Hurricane Helene’s catastrophic damage and flooding to the Southeastern states may affect the country’s medical supply chain.
Hospitals nationwide are bracing for a possible shortage of essential intravenous fluids after the cataclysmic storm inundated a vital manufacturing plant in North Carolina.
The plant is Baxter International’s North Cove manufacturing facility in Marion, which is about 35 miles northeast of Asheville. Helene unleashed unprecedented amounts of rain throughout the western part of the state, killing dozens and ravaging numerous communities, homes, and other structures, including the plant.
The North Cove plant produces 60 percent of the country’s supply of IV solutions, typically producing 1.5 million bags per day, according to the American Hospital Association. The dozens of sterile solutions Baxter makes at the facility are used for everything from intravenous rehydration and drug delivery to peritoneal dialysis used to treat kidney failure.
“Our hearts and thoughts are with all those affected by Hurricane Helene,” Baxter CEO José Almeida said in a statement on September 29. “The safety of our employees, their families, and the communities in which we operate remains our utmost concern, and we are committed to helping ensure reliable supply of products to patients. Remediation efforts are already underway, and we will spare no resource—human or financial—to resume production and help ensure patients and providers have the products they need.”
Critical supply
On October 2, Mass General Brigham, Massachusetts’ largest hospital and health care system, warned employees via email of a “serious and immediate IV fluid shortage,” according to the Boston Globe.
California’s infections bring the country’s total number of affected herds to 255 in 14 states, according to the USDA.
In a new release Thursday, California health officials worked to ease alarm about the human case, emphasizing that the risk to the general public remains low.
“Ongoing health checks of individuals who interact with potentially infected animals helped us quickly detect and respond to this possible human case. Fortunately, as we’ve seen in other states with human infections, the individual has experienced mild symptoms,” Tomás Aragón, director of California’s Department of Public Health, said. “We want to emphasize that the risk to the general public is low, and people who interact with potentially infected animals should take prevention measures.”
The release noted that in the past four months, the health department has distributed more than 340,000 respirators, 1.3 million gloves, 160,000 goggles and face shields, and 168,000 bouffant caps to farm workers. The state has also received 5,000 doses of seasonal flu vaccine earmarked for farm workers and is working to distribute those vaccines to local health departments.
Still, herd infections and human cases continue to tick up. Influenza researchers and other health experts are anxiously following the unusual dairy outbreak—the first time an avian influenza is known to have spilled over to and caused an outbreak in cattle. The more opportunities the virus has to spread and adapt to mammals, the more chances it could begin spreading among humans, potentially sparking an outbreak or even a pandemic.
Any striking marketing claims in companies’ ads about the gut benefits of a popular probiotic may be full of, well, the same thing that has their target audience backed up.
In a randomized controlled trial, the probiotic Bifidobacterium animalis subsp. lactis—used in many probiotic products, including Dannon’s Activia yogurts—did nothing to improve bowel health in people with constipation, according to data from a randomized triple-blind placebo-controlled clinical trial published Wednesday in JAMA Network Open.
The study adds to a mixed and mostly unconvincing body of scientific literature on the bowel benefits of the bacterium, substrains of which are sometimes sold with faux scientific-sounding names in products. Dannon, for instance, previously marketed its substrain, DN-173 010, as “Bifidus regularis.”
Digested data
For the new study, researchers in China recruited 228 middle-aged adults, 85 percent of whom were women. The participants, all from Shanghai, were considered healthy based on medical testing and records, except for reporting functional constipation. This is a condition defined by having two or more signs of difficulty evacuating the bowels, such as frequent straining and having rock-like stool. For the study, the researchers included the additional criterion that participants have three or fewer complete, spontaneous bowel movements (CSBMs) per week.
The participants were randomized to take either a placebo (117 participants) or the probiotic (112 participants) every day for eight weeks. Both groups got packets of sweetened powder that participants added to a glass of water taken before breakfast each morning. In addition to a sweetener, the daily probiotic packets contained freeze-dried Bifidobacterium animalis subsp. lactis substrain HN019, which is used in some commercial probiotic products. The first dose had a concentration of 7 × 109 colony-forming units (CFUs), then participants shifted to a daily dose of 4.69 × 109 CFUs. Many probiotic products have doses of B. lactis in ranges from 1 × 109 to 17 × 109.
Enlarge/ Residents line up for COVID-19 testing on November 30, 2020 in Chicago.
The co-owner of a Chicago-based lab has pleaded guilty for his role in a COVID testing scam that raked in millions—which he used to buy stocks, cryptocurrency, and several luxury cars while still squirreling away over $6 million in his personal bank account.
Zishan Alvi, 45, of Inverness, Illinois, co-owned LabElite, which federal prosecutors say billed the federal government for COVID-19 tests that were either never performed or were performed with purposefully inadequate components to render them futile. Customers who sought testing from LabElite—sometimes for clearance to travel or have contact with vulnerable people—received either no results or results indicating they were negative for the deadly virus.
The scam, which ran from around February 2021 to about February 2022, made over $83 million total in fraudulent payments from the federal government’s Health Resources and Services Administration (HRSA), which covered the cost of COVID-19 testing for people without insurance during the height of the pandemic. Local media coverage indicated that people who sought testing at LabElite were discouraged from providing health insurance information.
The list included five vehicles: a 2021 Mercedes-Benz, a 2021 Land Rover Range Rover HSE, a 2021 Lamborghini Urus, A 2021 Bentley, and a 2022 Tesla X. There was also about $810,000 in an E*Trade account, approximately $500,000 in a Fidelity Investments account, and $245,814 in a Coinbase account. Last, there was $6,825,089 in Alvi’s personal bank account.
On Monday, the Department of Justice announced a deal in which Alvi pleaded guilty to one count of wire fraud, taking responsibility for $14 million worth of fraudulent HRSA claims. He now faces up to 20 years in prison and will be sentenced on February 7, 2025.
Enlarge/ This video screenshot released by the US National Transportation Safety Board (NTSB) shows the site of a derailed freight train in East Palestine, Ohio.
On February 3, 2023, a train carrying chemicals jumped the tracks in East Palestine, Ohio, rupturing railcars filled with hazardous materials and fueling chemical fires at the foothills of the Appalachian Mountains.
The disaster drew global attention as the governors of Ohio and Pennsylvania urged evacuations for a mile around the site. Flames and smoke billowed from burning chemicals, and an acrid odor radiated from the derailment area as chemicals entered the air and spilled into a nearby creek.
Three days later, at the urging of the rail company Norfolk Southern, about 1 million pounds of vinyl chloride, a chemical that can be toxic to humans at high doses, was released from the damaged train cars and set aflame.
As environmental engineers, I and my colleagues are often asked to assist with public health decisions after disasters by government agencies and communities. After the evacuation order was lifted, community members asked for help.
In a new study, we describe the contamination we found, along with problems with the response and cleanup that, in some cases, increased the chances that people would be exposed to hazardous chemicals. It offers important lessons to better protect communities in the future.
Enlarge/ A computer model shows how chemicals from the train may have spread, given wind patterns. The star on the Ohio-Pennsylvania line is the site of the derailment.
Air pollution can find its way into buildings through cracks, windows, doors, and other portals. Once inside, the chemicals can penetrate home items like carpets, drapes, furniture, counters, and clothing. When the air is stirred up, those chemicals can be released again.
Evacuation order lifted, but buildings were contaminated
Three weeks after the derailment, we began investigating the safety of the area near 17 buildings in Ohio and Pennsylvania. The highest concentration of air pollution occurred in the 1-mile evacuation zone and a shelter-in-place band another mile beyond that. But the chemical plume also traveled outside these areas.
In and outside East Palestine, evidence indicated that chemicals from the railcars had entered buildings. Many residents complained about headaches, rashes, and other health symptoms after reentering the buildings.
At one building 0.2 miles away from the derailment site, the indoor air was still contaminated more than four months later.
Nine days after the derailment, sophisticated air testing by a business owner showed the building’s indoor air was contaminated with butyl acrylate and other chemicals carried by the railcars. Butyl acrylate was found above the two-week exposure level, a level at which measures should be taken to protect human health.
When rail company contractors visited the building 11 days after the wreck, their team left after just 10 minutes. They reported an “overwhelming/unpleasent odor” even though their government-approved handheld air pollution detectors detected no chemicals. This building was located directly above Sulphur Run creek, which had been heavily contaminated by the spill. Chemicals likely entered from the initial smoke plumes and also rose from the creek into the building.
Our tests weeks later revealed that railcar chemicals had even penetrated the business’s silicone wristband products on its shelves. We also detected several other chemicals that may have been associated with the spill.
Enlarge/ Homes and businesses were mere feet from the contaminated waterways in East Palestine.
Weeks after the derailment, government officials discovered that air in the East Palestine Municipal Building, about 0.7 miles away from the derailment site, was also contaminated. Airborne chemicals had entered that building through an open drain pipe from Sulphur Run.
More than a month after the evacuation order was lifted, the Ohio Environmental Protection Agency acknowledged that multiple buildings in East Palestine were being contaminated as contractors cleaned contaminated culverts under and alongside buildings. Chemicals were entering the buildings.
Enlarge/ The empty chair of Steward Health Care System Chief Executive Officer, Dr. Ralph de la Torre who did not show up during the US Senate Committee on Health, Education, Labor, & Pensions Examining the Bankruptcy of Steward Health Care: How Management Decisions Have Impacted Patient Care.
In a federal lawsuit filed Monday, Steward CEO Ralph de la Torre claimed the senators “bulldozed over [his] constitutional rights” as they tried to “pillory and crucify him as a loathsome criminal” in a “televised circus.”
The Senate committee—the Committee on Health, Education, Labor, and Pensions (HELP), led by Bernie Sanders (I-Vt.)—issued a rare subpoena to de la Torre in July, compelling him to testify before the lawmakers. They sought to question the CEO on the deterioration of his hospital system, which previously included more than 30 hospitals across eight states. Steward filed for bankruptcy in May.
Imperiled patients
The committee alleges that de la Torre and Steward executives reaped millions in personal profits by hollowing out the health care facilities, even selling the land out from under them. The mismanagement left them so financially burdened that one doctor in a Steward-owned hospital in Louisiana said they were forced to perform “third-world medicine.” A lawmaker in that state who investigated the conditions at the hospital described Steward executives as “health care terrorists.”
Further, the financial strain on the hospitals is alleged to have led to the preventable deaths of 15 patients and put more than 2,000 other patients in “immediate peril.” As hospitals cut services, closed wards, or shuttered entirely, hundreds of health care workers were laid off, and communities were left without access to care. Nurses who remained in faltering facilities testified of harrowing conditions, including running out of basic supplies like beds. In one Massachusetts hospital, nurses were forced to place the remains of newborns in cardboard shipping boxes because Steward failed to pay a vendor for bereavement boxes.
Meanwhile, records indicate de la Torre and his companies were paid at least $250 million in recent years and he bought a 190-foot yacht for $40 million. Steward also owned two private jets collectively worth $95 million.
While de la Torre initially agreed to testify before the committee at the September 12 hearing, the wealthy CEO backed out the week beforehand. He claimed that a federal court order linked to the bankruptcy case prevented him from speaking on the matter; additionally, he invoked his Fifth Amendment right to avoid self-incrimination.
The HELP committee rejected de la Torre’s arguments, saying there were still relevant topics he could safely discuss without violating the order and that his Fifth Amendment rights did not permit him to refuse to appear before Congress when summoned by a subpoena. Still, the CEO was a no-show, and the Senate moved forward with the contempt charges.
“Not the way this works”
In the lawsuit filed today, de la Torre argues that the senators are attempting to punish him for invoking his Constitutional rights and that the hearing “was simply a device for the Committee to attack [him] and try to publicly humiliate and condemn him.”
The suit describes de la Torre as having a “distinguished career, bedecked by numerous accomplishments,” while accusing the senators of painting him as “a villain and scapegoat[ing] him for the company’s problems, even those caused by systemic deficiencies in Massachusetts’ health care system.” If he had appeared at the Congressional hearing, he would not have been able to defend himself from the personal attacks without being forced to abandon his Constitutional rights, the suit argues.
“Indeed, the Committee made it abundantly clear that they would put Dr. de la Torre’s invocation [of the Fifth Amendment] itself at the heart of their televised circus and paint him as guilty for the sin of remaining silent in the face of these assaults on his character and integrity,” the suit reads.
De la Torre seeks to have the federal court quash the Senate committee’s subpoena, enjoin both contempt charges, and declare that the Senate committee violated his Fifth Amendment rights.
Outside lawyers are skeptical that will occur. The lawsuit is a “Hail Mary play,” according to Stan M. Brand, an attorney who represented former Trump White House official Peter Navarro in a contempt of Congress case. De la Torre’s case “has very little chance of succeeding—I would say no chance of succeeding,” Brand told the Boston Globe.
“Every time that someone has tried to sue the House or Senate directly to challenge a congressional subpoena, the courts have said, ‘That that’s not the way this works,’” Brand said.
Four years after the outbreak of the COVID-19 pandemic, doctors and researchers are still seeking ways to help patients with long COVID, the persistent and often debilitating symptoms that can continue long after a COVID-19 infection.
In adults, the most common long COVID symptoms include fatigue and brain fog, but for children the condition can look different. A study published last month suggests preteens are more likely to experience symptoms such as headaches, stomach pain, trouble sleeping, and attention difficulties. Even among children, effects seem to vary by age. “There seems to be some differences between age groups, with less signs of organ damage in younger children and more adultlike disease in adolescents,” says Petter Brodin, professor of pediatric immunology at Imperial College London.
While vast sums have been devoted to long COVID research—the US National Institutes of Health have spent more than a billion dollars on research projects and clinical trials—research into children with the condition has been predominantly limited to online surveys, calls with parents, and studies of electronic health records. This is in spite of a recent study suggesting that between 10 and 20 percent of children may have developed long COVID following an acute infection, and another report finding that while many have recovered, some still remain ill three years later.
Now, what’s believed to be the first clinical trial specifically aimed at children and young adults with long COVID is underway, recruiting subjects aged 7 to 21 on which to test a potential treatment. It builds on research that suggests long COVID in children may be linked to the gut.
In May 2021, Lael Yonker, a pediatric pulmonologist at Massachusetts General Hospital in Boston, published a study of multisystem inflammatory syndrome in children (MIS-C), which she says is now regarded as a more severe and acute version of long COVID. It showed that these children had elevated levels of a protein called zonulin, a sign of a so-called leaky gut. Higher levels of zonulin are associated with greater permeability in the intestine, which could enable SARS-CoV-2 viral particles to leak out of the intestines and into the bloodstream instead of being excreted out of the body. From there, they could trigger inflammation.
As Yonker began to see more and more children with long COVID, she theorized that many of the gastrointestinal and neurological symptoms they were experiencing might be linked. But her original study also pointed to a possible solution. When she gave the children with MIS-C a drug called larazotide, an existing treatment for people with issues relating to a leaky gut, the levels of viral particles in their blood decreased and their symptoms improved.
Enlarge/ A warning sign outside a laboratory testing the H5N1 bird flu virus at The Pirbright Institute in Woking, UK, on Monday, March 13, 2023.
More than a month after a person in Missouri mysteriously fell ill with H5-type bird flu, investigators in the state are still identifying people who became ill after contact with the patient, raising questions about the diligence of the ongoing health investigation.
On September 6, Missouri’s health department reported the state’s first human case of H5-type bird flu, one that appears closely related to the H5N1 bird flu currently causing a nationwide outbreak among dairy cows. But the infected person had no known contact with infected animals—unlike all of the other 13 human cases identified amid the dairy outbreak this year. Those previous cases have all occurred in dairy- or poultry-farm workers. In fact, Missouri has not reported bird flu in its dairy herds nor recent poultry outbreaks.
Given the unexplained source of infection, health investigators in the state have been working to track the virus both backward in time—to try to identify the source—and forward—to identify any potential onward spread. The bird flu patient was initially hospitalized on August 22 but recovered and had been released by the time the state publicly reported the case.
In an update Friday, September 27, the Centers for Disease Control and Prevention relayed that Missouri officials have now identified four more health care workers who experienced mild respiratory illnesses after caring for the person with bird flu. None of the four workers were tested for flu at the time of their illnesses and all have since recovered.
Testing new cases for antibodies to H5N1
The four newly identified cases bring the total number of health care workers who fell ill after contact to six. Missouri investigators had previously identified two other health care workers who developed mild respiratory symptoms. One of those workers was tested for flu around the time of their illness—and tested negative. But the other, like the four newly identified cases, was not tested. That person has since submitted a blood sample to test for bird flu antibodies, which would indicate a previous infection.
In addition, a household contact of the bird flu patient also fell ill at the same time as the patient, suggesting a possible common source of the infection.
The illnesses are concerning, given the fear that H5N1 bird flu could begin spreading from human to human and spark a widespread outbreak or even a pandemic. However, it can’t be overlooked that a plethora of other respiratory viruses are around—and SARS-CoV-2 transmission was relatively high in Missouri at the time—it’s impossible to draw any conclusions at this point about whether the illnesses were bird flu infections.
But, the illnesses do clearly raise concern about the health investigation, which is being conducted by Missouri officials. “The slow trickle of info is the most concerning part,” infectious disease expert Krutika Kuppalli wrote on social media Friday. The CDC can get involved at the request of a state, but such a request has not been made. For now, the CDC is only providing technical assistance from Atlanta.
In its update today, the CDC emphasized that “to date, only one case of influenza A(H5N1) has been detected in Missouri. No contacts of that case have tested positive for influenza A(H5N1).” The agency added that blood testing results for H5 antibodies are pending.
Enlarge/ An entomologist for the Louisville Metro Department of Public Health and Wellness in a swampland area on August 25, 2021 in Louisville, Kentucky collecting various mosquito species, and testing the samples for mosquito-borne diseases, such as EEE.
New York is facing an unusual boom in mosquitoes toting the deadly eastern equine encephalitis (EEE) virus, which has already led to one rare death in the state and a declaration of an “imminent threat” by officials.
While the state’s surveillance system typically picks up EEE-positive mosquitoes in two or three counties each year, this year there have been 15 affected counties, which are scattered all across New York, State Health Commissioner James McDonald said this week.
“Eastern equine encephalitis is different this year,” McDonald said, noting the deadly nature of the infection, which has a mortality rate of between 30 and 50 percent. “Mosquitoes, once a nuisance, are now a threat,” McDonald added. “I urge all New Yorkers to prevent mosquito bites by using insect repellents, wearing long-sleeved clothing, and removing free-standing water near their homes. Fall is officially here, but mosquitoes will be around until we see multiple nights of below-freezing temperatures.”
On Monday, McDonald issued a Declaration of an Imminent Threat to Public Health for EEE, and Governor Kathy Hochul announced statewide actions to prevent infections. At the same time as the declaration, the officials reported the death of a New Yorker who developed EEE. The case, which was confirmed in Ulster County on September 20, is the state’s first EEE case since 2015.
The disease is very rare in New York. Between 1971 and 2024, there were only 12 cases of EEE reported in the state; seven cases were fatal.
Rare but deadly
EEE is generally rare in the US, with an average of only 11 cases reported per year, according to the Centers for Disease Control and Prevention. The virus lurks in wild birds and spreads to people and other animals via mosquitoes. The virus is particularly deadly in horses—as its name suggests—with mortality rates up to 90 percent. In people, most bites from a mosquito carrying the EEE virus do not lead to EEE. In fact, the CDC estimates that only about 4–5 percent of infected people develop the disease; most remain asymptomatic.
Fo those who develop EEE, the virus travels from the mosquito bite into the lymph system and spreads from there to cause a systemic infection. Initial symptoms are unspecific, including fever, headache, malaise, chills, joint pain, nausea, and vomiting. This can progress to inflammation of the brain and neurological symptoms, including altered mental state and seizures. Children under the age of 15 and adults over the age of 50 are most at risk.
The CDC estimates that about 30 percent of people who develop severe EEE die of the disease. But, with small numbers of cases over time, the reported mortality rates can vary. In Massachusetts, for instance, about 50 percent of the cases have been fatal. Among those who survive neuro-invasive disease, many are left severely disabled, and some die within a few years due to complications. There is no vaccine for EEE and no specific treatments.
Overall numbers
While New York seems to be experiencing an unusual surge of EEE-positive mosquitoes, the country as a whole is not necessarily seeing an uptick in cases. Only 10 cases from six states have been reported to the CDC this year. That count does not include the New York case, which would bring the total to 11, around the country’s average number of cases per year.
In addition to New York, the states that have reported cases are Massachusetts, Vermont, New Jersey, Rhode Island, Wisconsin, and New Hampshire. Most cases have been in the Northeast, where cases are typically reported between mid-June and early October before freezing temperatures kill off mosquito populations.
EEE gained attention last month when a small town in Massachusetts urged residents to follow an evening curfew to avoid mosquito bites. The move came after the state announced its first EEE case this year (the state’s case count is now at four) and declared a “critical risk level” in four communities.
Between 2003 and 2023, the highest tally of cases in a year was in 2019, when states reported 38 EEE cases.
If you were looking for a reason to keep a flamethrower around the house, you may have just found one.
This week, the Los Angeles County health department reported that two people were infected with a raccoon parasite that causes severe, frequently fatal, infections of the eyes, organs, and central nervous system. Those who survive are often left with severe neurological outcomes, including blindness, paralysis, loss of coordination, seizures, cognitive impairments, and brain atrophy.
The parasitic roundworm behind the infection, called Baylisascaris procyonis, spreads via eggs in raccoons feces. Adult worms live in the intestines of the masked trash scavengers, and each female worm can produce nearly 200,000 eggs per day. Once in the environment, those eggs can remain infectious for years. They can survive drying out as well as most chemical treatments and disinfectants, including bleach.
Humans get infected if they inadvertently eat soil or other material that has become contaminated with egg-laden feces. Though infections are rare—there were 29 documented cases between 1973 and 2015—younger children and people with developmental disabilities are most at risk.
For instance, an 18-month-old boy with Downs syndrome in Illinois died from the infection after he chewed and sucked on pieces of contaminated firewood bark. An autopsy later found three worm larvae per gram of his brain tissue, with a total estimated burden of 3,027 parasitic larvae, according to a 2016 report.
Burn it down
In a news release this week, the LA health department said the risk to the general public is “low” but that the two cases are “concerning because a large number of raccoons live near people, and the infection rate in raccoons is likely high. The confirmed cases of this rare infection are an important reminder for all Los Angeles County residents to take precautions to prevent the spread of disease from animals to people, also known as zoonotic disease.”
According to the Centers for Disease Control and Prevention, one of the best prevention methods for raccoon roundworms is to kill it with fire. While chemicals stand little chance of killing off infectious eggs, extreme heat destroys them instantly.
If you have raccoons around your property, you might need to employ this method. Raccoons tend to poop in communal, pungent latrines, which are often at the base of trees, on raised surfaces—such as tree stumps, woodpiles, decks, and patios—as well as in attics and garages.
If you suspect you have an outdoor raccoon latrine on your property, the CDC recommends dousing the area in boiling water or setting it ablaze. While the CDC recommends a propane torch, specifically, a personal flamethrower could also do the trick. The agency does caution that flaming a latrine site “could cause a fire, burn injury, or surface damage.”
“Before flaming any latrine site, call your local fire department for details on local regulations and safety practices,” the CDC says. “Concrete pads, bricks, and metal shovels or garden implements can be flamed without damage. Do not attempt to flame surfaces that can melt or catch fire.”
For indoor latrines, the CDC advises not to use fire. Instead, it outlines a cautious cleaning method with hot, soapy water. However, if you want, any removed feces or contaminated material can be flamed outside, if not buried or put in the trash.
Enlarge/ A recall notice is posted next to Boar’s Head meats that are displayed at a Safeway store on July 31, 2024, in San Rafael, California.
The Boar’s Head deli-meat plant at the epicenter of a nationwide Listeria outbreak that killed nine people so far harbored the deadly germ in a common area of the facility deemed “low risk” for Listeria. Further, it had no written plans to prevent cross-contamination of the dangerous bacteria to other products and areas. That’s according to a federal document newly released by Boar’s Head.
On Friday, the company announced that it is indefinitely closing that Jarratt, Virginia-based plant and will never again produce liverwurst—the product that Maryland health investigators first identified as the source of the outbreak strain of Listeria monocytogenes. The finding led to the recall of more than 7 million pounds of Boar’s Head meat. The Jarratt plant, where the company’s liverwurst is made, has been shuttered since late July amid the investigation into how the outbreak occurred.
In the September 13 update, Boar’s Head explained that:
[O]ur investigation has identified the root cause of the contamination as a specific production process that only existed at the Jarratt facility and was used only for liverwurst. With this discovery, we have decided to permanently discontinue liverwurst.
While the statement seems to offer some closure on the outbreak’s source, previously released inspection reports described a facility riddled with sanitation failures. Between August 1, 2023, and August 2, 2024, the facility was cited for 69 violations, which included water leaks, mold in numerous places, algal growth, “meat buildup” caking equipment, and walls that were also crawling with flies and gnats, sightings of other insects, rancid smells, trash and debris on the floors, and even “ample amounts of blood in puddles.”
The New York Times also reported that a 2022 inspection found that the plant posed an “imminent threat” to public health and that inspectors cited “extensive rust, deli meats exposed to wet ceilings, green mold and holes in the walls.”
Cross-contamination
The document newly released by Boar’s Head is a letter dated July 31 from the US Department of Agriculture’s Food Safety and Inspection Service notifying the company that the Jarratt facility was suspended. The basis of the suspension was an inspection finding from July 24 and 25 of L. monocytogenes contaminating a pallet jack in a large room where ready-to-eat meats were processed. The room was a common area not specific to liverwurst processing and was deemed by Boar’s Head to be “low risk” for Listeria.
Meats from eight processing lines were in the room, with lines 1 through 4 on the left side and 5 through 8 on the right, handling hot dogs and other small sausages. The contaminated pallet jack was designated for production line 2, which was handling Beechwood Hams, and was used to move racks of hams from blast coolers to production lines in the processing room.
However, inspectors noted that the pallet jacks and product racks in the room weren’t kept to designated production lines, and instead, employees moved them between all of the lines and all of the blast coolers, enabling cross-contamination. And, while the equipment was moved around, people did, too. Although employees typically stuck to one production line, they would sometimes move between lines, and there were no procedures for employees to change personal protective equipment (PPE)—gloves, disposable aprons, and arm covers—when they switched. Inspectors saw them switching without changing their PPE.
“They also observed employees who freely move between all lines without directly interacting with product such as those removing garbage, removing product debris from the floors, removing condensation from overhead structures, or performing maintenance,” the USDA officials wrote.
Outbreak spread
Given that this was in a room full of meats that were supposedly ready to eat, the USDA concluded that Boar’s Head “failed to maintain sanitary conditions” and that its Listeria control program was “ineffective.”
To date, 57 people from 18 states have been sickened. All 57 were hospitalized, and nine people died. The Centers for Disease Control and Prevention reported that health officials have interviewed 44 people sickened during the outbreak, who said they ate various deli-sliced meats. Only 25 reported eating deli-sliced liverwurst.
In light of the outbreak, Boar’s Head said it is revamping its safety and quality assurances at its other facilities and hiring experienced food safety experts. “You have our promise that we will work tirelessly to regain your trust and ensure that all Boar’s Head products consistently meet the high standards that you deserve and expect. We are determined to learn from this experience and emerge stronger.”
Consumer Reports on Thursday reported the concentration of lead it found in 36 ground cinnamon products, leading to a round of startling headlines. The testing is particularly nerve-racking given that it closely follows the tragic poisoning of at least 519 US children, who were exposed to extremely high levels of lead from purposefully tainted cinnamon in applesauce snack pouches.
With that horrifying event in mind, parents are likely primed to be alarmed by any other lead findings in cinnamon. So, how concerning were the concentrations Consumer Reports found? And does one need to strictly adhere to the limits the organization recommends? By my calculations, not very and probably not. It’s really not an alarming report.
Similar to the outlet’s chocolate testing before it, the lead concentrations found in cinnamons were largely within standard ranges. In all, the report is more of a reminder that trace amounts of heavy metals are present in various common foods. And such watchdog testing can play a crucial role in keeping consumers safe, especially with underfunded and underpowered regulators.
Before I go into the data, I’ll be upfront with my conflict of interest here: I love cinnamon about as much as I love chocolate, which is to say: a lot. I can’t imagine fall or holidays without heavily cinnamoned treats. And if you believe that cinnamon isn’t a verb, you are incorrect (at least in my book). Still, my love of this tree-bark spice could certainly be shaken by my healthy aversion to neurotoxic things, especially with a small child at home gobbling up my baked goods. That’s why I dug in and did the math—and I’m happy to show my work.
Regulated concentrations
So, what did Consumer Reports (CR from here) find? The company collected three samples of each of the 36 products from grocery stores, specialty/international food shops, and online sellers. Then, they sent them off to a commercial lab for testing and reported back the average concentrations of lead in parts per million (ppm), which is equivalent to milligrams per kilogram (mg/kg).
CR judged the results by a threshold level of 1 ppm, which is the concentration at which the state of New York will issue a recall for a spice (currently, at least, they have proposed lowering it). It’s important to note that, even at the current 1 ppm threshold, New York is an outlier. As CR notes, New York is the only state to have such a threshold. The Food and Drug Administration doesn’t have a clear cut-off, but recent warnings from the agency were all regarding products that had lead concentrations of more than 2 ppm, not 1 ppm. The FDA also notes that the international food standard-setting body, Codex Alimentarius Commission, sets a limit for bark spices at 2.5 ppm. Further, the European Union set the maximum allowable lead concentration for bark spices at 2 ppm, according to regulations set in 2021 (PDF).
Despite the unusually low threshold, CR highlighted 12 products—mostly uncommon brands—that wouldn’t make it in the Big Apple. Of those, only three products were above the 2 ppm threshold that would have drawn the eyes of FDA and European Union regulators. The two brands behind the two highest readings (Paras at 3.52 ppm and EGN at 2.91 ppm) indicated to CR that they would voluntarily recall their products. The other product that came in above 2 ppm was Mimi’s Products cinnamon, with an average of 2.03 ppm. CR data shows that only one of the three samples was above 2 ppm (with readings of 1.97 ppm, 2.16 ppm, and 1.97 ppm).
That said, concentration thresholds for the purposes of regulatory recalls are one thing. Other things—likely to be far more relevant to consumers—are how much cinnamon people actually eat and what the maximum safe amount of lead is. So, what are those?
