Multistate Outbreak of Salmonella Virchow Infections Linked to a Powdered Meal Replacement Product-United States, 2015-2016.

Background: Nontyphoidal Salmonella is the leading cause of bacterial gastroenteritis in the United States. Meal replacement products containing raw and "superfood" ingredients have gained increasing popularity among consumers in recent years. In January 2016, we investigated a multistate outbreak of infections with a novel strain of Salmonella Virchow. Methods: Cases were defined using molecular subtyping procedures. Commonly reported exposures were compared with responses from healthy people interviewed in the 2006-2007 FoodNet Population Survey. Firm inspections and product traceback and testing were performed. Results: Thirty-five cases from 24 states were identified; 6 hospitalizations and no deaths were reported. Thirty-one of 33 (94%) ill people interviewed reported consuming a powdered supplement in the week before illness; of these, 30 (97%) reported consuming product A, a raw organic powdered shake product consumed as a meal replacement. Laboratory testing isolated the outbreak strain of Salmonella Virchow from leftover product A collected from ill people's homes, organic moringa leaf powder (an ingredient in product A), and finished product retained by the firm. Firm inspections at 3 facilities linked to product A production did not reveal contamination at the facilities. Traceback investigation identified that the contaminated moringa leaf powder was imported from South Africa. Conclusions: This investigation identified a novel outbreak vehicle and highlighted the potential risk with similar products not intended to be cooked by consumers before consuming. The company issued a voluntary recall of all implicated products. As this product has a long shelf life, the recall likely prevented additional illnesses.

Risk Assessment of Salmonellosis from Consumption of Alfalfa Sprouts and Evaluation of the Public Health Impact of Sprout Seed Treatment and Spent Irrigation Water Testing.

We developed a risk assessment of human salmonellosis associated with consumption of alfalfa sprouts in the United States to evaluate the public health impact of applying treatments to seeds (0-5-log10 reduction in Salmonella) and testing spent irrigation water (SIW) during production. The risk model considered variability and uncertainty in Salmonella contamination in seeds, Salmonella growth and spread during sprout production, sprout consumption, and Salmonella dose response. Based on an estimated prevalence of 2.35% for 6.8 kg seed batches and without interventions, the model predicted 76,600 (95% confidence interval (CI) 15,400-248,000) cases/year. Risk reduction (by 5- to 7-fold) predicted from a 1-log10 seed treatment alone was comparable to SIW testing alone, and each additional 1-log10 seed treatment was predicted to provide a greater risk reduction than SIW testing. A 3-log10 or a 5-log10 seed treatment reduced the predicted cases/year to 139 (95% CI 33-448) or 1.4 (95% CI <1-4.5), respectively. Combined with SIW testing, a 3-log10 or 5-log10 seed treatment reduced the cases/year to 45 (95% CI 10-146) or <1 (95% CI <1-1.5), respectively. If the SIW coverage was less complete (i.e., less representative), a smaller risk reduction was predicted, e.g., a combined 3-log10 seed treatment and SIW testing with 20% coverage resulted in an estimated 92 (95% CI 22-298) cases/year. Analysis of alternative scenarios using different assumptions for key model inputs showed that the predicted relative risk reductions are robust. This risk assessment provides a comprehensive approach for evaluating the public health impact of various interventions in a sprout production system.

Evaluation of ELISA Test Kits for Detection of Milk Protein in Frying Oil Treated at Different Temperatures.

Milk is a common ingredient in fried foods. Allergen cross-contact can occur through the reuse of frying oil. To enable assessment of the allergy risk of reused oil, methods for quantification of milk protein in oil are needed. This study evaluated four commercial ELISA test kits in comparison with the 660 nm total protein assay for the detection of milk protein in oil after frying. Corn oil spiked with nonfat or whole milk powder were fried at 150 °C or 180 °C for 3 min and were analyzed by ELISA kits either directly or after preextraction with phosphate-buffered saline containing 0.05% Tween (PBST). All four ELISA kits performed well in quantifying milk protein in unheated oil, achieving normalized recoveries of 72.1-115.9% compared with that determined in reference solutions (PBST spiked with nonfat or whole milk powder, 100%). Frying lowered the amount of protein detected, but the extent of reduction differed between test kits. In nonfat milk powder-spiked oil fried at 150 °C, normalized recoveries determined by Veratox Total Milk and BioKits BLG Assay (49.9% and 43.6%, respectively) were higher than that determined by the 660 nm assay (25.4%). Normalized recoveries determined by ELISA Systems Casein and Beta-Lactoglobulin (BLG) kits were substantially lower (9.7% and 2.4%, respectively). In samples fried under typical frying temperature (180 °C), very little protein (0.1-7.4%) was detected. Inclusion of PBST preextraction improved the detection of the two test kits targeting BLG but lowered the level of protein detected by Veratox and ELISA Systems Casein in fried samples. Overall, the ELISA kits evaluated could effectively quantify milk protein in unheated oil without the need to remove the oil phase prior to analysis. Heat treatment was the key factor negatively affecting protein quantitation. Such impact needs to be considered when ELISA test results are used for assessing the allergy risk of reused frying oil.

Quantitation of milk proteins in thermally treated milk samples and commercial food products by ELISA test kits.

This study evaluated four ELISA kits for quantitation of milk proteins in thermally treated milk samples and food products. How reference materials may be used for comparison of kit performance was examined. Protein contents determined by Veratox Total Milk generally reflected those determined by the 660 nm total protein assay. BioKits BLG Kit was less affected by thermal treatment but resulted in overestimation of protein contents in samples that were boiled, autoclaved or dry-heated at ≤149 °C, while ELISA Systems Casein (ES Casein) and Beta-Lactoglobulin (ES BLG) assays underestimated protein levels in these samples. The four kits gave similar results for ice cream. Veratox registered higher concentrations in all products tested but its sensitivity was greatly lowered in retorted products. ES Casein underperformed Veratox for baked and retorted products. BioKits BLG maintained a better sensitivity towards fried, baked and retorted products while ES BLG exhibited reduced sensitivity for these products.

Comparison of Commercial Test Kits for Detection of Salmonella and E. coli O157:H7 in Alfalfa Spent Sprout Irrigation Water.

BACKGROUND: Sprout growers in the United States are required to test spent sprout irrigation water (SSIW) or in-process sprouts for Escherichia coli O157:H7 and Salmonella species. Pathogen screening kits are commercially available; however, few have been validated for analysis of sprouts or SSIW. OBJECTIVE: This study evaluated AOAC-certified test kits (lateral flow devices [LFDs], enzyme immunoassays [EIAs], and molecular assays) in comparison with culture methods described in the U.S. Food and Drug Administration (FDA) Bacteriological Analytical Manual (BAM) for detection of Salmonella and E. coli O157:H7 in alfalfa SSIW. METHOD: Twenty-five milliliter aliquots of alfalfa SSIW, either uninoculated or inoculated with Salmonella or E. coli O157:H7 at a low (∼0.5-0.7 CFU/25 mL) or high level (∼10-20 CFU/25 mL), were subjected to the enrichment and assay protocols recommended by each test. Pathogen presence was confirmed following FDA BAM procedures and, if applicable, test kit manufacturer protocols. RESULTS: Twelve of the 13 Salmonella test kits evaluated (except VIDAS UP) performed well and detected Salmonella in 100% of SSIW samples contaminated at 0.61 CFU/mL. Performance varied among E. coli O157:H7 test kits, with four (Reveal, MicroSEQ, GDS, MDA) of 12 kits designed for next-day detection, and four (Reveal, VIP Gold, MicroSEQ, GDS) of seven kits designed for same-day detection capable of detecting the pathogen in 100% samples contaminated at 0.90 CFU/mL. CONCLUSIONS: Enrichment conditions play a key role in determining the performance of test kits and the success of confirmation. HIGHLIGHTS: This study is the first to compare a wide range of commercial test kits for detection of Salmonella and E. coli O157:H7 in SSIW.

Determination of protein levels in soy and peanut oils by colorimetric assay and ELISA.

Analytical methods are needed for measuring the levels of protein from allergenic food transferred into cooking oil. A simple method for determination of total protein in cooking oils was developed. Oil was extracted with phosphate-buffered saline with 0.05% Tween (PBST) and the extracts were partitioned with hexane to remove residual oil. Total protein in the PBST extracts was assayed with bicinchoninic acid (BCA), micro-BCA, reducing-agent compatible BCA and CB-XT kits. These methods were used to measure recovery of protein from peanut butter spikes of soy and peanut oil in the range of 50-1000 ppm. Recoveries were generally above 70%. However, the BCA and micro-BCA assays were subject to interference and enhanced color formation which were probably due to co-extracted antioxidants present in oil. The reducing agent-compatible BCA and CB-X protein assays reduced interference and gave lower protein values in crude, cold-pressed, and refined peanut oils. Heating oil to 180 degrees C before extraction also reduced interference-induced color enhancement. A commercial ELISA test kit was also used to measure peanut protein in oil spiked with peanut butter. Recovery of peanut residues measured by ELISA was significantly decreased when the peanut butter-spiked oil was heated to 180 degrees C compared to unheated oil. Recovery of spiked peanut butter protein measured by the buffer extraction-colorimetric method was not decreased in heated oil. The method developed here could be used to determine protein levels in crude and refined oil, and to assess the potential for allergen cross-contact from reused cooking oil.

Purification and crystallization of Cor a 9, a major hazelnut allergen.

Hazelnut (Corylus avellana) is one of the food sources that induce allergic reaction in a subpopulation of people with food allergy. The 11S legumin-like seed-storage protein from hazelnut has been identified as one of the major hazelnut allergens and named Cor a 9. In this study, Cor a 9 was extracted from hazelnut kernels using a high-salt solution and was purified by desalting out and FPLC to a highly purified state. Diffraction-quality single crystals were obtained using the hanging-drop vapour-diffusion method. Diffraction data were collected and a structure solution has been obtained by molecular-replacement calculations. Further refinement of the structure is currently in progress.

Factors influencing the growth of Salmonella during sprouting of naturally contaminated alfalfa seeds.

In this study, the factors that affect Salmonella growth during sprouting of naturally contaminated alfalfa seeds associated with two previous outbreaks of salmonellosis were examined. A minidrum sprouter equipped with automatic irrigation and rotation systems was built to allow sprouting to be conducted under conditions similar to those used commercially. The growth of Salmonella during sprouting in the minidrum was compared with that observed in sprouts grown in glass jars under conditions commonly used at home. The level of Salmonella increased by as much as 4 log units after 48 h of sprouting in jars but remained constant during the entire sprouting period in the minidrum. The effect of temperature and irrigation frequency on Salmonella growth was examined. Increasing the sprouting temperature from 20 to 30 degrees C increased the Salmonella counts by as much as 2 log units on sprouts grown both in the minidrum and in the glass jars. Decreasing the irrigation frequency from every 20 min to every 2 h during sprouting in the minidrum or from every 4 h to every 24 h during sprouting in the glass jars resulted in an approximately 2-log increase in Salmonella counts. The levels of total aerobic mesophilic bacteria, coliforms, and Salmonella in spent irrigation water closely reflected those found in sprouts, confirming that monitoring of spent irrigation water is a good way to monitor pathogen levels during sprouting.

Cleaning and other control and validation strategies to prevent allergen cross-contact in food-processing operations.

Food allergies affect an estimated 10 to 12 million people in the United States. Some of these individuals can develop life-threatening allergic reactions when exposed to allergenic proteins. At present, the only successful method to manage food allergies is to avoid foods containing allergens. Consumers with food allergies rely on food labels to disclose the presence of allergenic ingredients. However, undeclared allergens can be inadvertently introduced into a food via cross-contact during manufacturing. Although allergen removal through cleaning of shared equipment or processing lines has been identified as one of the critical points for effective allergen control, there is little published information on the effectiveness of cleaning procedures for removing allergenic materials from processing equipment. There also is no consensus on how to validate or verify the efficacy of cleaning procedures. The objectives of this review were (i) to study the incidence and cause of allergen cross-contact, (ii) to assess the science upon which the cleaning of food contact surfaces is based, (iii) to identify best practices for cleaning allergenic foods from food contact surfaces in wet and dry manufacturing environments, and (iv) to present best practices for validating and verifying the efficacy of allergen cleaning protocols.

Crystallization and initial crystallographic characterization of a vicilin-type seed storage protein from Pinus koraiensis.

The cupin superfamily of proteins includes the 7S and 11S seed storage proteins. Many members of this family of proteins are known allergens. In this study, the Korean pine (Pinus koraiensis) vicilin-type 7S seed storage protein was isolated from defatted pine-nut extract and purified by sequential gel-filtration and anion-exchange chromatography. Well diffracting single crystals were obtained by the vapor-diffusion method in hanging drops. The crystals belong to the primitive cubic space group P2(1)3, with unit-cell parameters a = b = c = 148.174 A. Two vicilin molecules were present in the asymmetric unit and the Matthews coefficient was determined to be 2.90 A(3) Da(-1), with a corresponding solvent content of approximately 58%. A molecular-replacement structural solution has been obtained using the program Phaser. Refinement of the structure is currently under way.

Effect of Water Hardness on Efficacy of Sodium Hypochlorite Inactivation of Escherichia coli O157:H7 in Water.

This study examined how the hardness of water affected the efficacy of sodium hypochlorite in inactivating Escherichia coli O157:H7 in water. Water was prepared at different degrees of total hardness (0, 50, 100, 200, 500, 1,000, 2,000, and 5,000 mg/liter CaCO3). Inactivation was assessed at different levels of free chlorine (0, 0.2, 0.5, and 1.0 ppm) at 2 to 4°C and pH 6.5. Thirty milliliters of chlorinated water was inoculated with 6 log CFU/ml of E. coli O157:H7 and allowed to mix for 3, 10, 20, or 30 s. In the absence of sodium hypochlorite, no reduction in counts of E. coli O157:H7 was observed regardless of the degree of water hardness. However, in the presence of hard water, under certain chlorine concentrations and exposure times, the reduction of E. coli O157:H7 in chlorinated hard water was significantly less than the reduction observed in chlorinated deionized water. For example, after exposure to 0.5 ppm of free chlorine for 10 s, E. coli O157:H7 counts were reduced by 4.8 ± 1.4, 2.0 ± 1.3, 1.6 ± 0.7, 0.5 ± 0.7, and 0.0 ± 0.1 log CFU/ml in water containing 0, 100, 1,000, 2,000, and 5,000 mg/liter CaCO3, respectively. With the exception of 5,000 mg/liter CaCO3, the effect of water hardness was no longer visible after 20 s of exposure to 0.5 ppm of free chlorine. Also, hard water significantly lowered the efficacy of sodium hypochlorite at 3 s of exposure to 1.0 ppm of free chlorine. But after 20 s of exposure to 1.0 ppm of free chlorine, the impact of water hardness was no longer observed. This study demonstrated that water hardness can affect the germicidal efficacy of sodium hypochlorite, and such an impact may or may not be apparent depending on the condition of the solution and the treatment time at which the observation is made. Under the conditions typically seen in commercial produce washing operations, the impact of water hardness on chlorine efficacy is likely to be insignificant compared with that of organic load.

Crystal Structure of Cocosin, A Potential Food Allergen from Coconut (Cocos nucifera).

Coconut (Cocos nucifera) is an important palm tree. Coconut fruit is widely consumed. The most abundant storage protein in coconut fruit is cocosin (a likely food allergen), which belongs to the 11S globulin family. Cocosin was crystallized near a century ago, but its structure remains unknown. By optimizing crystallization conditions and cryoprotectant solutions, we were able to obtain cocosin crystals that diffracted to 1.85 Å. The cocosin gene was cloned from genomic DNA isolated from dry coconut tissue. The protein sequence deduced from the predicted cocosin coding sequence was used to guide model building and structure refinement. The structure of cocosin was determined for the first time, and it revealed a typical 11S globulin feature of a double layer doughnut-shaped hexamer.

Assessing the Public Health Impact and Effectiveness of Interventions To Prevent Salmonella Contamination of Sprouts.

Sprouts have been a recurring public health challenge due to microbiological contamination, and Salmonella has been the major cause of sprout-associated outbreaks. Although seed treatment and microbiological testing have been applied as risk reduction measures during sprout production, the extent to which their effectiveness in reducing the public health risks associated with sprouts has not been well investigated. We conducted a quantitative risk assessment to measure the risk posed by Salmonella contamination in sprouts and to determine whether and how mitigation strategies can achieve a satisfactory risk reduction based on the assumption that the risk reduction achieved by a microbiological sampling and testing program at a given sensitivity is equivalent to that achieved by direct inactivation of pathogens. Our results indicated that if the sprouts were produced without any risk interventions, the health impact caused by sprouts contaminated with Salmonella would be very high, with a median annual estimated loss of disability-adjusted life years (DALYs) of 691,412. Seed treatment (with 20,000 ppm of calcium hypochlorite) or microbiological sampling and testing of spent irrigation water (SIW) alone could reduce the median annual impact to 734 or 4,856 DALYs, respectively. Combining seed treatment with testing of the SIW would further decrease the risk to 58 DALYs. This number could be dramatically lowered to 3.99 DALYs if sprouts were produced under conditions that included treating seeds with 20,000 ppm of calcium hypochlorite plus microbiological testing of seeds, SIW, and finished products. Our analysis shows that the public health impact due to Salmonella contamination in sprouts could be controlled if seeds are treated to reduce pathogens and microbiological sampling and testing is implemented. Future advances in intervention strategies would be important to improve sprout safety further.

Effects of heat and high-pressure treatments on the solubility and immunoreactivity of almond proteins.

The effects of dry and moist heat, autoclave sterilization and high-pressure treatment on the biochemical characteristics and immunological properties of almond proteins were investigated. Changes in the solubility and immunoreactivity of almond proteins extracted from treated almond flour were evaluated using a total protein assay, indirect competitive inhibition enzyme-linked immunosorbent assay (IC-ELISA), and sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Almond proteins were stable during dry-heat treatment at temperatures below 250°C. Dry heat at 400°C, boiling, autoclave sterilization and high-pressure treatment in the presence of water at ⩾ 500 MPa greatly reduced the solubility and immunoreactivity of almond proteins. SDS-PAGE revealed that the protein profiles of almond flour samples treated under these conditions also changed significantly. The synergistic effects of heat, pressure and the presence of water contributed to significant changes in solubility and immunoreactivity of almond proteins.

Effects of processing on the recovery of food allergens from a model dark chocolate matrix.

To alleviate the risk to allergic consumers, it is crucial to improve factors affecting the detection of food allergens in processed chocolate products. This study evaluated processing effects on (1) recovery of peanut, egg, and milk allergens using five different extraction buffers, and (2) identification of specific allergenic proteins from extracts of incurred chocolate using allergen-specific antibodies and human allergic sera. Immunochemical staining with polyclonal antibodies showed that the addition of detergent or reducing agent improved extraction efficiency of peanut proteins, but not of egg and milk proteins. Tempering decreased antibody binding regardless of extractant. Detection of IgE-reactive peanut, egg, and milk allergens was differentially affected by tempering and extractant. Detection problems associated with matrix and processing effects may be overcome by the choice of extraction buffer and detecting antibody.

Multi-allergen Quantitation and the Impact of Thermal Treatment in Industry-Processed Baked Goods by ELISA and Liquid Chromatography-Tandem Mass Spectrometry.

Undeclared food allergens account for 30-40% of food recalls in the United States. Compliance with ingredient labeling regulations and the implementation of effective manufacturing allergen control plans require the use of reliable methods for allergen detection and quantitation in complex food products. The objectives of this work were to (1) produce industry-processed model foods incurred with egg, milk, and peanut allergens, (2) compare analytical method performance for allergen quantitation in thermally processed bakery products, and (3) determine the effects of thermal treatment on allergen detection. Control and allergen-incurred cereal bars and muffins were formulated in a pilot-scale industry processing facility. Quantitation of egg, milk, and peanut in incurred baked goods was compared at various processing stages using commercial enzyme-linked immunosorbent assay (ELISA) kits and a novel multi-allergen liquid chromatography (LC)-tandem mass spectrometry (MS/MS) multiple-reaction monitoring (MRM) method. Thermal processing was determined to negatively affect the recovery and quantitation of egg, milk, and peanut to different extents depending on the allergen, matrix, and analytical test method. The Morinaga ELISA and LC-MS/MS quantitative methods reported the highest recovery across all monitored allergens, whereas the ELISA Systems, Neogen BioKits, Neogen Veratox, and R-Biopharm ELISA Kits underperformed in the determination of allergen content of industry-processed bakery products.

Protein digestibility and relevance to allergenicity.

In January 2001 a Joint Food and Agriculture Organization of the United Nations/World Health Organization Expert Consultation Committee on Allergenicity of Foods Derived from Biotechnology published a report outlining in detail an approach for assessing the allergenic potential of novel proteins. One component of this decision tree is a determination of whether the protein of interest is resistant to proteolytic digestion. Although these (Italic)in vitro(/Italic) methodologies have been useful, the correlation between resistance to proteolysis and allergenic activity is not absolute. Two views and highlights of supporting research regarding the relationship of resistance to digestion and allergenicity are presented in this article.

Digestion stability as a criterion for protein allergenicity assessment.

Assessing the allergenic potential of transgenic proteins introduced into genetically engineered food remains a critical part of the overall safety assessment of these foods. Stability to digestion has been proposed as one of the steps in the decision tree approach to assess the allergenic potential of transgenic proteins. The validity of digestion stability as a criterion for protein allergenicity assessment, however, has encountered some criticism in recent years. This chapter gives an overview of the rationale behind the use of digestion stability as a criterion for protein allergenicity assessment and reviews the available data that may or may not support its use. The application of in vitro digestion assays for the assessment of allergenic potential of novel proteins and the factors that affect the assay results are also discussed. There is a need to establish standardized assay conditions so that direct comparison of results from different laboratories can be made. Consensus also needs to be reached on relating the measured digestibility to the allergenic potential of proteins.

Digestibility of food allergens and nonallergenic proteins in simulated gastric fluid and simulated intestinal fluid-a comparative study.

Information on the comparative digestibility of food allergens and nonallergenic proteins is crucial when stability to digestion is to be used as a criterion to assess the allergenic potential of novel proteins. In this work, we compared the digestive stability of a number of food allergens and proteins of unproven allergenicity and examined whether allergens possess a higher stability than nonallergenic proteins of similar cellular functions, and whether there is a correlation between protein digestibility and allergenicity. The stability of groups of storage proteins, plant lectins, contractile proteins, and enzymes, both allergens and proteins with unproven allergenicity, in a standard simulated gastric fluid and a standard simulated intestinal fluid was measured. Food allergens were not necessarily more resistant to digestion than nonallergenic proteins. There was not a clear relationship between digestibility measured in vitro and protein allergenicity.

Crystal structure of Korean pine (Pinus koraiensis) 7S seed storage protein with copper ligands.

The prevalence of food allergy has increased in recent years, and Korean pine vicilin is a potential food allergen. We have previously reported the crystallization of Korean pine vicilin purified from raw pine nut. Here we report the isolation of vicilin mRNA and the crystal structure of Korean pine vicilin at 2.40 Å resolution. The overall structure of pine nut vicilin is similar to the structures of other 7S seed storage proteins and consists of an N-terminal domain and a C-terminal domain. Each assumes a cupin fold, and they are symmetrically related about a pseudodyad axis. Three vicilin molecules form a doughnut-shaped trimer through head-to-tail association. Structure characterization of Korean pine nut vicilin unexpectedly showed that, in its native trimeric state, the vicilin has three copper ligands. Sequence alignments suggested that the copper-coordinating residues were conserved in winter squash, sesame, tomato, and several tree nuts, while they were not conserved in a number of legumes, including peanut and soybean. Additional studies are needed to assess whether the copper-coordinating property of vicilins has a biological function in the relevant plants. The nutritional value of this copper-coordinating protein in tree nuts and other edible seeds may be worth further investigations.