test the effectiveness of a protocol in responding to an intentional tampering incident. Participants included representatives from food enforcement agencies, industry, and police.

Food law changes
From 2022 to 2023, FSANZ received applications for two new foods not previously assessed – one for a genetically modified whole fruit and another for a cell-based food. FSANZ is assessing an application from Vow Group Pty to allow cultured quail as a novel food ingredient. A call for public comment is expected in 2023 or 2024.

Businesses in the food service sector will need to implement two or three food safety management tools beginning in December 2023 based on their food handling activities. Work is also progressing on a standard for egg food safety and primary production requirements. A public comment period is set for late 2023.

FSANZ established the Science and Food Safety Dialogue to build government collaboration among food safety and risk assessment agencies in the Asia-Pacific region. The first meeting was held in April 2023 in Singapore. Australia also attended the International Heads of Food Agencies Forum (IHFAF) meeting in Ireland. IHFAF has 16 country members, including Codex, the FAO, and WHO.

Emerging issues considered by FSANZ included the use of recycled packaging, cell-based meat, and Listeria in enoki mushrooms.

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The number of food safety incidents involving a global network declined in the final quarter of 2022 according to a new report.

The International Food Safety Authorities Network (INFOSAN) was part of 47 alerts from October through December compared to 58 in the third quarter of 2022.

In the whole year, the network was involved in 198 incidents. This is down from 248 events in 2021 but up compared to 127 in 2020 and 84 in 2019.

Thirty incidents in the fourth quarter of 2022 involved a biological hazard with Salmonella behind a dozen cases.

Listeria monocytogenes were mentioned in six events, Clostridium botulinum in three and E. coli and Yersinia enterocolitica in two. Hepatitis A, Cronobacter, Norovirus, Shigella, and Staphylococcus were all responsible for one incident.

Information on hazard type
Seven featured a chemical hazard such as lead, methyl alcohol, histamine, or thebaine. Thebaine is a natural chemical in poppy seeds that can be toxic in high concentrations. It was linked to at least 40 illnesses in Australia in people who drank poppy seed tea.

Five were caused by physical hazards like glass, metal, and plastic, and only three were due to an undeclared allergen or ingredient.

INFOSAN is managed by the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) of the United Nations.

Food categories most commonly involved were meat and meat products; vegetables and vegetable products; composite food; food for infants and small children; and milk and dairy products.

Snacks, desserts, and other foods; fish and other seafood; alcoholic beverages; fruit and fruit products; herbs, spices, and condiments; non-alcoholic drinks; and nuts and oilseeds also caused a few incidents.

Overall, 60 percent of incidents were reported to INFOSAN by network members, 15 percent through the European Commission’s Rapid Alert System for Food and Feed (RASFF), and 25 percent via various WHO channels.

INFOSAN involved in Salmonella outbreak
A major outbreak of Salmonella with almost 200 cases linked to ready-to-eat chicken products was highlighted.

The Salmonella Mbandaka outbreak has sickened 196 people in nine countries. Nineteen people have been hospitalized, five had septicemia and one person died in the United Kingdom. Finland has the most infections with 89 followed by the UK with 81.

 In late December 2022, a meeting was organized involving INFOSAN colleagues in the UK and Israel and European Centre for Disease Prevention and Control (ECDC) officials. The meeting exchanged information on the outbreak situation and food chain investigations in the concerned countries.

Epidemiological data and microbiological evidence from whole genome sequencing of human isolates indicate there could be several active sources through different food distribution chains, with a common source higher up in the chicken supply chain.

Regional INFOSAN events were also held in Asia Pacific and the Americas.

In December in Asia, INFOSAN members from 10 countries received updates about activities to develop the network in the region during 2022; shared their feedback on obstacles and barriers to active participation in the network, and discussed methods to strengthen food safety emergency response in their country and at the regional level.

In November, INFOSAN members from the Americas met in Brazil. The event was held alongside the annual meeting of the PulseNet Latin America and the Caribbean Network, a group for regional surveillance of foodborne diseases through molecular subtyping.

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— OPINION —

Will 2022 be remembered as the year of Salmonella in chocolate or Cronobacter in infant formula? Or did something else grab and keep your attention in the past 12 months?

Sometimes it feels as if all I’ve been writing about since 2020 is coronavirus, the United Kingdom leaving the European Union, and ethylene oxide contamination. While this isn’t the case, these three subjects did feature again on the 2022 news agenda, so we’ll address them first.

Major outbreaks of Listeria in Italy and E. coli in the UK, Salmonella Mbandaka in several countries, and Hepatitis A in New Zealand surfaced while the Salmonella tahini/halva incident rumbled on.  

This year also threw up some different topics as well as outbreaks and recalls. We had drugs in champagne, pet food contamination, bird flu, poppy seed poisonings, and poisoned alcohol.

  • Coronavirus and food outbreak and illness statistics

As predicted last year, in most countries outbreaks and illness reports went up in 2021 from 2020 but are still below levels pre-COVID-19 pandemic. This is backed up by the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC) report on outbreaks and illnesses in 2021. The virus hasn’t gone away but restrictions have eased so it is likely levels will go up again when we see 2022 figures and we may get back to pre-pandemic numbers.

  • UK leaving the EU

It was six years ago when the UK decided to exit the EU in a referendum. We’ve heard plenty about lost access to the Rapid Alert System for Food and Feed (RASFF) portal and networks such as the Heads of Food Safety Agencies. But Brexit keeps throwing up new issues. Whether it is the Northern Ireland protocol, delays to border controls, an impact on resources — highlighted by the Food Standards Agency and Food Standards Scotland recently — or The Retained EU Law Bill that aims to remove EU laws from UK legislation by 2023, although this date can be extended until 2026. Initial analysis by the FSA shows it intends to advise ministers to either preserve, extend or restate the majority of the rules it deals with.

  • Ethylene oxide incident

As a quick refresher, Belgium raised the alert in September 2020 concerning sesame seeds from India. It was later found in additives including locust bean gum. The use of ethylene oxide to disinfect foodstuffs is not permitted in Europe. National authorities have taken different approaches including recalls and withdrawals. The European Union has tightened rules several times to tackle the problem. The incident appears to be winding down with the removal of related pages on the EU Commission’s website but RASFF notifications continue. It was the biggest food recall operation in EU history, according to the Alert and Cooperation Network (ACN) report.

  • Large French E. coli outbreak

Frozen pizzas were behind the largest E. coli-HUS outbreak ever seen in France. Nestlé has recently been allowed to restart operations at the Buitoni plant in Caudry after production was stopped in April. Overall, 56 confirmed and two probable cases with a median age of 6 fell sick between mid-January and April. There were 50 cases of kidney failure known as Hemolytic Uremic Syndrome (HUS) and two children died. Most illnesses were Shiga toxin-producing E. coli (STEC) O26:H11 but a couple of O103:H2 infections were recorded. In France, STEC surveillance is based only on HUS in children younger than 15, so it is likely many more people were sick. Outbreak strains were isolated from pizzas sampled in patients’ homes and at the manufacturing plant. E. coli was also found in the flour used to make pizzas. Criminal and civil proceedings are ongoing.

  • Salmonella in chocolate

Salmonella in confectionery has been a major theme this year. We start with the monophasic Salmonella Typhimurium outbreak from Kinder chocolate made by Ferrero in Belgium that sickened 450 people in multiple countries. Children were particularly affected and many were hospitalized. People fell sick between December 2021 and June 2022. There were four cases in Canada and one in the United States. The Arlon facility was given the all-clear in September after being shut in April. An investigation by the Luxembourg Public Prosecutor’s Office is ongoing.

In Israel, Strauss Group issued a product recall and closed a factory in April due to Salmonella. The plant in Nof Hagalil restarted in August. Elite products were recalled from the United States, Australia, Europe, and the UK with related illnesses reported in Israel. Estimated costs are around $90 million.

Barry Callebaut also felt the impact of Salmonella contamination despite implicated chocolate not entering the retail chain. The cost was $77 million, according to the company’s financial results. The Wieze factory in Belgium paused operations after Salmonella Tennessee was detected in lecithin from a supplier in Hungary in June.

While on the subject of lecithin, it is also worth mentioning an issue with soya lecithin from India because of potential peanut contamination. The problem was raised by Germany via a RASFF alert in April and affected 60 countries including the United States. It was believed to have been caused by cross-contamination during processing. Soybean lecithin is used in a range of foods, such as chocolate, cheese, margarine, and salad dressing.

  • Cronobacter in infant formula

The main Cronobacter in the infant formula story is from the United States and involves Abbott Nutrition’s Sturgis, MI, plant. Four infants were infected with Cronobacter and two died. Abbott says there is no conclusive evidence that the illnesses were connected to its product.

In Europe, a brand of infant formula was recalled in November in Slovakia and the Czech Republic because of Cronobacter. The affected goat’s milk formula was made by Goldim.

Cronobacter was also detected in another formula from a different producer in the Czech Republic and sent to Moldova. Numil initial infant milk formula made by Corinos House was recalled in June.

Earlier in 2022, a batch of KetoCal 3:1 was positive for Cronobacter after sampling by Australian customs officials. Nutricia, which is owned by Danone, said the affected batch was made in Europe and was negative before leaving the production plant.

We also found out about an outbreak of Cronobacter sakazakii involving four babies and one death at a hospital in Germany in 2021. It was due to the hospital-mixed probiotic infant formula. 

  • MDMA in champagne

In early 2022, a warning about champagne contaminated with ecstasy in Europe was issued by authorities. Eight people fell sick in February in Germany and one died. There were also four illnesses in the Netherlands. Bottles of Moët and Chandon Ice Imperial were emptied of champagne, and the corks changed and filled with pure liquid MDMA, also known as ecstasy. An investigation involved Europol and agencies in France, Italy, Belgium, Germany, and the Netherlands.

  • Monoethylene glycol is back in the news

While there were developments in the Cervejaria Backer brewery contamination case of 2020 in Brazil linked to 10 deaths — including fines and the firm being given the approval to restart beer sales — mono ethylene glycol hit the headlines for other reasons.

The toxic substance was used instead of propylene glycol, a permitted additive, in pet food. Six companies that produced dog food were involved: Bassar Pet Food, Peppy Pet, Upper Dog, Petitos, Pets Mellon, and FVO Alimentos. Five suppliers were listed by Brazilian authorities: Tecnoclean Industrial, A, and D Quimica, Atias Quimica, Bella Donna, and Saber Quimica. Local media reported that at least 15 dogs died.

  • Food safety strategies

The World Health Organization (WHO) launched its food safety strategy for 2022 to 2030. One target is a 40 percent reduction by 2030 in the global average of foodborne diarrheal disease incidence. The first progress report will be in 2024 at the World Health Assembly.

In early December, the Council of FAO endorsed the strategic priorities for food safety within the FAO Strategic Framework for 2022 to 2031. FAO hopes it will spur investments and secure human and financial resources for the agency to implement its food safety program and to provide international guidance, policy, and advocacy for policymakers.

Work has also started to update estimates on the burden of foodborne diseases published in 2015. The Foodborne Disease Burden Epidemiology Reference Group (FERG) has issued a few calls for help with systematic reviews and other studies. A new report is planned for 2025.

  • Other highlights

There are many topics around food safety that I feel don’t get enough column inches — such as heavy metals, mycotoxins, and pesticide residues, and those that are only mentioned occasionally like wild mushroom poisonings, foodborne parasites, and allergens. One issue, in particular, cropped up several times this year — tainted alcohol. It was responsible for illnesses and deaths in India, Peru, Ecuador, Colombia, Uganda, Vietnam, and Turkiye. If food safety is “Everyone’s Responsibility,” as we are often told, then we have a lot of things to be getting on with in 2023.

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Drew’s Organics LLC of Chester, VT, is recalling one lot code of Aldi Simply Nature Organic Poppy Seed Dressing because of a processing issue that could allow for microbial growth.

The recall was initiated after Drew’s Organics observed a color difference in the Simply Nature Organic Poppy Seed Dressing after manufacturing. Investigation revealed out-of-specification pH with the potential for microbial growth, including Clostridium botulinum.

There is concern that consumers may have the dressing in their homes because of the long shelf life. Some of the product does not expire until 2023.

The recalled product was been distributed to select Aldi stores between Aug. 20 and Sept. 10 in the following states: Alabama, Arizona, California, Connecticut, Delaware, Georgia, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Michigan, Minnesota, Mississippi, North Dakota, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Virginia, Vermont, Wisconsin and West Virginia.

Consumers can use the following information to determine whether they ave the recalled dressing in their homes:

  • The recalled product comes in 12 fluid ounce glass bottles.
  • It has a “Best if Used By” date of Feb. 15, 2023.
  • The UPC number is 4099100023169.  
  • The lot code is printed on the shoulder of the bottle above the label.

As of the posting of this recall, no illnesses related to this product have been reported. 

Consumers should discontinue use of this product and return it to their place of purchase for a full refund.

About botulism
While a variety of food poisoning can result from eating under-processed food, one of the most dangerous is botulism poisoning. Untreated, botulism can paralyze the muscles needed for breathing, resulting in sudden death.

Anyone who has eaten any recalled products and developed signs of botulism poisoning should immediately seek medical attention, according to the U.S. Centers for Disease Control and Prevention (CDC).

“In foodborne botulism, symptoms generally begin 18 to 36 hours after eating contaminated food. However, symptoms can begin as soon as 6 hours after or up to 10 days later,” according to the CDC website.

The symptoms of botulism may include some or all of the following: double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, difficulty breathing, a thick-feeling tongue, dry mouth, and muscle weakness. People with botulism poisoning may not show all of these symptoms at once.

These symptoms result from muscle paralysis caused by the toxin. If untreated, the disease may progress, and symptoms may worsen to cause paralysis of specific muscles, including those used in breathing and those in the arms, legs, and the body from the neck to the pelvis area. Many patients must be placed on ventilators to breath.

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Changing consumer behavior is driving many of the emerging issues in food safety, according to experts.

This factor was identified for half of the 13 issues discussed in 2019 by emerging risk specialists as part of work by the European Food Safety Authority (EFSA).

Potential issues were classed according to the hazard, with nine being microbiological and five chemical, or driver identified with six being due to new consumer trends and two because of new processor technology.

Of 17 potential issues debated, 13 were judged to be emerging topics. One was the identification of emerging food allergens as EU regulation on labeling does not apply to commercial airlines. The recommendation was that countries do education campaigns for public transport companies where food is served.

GBS and minimally processed foods
Others included human consumption of microplastics and nanoplastics in table salt; cannabidiol (CBD) and cannabidiol-containing products; foodborne invasive infections with Streptococcus agalactiae, also known as group B Streptococcus (GBS), hepatoxicity associated with food supplements containing turmeric and food safety risks linked to the trend of minimally processing.

An outbreak with Streptococcus agalactiae occurred in Singapore in 2015, affecting 238 people. Raw consumption of regional freshwater fish was identified as the source of infections. Since Europe imports fish from Southeast Asia and it is not always prepared well cooked, and because of raw fish consumption habits like sushi and ceviche, foodborne infections in Europe may also occur. Earlier this year, officials in Singapore said they were investigating an increase in GBS cases.

The Italian System for Phyto- and Nutri-Vigilance received 27 reports of hepatotoxicity associated with curcumin-containing supplements from December 2018 to June 2019. All but one were hospitalized with acute hepatitis. The age of cases ranged from 29 to 71 and 24 were female. EFSA and the Federal Office of Consumer Protection and Food Safety in Germany (BVL) are considering presenting at a workshop on emerging risks in food supplements.

For the minimally processed foods trend, sous vide cooking and reduced additives usage were discussed. Sous vide is where raw or par-cooked food is sealed in a vacuumed laminated plastic pouch or container, heat-treated by controlled cooking, rapidly cooled, and then reheated for service after chilled storage. Avoidance of additives, such as preservatives and antioxidants makes products more vulnerable to the development of pathogenic microorganisms during shelf life.

A trend towards light products with decreased fat content and with clean label considerations may present new levels of risk due to low concentration of preservatives. The demand for slow cooking at a lower temperature was also discussed.

The potential knock-on impact of reducing plastic
The report summarizes the activities of all groups involved in the emerging risk identification procedure and issues identified in 2019. EFSA’s contributing networks include the Emerging Risks Exchange Network (EREN), the Stakeholder Discussion Group on Emerging Risks, EFSA’s units, scientific panels, and the scientific committee and its working groups.

One area not classed as an emerging issue was the increased risk of foodborne illness due to proposed reductions and bans on food and beverage service packaging made with plastic. These items help prevent cross-contamination of food products, and a ban on, or reduced access to them, in the absence of changes in consumer practice, will lead to greater persistence and circulation of foodborne pathogens within the supply chain, and increased risks of illness in Europe, according to Serving Europe, which represents branded food and beverage service chains at EU level.

EFSA and member states said they would evaluate the issue and consider risk and benefit in future risk assessments.

Another 28 issues resulting from countries’ own horizon scanning were presented to EREN. Germany raised the topics of E. coli, Salmonella, and Listeria in raw wheat; tortillas linked to aflatoxin exposure in Guatemala and supplements vitamin C intake and increased risk of kidney stones.

France flagged unexpected tick-borne viruses in Europe; high opioids content in poppy seed and circulation of coronaviruses in wildlife in the country. Lychee intoxication linked to encephalitis was a concern for the World Health Organization as was foraged food in urban environments for EFSA.

Hungary brought attention to a number of issues including risks related to homemade rice milk and other plant-based milk; lab-grown and plant-based meat; Salmonella migration into the bloodstream; unsafe levels of radiation in Japanese processed food imports; Acinetobacter in raw meat and ecdysterone in spinach extract.

The Swiss Federal Food Safety and Veterinary Office (FSVO) has investigated using social media analysis as an early warning system for foodborne outbreaks. FSVO and the HumanTech Institute tested a platform that tracks food intoxication in Switzerland in real-time by analyzing posts on Twitter.

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A quarter of food products imported into the Czech Republic from a third country were non-compliant last year, according to a report.

Inspection results revealed the highest number of violations for foodstuffs imported from third countries at 25.1 percent and those made by producers in the European Union at 16.9 percent. Domestic production had the least violations at 13 percent.

Findings come from the Czech Agriculture and Food Inspection Authority’s (CAFIA) 2018 annual report.

It identified foodstuffs with over-the-limit pesticide residues, pesticides prohibited in Europe for several years and food supplements with harmful substances.

Martin Klanica, director-general of the agency, said trends seen in recent years continued.

“There are concrete facts indicting that in products imported from abroad, there is a considerably higher share of non-compliant batches than among foodstuffs originating in the Czech Republic. We had to take this fact into account in our long-term strategy and inspection panels for future periods. Unsafe or adulterated foodstuffs do not belong on the market, must not be tolerated and are a direct violation of consumers’ interests.”

Reasons for non-compliance

CAFIA made 43,401 visits to food business operators, public caterers, customs warehouses and Internet shops. The agency found 3,514 non-compliant lots of foodstuffs.

The most problematic items are chocolate and confectionery (53.9 percent), honey (46.3 percent), starch and starch products (45.5 percent), dehydrated products, liquid flavoring substances, dressings, salt and mustard (44.3 percent), other items including frozen foods (43.8 percent) and additives and aromas (37.5 percent).

Issues were found with a third of coffee, coffee substitutes, and teas, non-alcoholic drinks (31.6 percent) egg and egg products (30.3 percent), ice cream and frozen creams (29.5 percent), nuts (28.2 percent), natural sweeteners (25 percent), wine (23.9 percent), pasta (23.9 percent), processed vegetables and mushrooms (22.3 percent), edible fats and oils (21.7 percent) and food supplements (14 percent).

In 2018, checks for microbiological compliance were done on 5,741 batches of foodstuffs, meals, ice, and bottled water, of which 1,792 were checked in-situ and 3,949 through samples in laboratories. In-situ controls uncovered 146 batches unfit for human consumption and 116 non-compliant samples were found at the labs.

In the lab samples, Listeria monocytogenes was found in a hummus spread and potato salad. Salmonella spp. was detected in meat products, fresh chicken, confectionery, ready-made salad, and a vegetable salad meal. Shiga toxin-producing E. coli was identified in mixed tartare steak.

Most batches found to be unsafe were meat products, dairy, and fresh vegetables. The top cause was the growth of visible mold and spoilage due to microbial activity.

Checks for inorganic substances on 4,449 food batches revealed 161 were non-compliant. Above-threshold amounts of pesticide residue were found in 35 of 1,194 batches of packaged water, teas, fruit, poppy seeds and vegetables. Five of 453 analyzed batches were non-compliant for ochratoxin A and Aflatoxin B1.

The maximum quantity of cadmium was exceeded in a celery sample and the level permitted of calcium and metallic magnesium was too high in a food supplement.

Regulatory action

In 2018, CAFIA received 3,929 complaints, which was 698 less than in 2017. A total of 3,687 batches of food products were inspected on the basis of complaints and 847 were non-compliant.

Last year, CAFIA imposed 12,397 bans for an amount of Czech Koruna 53,625,509 ($2.33 million). Foodstuffs on which a ban was set most frequently included dairy and meat products. The greatest monetary volume was imposed on wine and fresh fruits. Last year saw the conclusion of 2,216 administrative proceedings with food businesses, in which fines were imposed for a total of CZK 100,594,000 ($4.37 million).

During 2018, 67 public catering facilities were closed due to unacceptable hygiene conditions.

CAFIA considers findings of adulterated foodstuffs such as meat or fish with low meat content, ketchup with low tomato content, or wine with water content or adulterated origin, to be severe deficiencies.

In five samples of kebabs, where it was declared on the menu or during the order that they were made of beef or veal, presence of undeclared turkey or chicken was detected. Only two of seven samples were compliant. Adulterated production of wine was identified in four cases.

Out of 81 sampled honey batches, 40 were non-compliant; 16 batches stated the Czech Republic as the origin but five of these batches contained honey from non-existent companies.

Last year, 441 notifications were sent through the Administrative Assistance and Cooperation System (AACS) which deals with food fraud and 30 cases were for the Czech Republic.

A total of 2,811 notifications were distributed through RASFF made up of 191 original notifications concerning the Czech Republic and 2,620 additional information notices. The Czech Republic sent 47 original notifications.

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