Hanbit Enterprises, Inc. dba Jack and the Beanstalk is recalling Soybean Sprouts in 1lb, 1.5lb, 10 lb, and Natto plastic bags distributed up to and including February 12, 2015 with Best if Used by dates up to February 19, 2015, because they have the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer long-­‐term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeriainfection can cause miscarriages and stillbirths among pregnant women.

The soybean sprouts were distributed to Bay Area stores and restaurants.

1LB SOYBEAN SPROUT BAR CODE – 7-27580-12366-9
1.5LB SOYBEAN SPROUT BAR CODE – 7-27580-12365-2
10LB SOYBEAN SPROUT BAR CODE – 7-27580-12351-5
NATTO SOYBEAN SPROUT BAR CODE – 7-27580-12367-6

No illnesses that have been reported to date.

The recall was the result of a routine sampling program by the FDA which revealed that the finished products contained the Listeria bacteria. The company has ceased the production and distribution of the product as FDA and the company continues their investigation as to what caused the problem.

Two Deaths confirmed.

The Minnesota Departments of Health and Agriculture are working with the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration on a multi-state outbreak of listeriosis linked to eating caramel apples.

Four people in Minnesota have become ill as part of this outbreak. All were adults ages 59 to 90 years. They became ill in late October and November. All were hospitalized and two died.

Health officials are warning consumers who may have purchased any pre-packaged, commercially-produced caramel apples, including caramel apples with other toppings such as nuts, chocolate, and sprinkles, to not eat them until more information from the investigation becomes available.

Minnesota cases purchased caramel apples from Cub Foods, Kwik Trip, and Mike’s Discount Foods, which carried Carnival brand and Kitchen Cravings brand caramel apples. These two brands are no longer available for purchase at retail locations; however, health officials are concerned that persons who purchased them may still have them in their homes. The investigation is evolving, and other caramel apple brands and locations may also be impacted. Minnesota officials are working with national partners to determine the scope of products impacted. Consumers should not eat any brands of commercially-produced pre-packaged caramel apples until additional information is available. At this time, no illnesses related to this outbreak have been linked to apples that are not caramel-coated and not pre-packaged.

Listeriosis is a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes. The disease affects primarily older adults, pregnant women, newborns, and persons with weakened immune systems. On average, seven cases of listeriosis are reported in Minnesota each year. Symptoms of listeriosis include fever, muscle aches, headache, stiff neck, confusion, loss of balance, and convulsions. Infected pregnant women may experience only a mild, flu-like illness; however, infections during pregnancy can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn. Symptoms begin from 3 to 70 days after consuming the bacteria.

Anyone who believes they may have become ill with listeriosis should contact their health care provider.

Oasis Brands Inc. of Miami, FL, has recalled 12-oz. packages of Cuajada en Hoja (fresh curd) with Best-By dates of 10/01/14-10/08/14 and 10/18/14 because it has the potential to be contaminated with Listeria monocytogenes. The recalled product was distributed in South Florida through retail stores.

The recalled product comes in plastic bags and is labeled Cuajada en Hoja 12-oz., Brand Lacteos Sta. Martha, Fresh Curd, Best by 10-01-14-10/08/14 and 10/18/14.

No illnesses have been reported to date.

The recall is the result of sampling by the U.S. Food and Drug Administration (FDA). The company has ceased production and distribution of the product as FDA and the company continue their investigation into what caused the problem.

Fresh Express Incorporated has issued a recall of a limited number of cases of 10 oz. and 6oz. Italian Salad with the already expired Use-by Date of March 26 and a Product Code of H071A11A due to a possible health risk from Listeria monocytogenes. No illnesses have been reported in association with the recall and no other Fresh Express products are being recalled.

The company is confirming with retailers that the expired product has already been removed from store shelves and inventories in accordance with its strict procedures for products that have reached their expiration date.

Only Fresh Express Italian Salad with the specific Product Code of H071A11A and March 26 Use-by Date is included in the recall. Consumers who have the recalled product should not eat it but rather discard it. Consumers with questions may call Fresh Express at (800) 242-5472 during the hours of 8 a.m. to 7 p.m. EDT.

Listeria monocytogenes is an organism that can cause foodborne illness in a person who eats a food item contaminated with it. Symptoms of infection may include fever, muscle aches, gastrointestinal symptoms such as nausea or diarrhea. The illness primarily impacts pregnant women and adults with weakened immune systems. Most healthy adults and children rarely become seriously ill.

Although the product was already expired and no illnesses were reported, the company elected to issue a recall as a precaution when it learned a single sample in a random test had yielded a positive result for Listeria monocytogenes. Fresh Express is coordinating closely with regulatory officials.

The recalled salad was distributed in limited quantities to predominantly Eastern and Mid-Atlantic states.

Fresh Express Italian Salad being recalled displays a Use-by Date of March 26, 2014 with a Product Code of H071A11A in the upper right-hand side of the package.

BRAND PRODUCT NAME SIZE UPC Production Code Best If Used By Date POSSIBLE DISTRIBUTION STATES
Fresh Express Italian 10 oz. 0 71279-21100 8 H071A11A 26-Mar CT, DE, MA, MD, ME, NC, NH, NY, NJ, OH, PA, RI, VA, VT, WV, DC

Health officials in Pennsylvania are advising customers of Stump Acres Dairy in York County to discard any raw milk purchased from the dairy after a sample tested positive for Listeria monocytogenes, local news station WHPTV reports.

The Pennsylvania Department of Agriculture collected the sample on April 24 and confirmed the presence of the Listeria bacteria Thursday.

No illnesses have been reported. Symptoms of Listeria infection generally take three days to three weeks to appear.

In 2007, raw milk from Stump Acres caused a Salmonella outbreak that sickened 29 individuals, which prompted the agriculture department to revoke the dairy’s raw milk license. Pennsylvania state law allows for licensed dairies to sell raw milk, though Stump Acres has reportedly been operating without a license since the 2007 outbreak.

The Pennsylvania Department of Health is advising anyone who drank milk from Stump Acres and experiences symptoms of Listeria poisoning to contact a healthcare provider.

Dole Fresh Vegetables is voluntarily recalling a limited number of cases of Dole American Blend salad in 12 oz. bags, coded A275208A or B, with Use-by date of October 17 and UPC 7143000933, due to a possible health risk from Listeria monocytogenes. Dole Fresh Vegetables is coordinating closely with regulatory officials. No illnesses have been reported in association with the recall.

The product code and Use-by date are in the upper right-hand corner of the package; the UPC code is on the back of the package, below the barcode. The salads were distributed in 10 U.S. states (Illinois, Indiana, Maine, Missouri, New Jersey, New York, Ohio, Pennsylvania, Tennessee and Wisconsin).

No illnesses have been reported in association with the recall. This precautionary recall notification is being issued due to an isolated instance in which a sample of Dole American Blend salad yielded a positive result for Listeria monocytogenes in a random sample test conducted by the Tennessee Department of Agriculture.

Dole Fresh Vegetables customer service representatives are already contacting retailers and are in the process of confirming that the recalled product is being removed from the stream of commerce.

After the final update on December 8, investigators learned that a Listeria isolate that had been isolated from a sample of cut cantaloupe from a patient’s home during the outbreak investigation had a PFGE pattern combination that was different from the four known pattern combinations in the outbreak. A search of the PulseNet database for matching DNA fingerprint patterns from isolates collected during the outbreak time period identified one human matching isolate. The person from whom the Listeria was isolated reported eating cantaloupe before becoming ill; this case was added to the case count.

A total of 147 persons infected with any of the five outbreak-associated subtypes of Listeria monocytogenes were reported to CDC from 28 states. The number of infected persons identified in each state was as follows: Alabama (1), Arkansas (1), California (4), Colorado (40), Idaho (2), Illinois (4), Indiana (3), Iowa (1), Kansas (11), Louisiana (2), Maryland (1), Missouri (7), Montana (2), Nebraska (6), Nevada (1), New Mexico (15), New York (2), North Dakota (2), Oklahoma (12), Oregon (1), Pennsylvania (1), South Dakota (1), Texas (18), Utah (1), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (4).

Among persons for whom information was available, reported illness onset ranged from July 31, 2011 through October 27, 2011. Ages ranged from <1 to 96 years, with a median age of 78 years. Most ill persons were over 60 years old. Fifty-eight percent of ill persons were female. Among the 145 ill persons with available information on whether they were hospitalized, 143 (99%) were hospitalized. Thirty-three outbreak-associated deaths were reported: Colorado (9), Indiana (1), Kansas (3), Louisiana (2), Maryland (1), Missouri (3), Montana (1), Nebraska (1), New Mexico (5), New York (2), Oklahoma (1), Texas (2), and Wyoming (2). Among persons who died, ages ranged from 48 to 96 years, with a median age of 81 years. In addition, one woman pregnant at the time of illness had a miscarriage. Ten deaths not attributed to listeriosis occurred among persons who had been infected with an outbreak-associated subtype. State and local public health officials reviewed causes of death listed on death certificates to determine whether to attribute these deaths to listeriosis. Deaths included in this review occurred as recently as February 29, 2012.

Seven of the illnesses were related to a pregnancy; three were diagnosed in newborns and four were diagnosed in pregnant women. One miscarriage was reported.

Hunt K, Drummond N, Murphy M, Butler F, Buckley J, Jordan K. Ir Vet J. 2012 Jul 6;65(1):13.

During routine sampling of bulk raw milk on a dairy farm, the pathogenic bacteria Listeria monocytogenes was found to be a contaminant, at numbers < 100 cfu/ml. A strain with an indistinguishable pulsed-field gel electrophoresis pattern was isolated from the bulk milk two months later. Environmental swabs taken at the dairy environment were negative for the presence of L. monocytogenes, indicating a possible case of excretion of the L. monocytogenes directly into the milk. Milk samples were collected from the individual cows and analysed, resulting in the identification of L. monocytogenes excretion (at 280 cfu/ml) from one of the 4 mammary quarters of one dairy cow out of 180. When the infected cow was isolated from the herd, no L. monocytogenes was detected from the remaining herd. The pulsed-field gel electrophoresis pattern of the strain from the individual cow was indistinguishable from that originally isolated from the bulk milk. The infected cow did not show any clinical signs of disease, nor did the appearance of the milk have any physical abnormalities. Antibiotic treatment of the infected mammary quarter was found to be ineffective. This study shows that there can be risks associated with direct contamination of raw milk with L. monocytogenes.

Full Article

Bad Bug Book – Foodborne Pathogenic Microorganisms and Natural Toxins – Second Edition

1. Organism

Listeria monocytogenes (Listeria) is a foodborne disease-causing bacterium; the disease is called listeriosis. Listeria can invade the body through a normal and intact gastrointestinal tract. Once in the body, Listeria can travel through the blood stream but Listeria bacteria are often found inside cells. Listeria also produces toxins that damage cells. Image (c) Dennis Kunkel Microscopy, Inc.

Listeria monocytogenes is a Gram-positive, rod-shaped, facultative bacterium, motile by means of flagella, that is among the leading causes of death from foodborne illness. It has 13 serotypes, including 1/2a, 1/2b, 1/2c, 3a, 3b, 3c, 4a, 4ab, 4b, 4c, 4d, 4e, and 7. Among them, serotypes 1/2a, 1/2b, and 4b have been associated with the vast majority of foodborne infections.

[Image, right, (c) Dennis Kunkel Microscopy, Inc.]

L. monocytogenes is hardy; it is salt-tolerant and not only can survive in temperatures below 1°C, but also grow in these conditions, unlike many other pathogens. It is also notable for its persistence in food-manufacturing environments. The bacterium is ubiquitous in the environment and can be found in moist environments, soil, and decaying vegetation.

Of the five other species in the genkus Listeria – L. grayi, L. innocua. L. ivanovii, L. seeligeri and L. welshimeri – only L. ivanovii is considered pathogenic, and mainly in ruminants, rather than in humans.

2. Disease

• Mortality: Although not a leading
cause of foodborne illness, L.
monocytogenes is among the leading
causes of death from foodborne
illness. The severe form of the infection has a case-fatality rate ranging from 15% to 30%, overall. When listerial meningitis occurs, the overall case-fatality rate may be as high as 70%; from septicemia, 50%, overall; and in perinatal/neonatal infections, more than 80%.

• Infective dose: The infective dose of L. monocytogenes is undetermined, but is believed to vary with the strain and susceptibility of the host, and the food matrix involved also may affect the dose-response relationship. In cases associated with raw or inadequately pasteurized milk, for example, it is likely that fewer than 1,000 cells may cause disease in susceptible individuals. As noted, however, the infective dose may vary widely and depends on a variety of factors.

• Onset: Gastroenteritis caused by L. monocytogenes has a relatively short incubation period, from a few hours to 2 or 3 days. The severe, invasive form of the illness can have a very long incubation period, estimated to vary from 3 days to 3 months.

• Illness / complications: L. monocytogenes infection causes two forms of disease in humans: 
1) non-invasive gastrointestinal illness, which generally resolves in otherwise healthy people. 
2) the much more serious, invasive form of the illness, which may cause septicemia and meningitis. 
Manifestations of L. monocytogenes infection tend to be host-dependent. In people with intact immune systems, it may cause acute febrile gastroenteritis, the less severe form of the disease. In vulnerable populations, however, the more severe form of the disease may result in sepsis and spread to the nervous system, potentially causing meningitis. In elderly and immunocompromised people who develop the severe form, it usually manifests in this manner. 
Pregnant women, who are disproportionately infected with L. monocytogenes, may experience mild, flu-like symptoms; however, their offspring do not fare as well – they may abort or be stillborn, and those born alive may have bacteremia and meningitis. One- third of confirmed cases of maternal-fetal L. monocytogenes infections lead to abortion or stillbirth.

• Symptoms: Otherwise healthy people might have mild symptoms or no symptoms if infected with L. monocytogenes, while others may develop fever, muscle aches, nausea and vomiting, and, sometimes, diarrhea. When the more severe form of the infection develops and spreads to the nervous system, symptoms may include headache, stiff neck, confusion, loss of balance, and convulsions.

• Duration: The duration of symptoms generally depends on the health status of the infected person. The symptoms can last from days to several weeks.

• Route of entry: Oral.

• Pathway: The pathogenesis of L. monocytogenes is unique, because the organism is able to spread directly from cell to cell in the host, rather than having to “travel” interstitially to reach other cells. Once the bacterium enters the host’s monocytes, macrophages, or polymorphonuclear leukocytes, it can reproduce, and it is bloodborne. Groups of proteins on the L. monocytogenes cell surface enable it to survive in phagocytic cells and enhance its cell-to-cell spread. 
3. Frequency 
Based on a survey collected through 1997 by the Centers for Disease Control and Prevention (CDC), listeriosis was responsible for approximately 2,500 illnesses and 500 deaths in the United States annually. By 2008, the number of L. monocytogenes infections had declined 36 percent, compared to the period from 1996 to 1998. There was a moderate increase in the incidence of L. monocytogenes from 2008 to 2009; however, it was still lower than the incidence measured 10 years before that.

4. Sources

Many foods have been associated with L. monocytogenes. Examples include raw milk, inadequately pasteurized milk, chocolate milk, cheeses (particularly soft cheeses), ice cream, raw vegetables, raw poultry and meats (all types), fermented raw-meat sausages, hot dogs and deli meats, and raw and smoked fish and other seafood. L. monocytogenes can grow in refrigerated temperatures, which makes this organism a particular problem for the food industry.

Potential contamination sources include food workers, incoming air, raw materials, and food- processing environments. Among those, post-processing contamination at food-contact surfaces poses the greatest threat to product contamination.

5. Target Populations

The main target populations for listeriosis are:

• pregnant women/fetuses/neonates – perinatal and neonatal infections;

• persons immunocompromised by, for example, corticosteroids, anticancer drugs, graft suppression therapy, AIDS;

• cancer patients, particularly leukemic;

• (less frequently reported) diabetic, cirrhotic, asthmatic, and ulcerative colitis patients;

• the elderly;

• healthy people – some reports suggest that healthy people are at risk, and that antacids or cimetidine may predispose them to the infection. Some studies suggested that healthy, uncompromised people could develop the disease, particularly if the food eaten was heavily contaminated with L. monocytogenes.

6. Diagnosis

Identification of culture isolated from tissue, blood, cerebrospinal fluid, or another normally sterile site (e.g., placenta or fetus) is needed for diagnosis of L. monocytogenes infection. Stool cultures are not informative, since some healthy humans may be intestinal carriers of L. monocytogenes.

7. Food Analysis

Methods of analyzing foods for purposes of identifying L. monocytogenes are complex and time- consuming. The present FDA method, revised in January 2003, uses a single enrichment broth, buffered Listeria enrichment broth, and requires 24 to 48 hours of enrichment, followed by a variety of agars and, finally, biochemical confirmation. Total time to identification is from 5 to 7 days. Many other enrichment broths, such as UVM broth and Fraser broth, are also included in various protocols. Agars that have been extensively evaluated include Oxford agar, PALCAM, LPM plus esculin and ferric iron and MOX.

New molecular biology techniques have been used to develop various rapid-screening kits for L. monocytogenes. These kits generally rely on ELISA, PCR, and probe-based identification.

8. Examples of Outbreaks

L. monocytogenes has caused significant outbreaks worldwide over the past decades. Some examples are listed below.

Los Angeles, 1985. A large-scale listeriosis outbreak occurred in Los Angeles County, California, due to the consumption of contaminated Mexican-style soft cheese. Human listeriosis cases reported numbered 142. Among them, 93 cases occurred in pregnant women or their offspring, and the remaining cases occurred in non-pregnant adults. The outbreak led to 48 deaths, including 20 fetuses, 10 neonates, and 18 non-pregnant adults. An investigation of the cheese plant suggested that the cheese was commonly contaminated by unpasteurized milk. The outbreak strain was serotype 4b.

U.S., 1989, 2000. A serotype 1/2a strain was isolated from a single case of human listeriosis in 1989, which was caused by the consumption of processed meat. Eleven years later, the same strain isolated from sliced turkey produced by the same processing plant was implicated in a listeriosis outbreak. This provides a powerful illustration of L. monocytogenes’s tenacity and prolonged survival in food-processing environments.

U.S., 1998 to 1999. A large scale multistate outbreak of listeriosis caused at least 50 cases in 11 states. Six adults died, and two pregnant women had spontaneous abortions. Contaminated hot dogs were linked to this outbreak. All L. monocytogenes isolates from these cases were serotype 4b.

U.S., 2002. A multistate outbreak of listeriosis in the Northeastern U.S. resulted in 46 cases, including 7 deaths and 3 stillbirths or miscarriages in eight states. The outbreak was linked to eating sliceable turkey deli meat. L. monocytogenes was isolated from 1 food product and 25 environmental samples from a poultry-processing plant. The isolate from the food product had a PFGE pattern different from the outbreak strain; however, two environmental isolates from floor drains had an identical PFGE pattern to that of outbreak patient isolates, suggesting that the plant might have been the source of the outbreak. The outbreak strain was serotype 4b.

Canada, 2008. A widespread outbreak of listeriosis occurred in Canada and was linked to deli meat produced by a Maple Leaf Foods plant in Toronto, Ontario. The outbreak caused 57 confirmed cases in seven provinces, and 22 people died. The outbreak strain was serotype 1/2a.

(sic) U.S. 2011. A total of 146 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes were reported to CDC from 28 states linked to cantaloupe consumption. Thirty deaths were reported. In addition, one woman pregnant at the time of illness had a miscarriage.

9. Resources

• Loci index for genome Listeria.

• GenBank Taxonomy database.

• CDC facts about listeriosis.

• The U.S. Department of Agriculture provides information about Listeria monocytogenes.

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