1. Florida Association for Food Protection
The Impact of the 2018 Romaine Lettuce Outbreaks Past, Present and Future
Florida Association for Food Protection
February 12, 2019
Will come from VP of CS Food Safety (Jill)
Jill Hollingsworth, DVM
VP, Food Safety & Regulatory Affairs
Chemstar/Sterilox

2. Today’s Discussion Past – 2018 Spring & Fall Romaine Lettuce Outbreaks
Present – What We Know & What’s Happening Now
Future – Opportunities for Retailers

3. Spring 2018 E. coli O157:H7 Infections Linked to Romaine Lettuce

4. Fall 2018 E. coli O157:H7 Infections Linked to Romaine Lettuce

5. Outbreak Comparisons Spring: March 14 – June 28, 2018
Yuma Valley Region
Over 200 illnesses, 5 deaths, and 95 hospitalizations
Suspected water source
Three samples of irrigation canal water tested positive
E. coli O157:H7 strain unrelated to the Fall outbreak
Fall: October 9, 2018 – January 7, 2019
Three counties in central coastal region of California
62 illnesses; 25 hospitalizations
Suspected water source
One positive sample from sediment of an agricultural water reservoir on one farm
Outbreak strain matches previous outbreaks from 2017 and 2016

6. Lettuce Fields and Irrigation Supply

7. The Past – Fall 2018 Romaine Outbreak
November 20
CDC and FDA issue nationwide advisories announcing E.coli O157:H7 outbreak linked to romaine lettuce
Retailers and restaurants should not sell or serve [any] romaine lettuce
November 23-25
Six produce companies negotiate new voluntary labeling program with FDA (location & date)
November 26
Traceback to Central Coast growing regions of northern and central California
FDA announced voluntary labeling recommendations for romaine lettuce
Voluntary program – PURPOSE: to reintroduce romaine into the market

8. Concerns Raised by Retailers
No recall (and no withdrawal)
No retail input on labeling agreement between FDA and produce industry
Responsibility for labeling included retail signage, verification
Retailers responsible for explaining labels and FDA/suppliers actions
Labeling for re-introduction of “safe” (not recalled) product
Does voluntary = mandatory (“new norm”)

9. Present Consumers want safe food
Retailers only want to sell/serve safe food
Labeling the source of product does not make food safer
Consumers cannot be expected to buy produce based on signage/labels declaring where and when it was grown/harvested
Is there a better way to conduct investigations and traceback?

10. Present Labeling Issues
Posting growing/harvest region signs at retail is not sustainable
Constantly changing/multiple growing regions confusing to consumers
If all romaine is to labeled with a harvest region, then the suppliers need to put this information on every package, head etc. and not just on cartons
Restocking a previously recalled product at retail should not necessitate consumer notification --- retailers only restock with non- recalled, or non-implicated products.

11. Is Produce Safer Now?
Produce Safety Rule (FSMA) implemented; no water standard
Agricultural water is the focus of investigations
Product is being exposed to contamination on the farm
Same growing regions and water are in use

12. Joint Romaine Task Force
Science and Prevention
Agriculture water
Growing environment
Auditing depth
Root cause analysis
Traceability
PTI
Provenance Labeling
All leafy greens
Outbreak Investigation
Alerts and Advisories
Recalls
Organized by United Fresh & PMA
FDA
CDC
Retailers
Suppliers
Academia

13. Future - What Should Retailers Expect
Traceability
Produce Traceability Initiative (PTI)
Supply chain-wide adoption of electronic traceability
Labeling and record-keeping
Consumer purchase information
Supplier Agreements
Recalls
Advisories, Safety Alerts, Notices and Consumer Warnings
Retail Best Practices for Leafy Greens
Conference for Food Protection (CFP) Committee

14. CFP Produce Washing and Crisping Committee
Charges:
Develop a Produce Washing and Crisping Guidance for Retail Food Establishments which includes the following:
Detail the handling, cleaning, and sanitation practices related to the washing and crisping of produce.
Describe the criteria for produce crisping vs. produce washing.
Clarify the types of chemicals and their use for washing and crisping.

15. Washing and Crisping Produce at Retail
Different methods – no single procedure or protocol is being used
Pre-requisites are already in the Food Code
Supplier – approved source/specifications
Employee Health and Hygiene
Cleaning and sanitizing
Risks include cross-contamination and infiltration
Since there is no “kill” step, controlling pathogens in the water is the most effective preventive control
Antimicrobial treatments are most efficacious at reducing/minimizing pathogens in the water
Washing and Crisping Produce at Retail

16. “A Fresh Approach to Food Safety”
Jill Hollingsworth, DVM Interstate West Parkway
Lithia Springs, GA 30122
| chemstarcorp.com

17. https://blogs. fda. gov/fdavoice/index

18. Are there more foodborne illnesses or are we better at finding them
Are there more foodborne illnesses or are we better at finding them? fiscal year 2018, In fiscal year 2018, there were a total of 1,935 FDA recalls (food & cosmetics) with 548 that were Class I. That figure represents a five-year low in recalls.

19. E. Coli 0157:H7 PFGE

20. Whole Genome Sequencing
E. coli O157:H7
Whole Genome Sequencing