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FDA Reissues Warning Against
Eating Raw Sprouts


Here is a warning from the FDA regarding raw sprouts, which could be hazzardous to those who have Hep C and/or other chronic infections.

People with chronic infections including HIV, HBV and HCV may be at higher risk
Due to outbreaks of Salmonella food poisoning traced to raw sprouts, the US Food and Drug Administration (FDA) has reissued an advisory warning against consuming them. The warning represents an update of an advisory issued in the summer of 1998. However, due to additional case reports of Salmonella from clover and alfalfa sprouts, the warning has been re-issued. People who have compromised immune systems, children and the elderly are at the greatest risk for developing serious illness due to food poisoning.

Since May 1999, 37 additional people with Salmonella poisoning from clover sprouts have been diagnosed in California. One of them has died. Since March 1999, approximately 101 people in Colorado became ill after eating clover sprouts. Also, 85 people developed Salmonella food poisoning resulting from alfalfa sprout consumption in California, Oregon and Washington. Lea Brooks, spokesperson at the California Department of Health, said, "Clover sprouts should not be served in day care centers, school lunch programs, nursing homes or hospitals." Symptoms of Salmonella include diarrhea often with blood, abdominal cramping, nausea and fever. Not all symptoms need to be present. In the most severe form, the infection spreads through the bloodstream, which can be life-threatening. It is treated with standard prescription antibiotics. The infection occurs due to stool contamination of the sprouts or other food.

After ingestion of Salmonella-contaminated food, symptoms develop after an incubation period of up to 3 days. Often, several more days pass until patients see their physicians. Stool (and/or blood) cultures take another 2 days.  Subsequently, "serotyping" is performed by additional tests at a state laboratory. Additional DNA tests require another week to determine if the strain is the same one that is causing an outbreak. Treatment can be started when the stool culture is positive. In suspected secondary cases (after one patient has already had a positive stool test), some physicians would treat  "empirically," without stool test results.

Measures to kill the Salmonella bacteria on the sprouts are only experimental. The combination of chemical treatment with calcium hypochlorite and irradiation may provide some benefit. Agricultural practices would also help. One possibility would include mandatory HACCP, Hazard Analysis and Critical Control Point, programs for growers.

Raw sprouts can also carry E. Coli 0157, another bacterium that can be lethal. Since 1995, there have been 10 documented outbreaks of food poisoning from raw sprouts in the US alone that were due to either Salmonella or E. Coli 0157. This latter infection is lethal for 3-5% of children who develop the complication of HUS, hemolytic uremic syndrome. (HUS occurs when the kidneys fail and red cells in the blood burst open.) E. Coli 0157 has been linked to undercooked hamburgers and raw, unpasteurized (not heated) fresh fruit juice. The worst documented outbreak of E. Coli 0157 infection occurred in Japan in 1996, when 9,000 people were ill and 17 people died. The source was contaminated raw radish sprouts.

The number of cases of food-borne illnesses has increased somewhat in recent years. For some of the infections, this has been due to importation of raw fruits and vegetables from outside the US.

The term "Typhoid Mary" refers to a food handler infected with Salmonella typhoid who transmitted the infection to many people decades ago. Some people can carry the infection in their stool without active symptoms. If they do not wash their hands with soap and water after a bowel movement, infected stool can then contaminate food that the person then prepares.

9/17/99 Source:
Chamberlain LJ. Salmonellosis from raw sprouts causes FDA warning.
Infectious Disease News 12(8), 9. August 1999.

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