Daniel Rosenbaum for The New York Times

. It seems as if every time we turn around there is another outbreak of a scary foodborne illness.

More Articles in This SeriesThis summer’s huge egg recall was the latest reminder that we do battle against dangerous pathogens like E. coli and salmonella in our kitchens every day.

That battle can be expensive. After a recall makes headlines, it is not unusual for consumers to flock to higher-priced organic and locally grown meats, poultry, eggs and produce that can cost two or three times as much as conventional food. And expensive antibacterial soaps and washes, cutting boards and meat thermometers are promoted as tools of the trade for a germ-free kitchen.

Kathleen McCleary of Falls Church, Va., revamped her shopping and cooking routines after she became ill with E. coli that she and her doctors thought she got from bagged lettuce. The 50-year-old novelist described her new routine: “I buy almost all my meat and produce from the local farmers’ market, I cook everything thoroughly, my cutting board is clearly labeled on either side for meats and vegetables and I keep a little hydrogen peroxide on my sink to wash down surfaces where any dangerous germs could lurk.”

Ms. McCleary estimates that her grocery bill is 20 to 30 percent higher than it used to be. “I’m still a careful shopper and watch my budget, but the extra expense is worth it to me,” she said. “I just never want to get that sick again, and I never want to put my kids at risk.”

There is good reason to be scared into action. Every year, 76 million cases of foodborne illness occur, leading to about 300,000 hospitalizations and 5,000 deaths. Young children, pregnant women, the elderly and anyone with a compromised immune system are most at risk for getting a severe or life-threatening case of food poisoning, but anyone can get hit hard. Survivors of serious cases can have long-lasting health issues like kidney problems.

As more outbreaks occur, the costs to society are skyrocketing. As of this year, the nation spent an estimated $152 billion annually on medical and lost productivity costs because of illnesses from tainted food, according to a recent study by the Produce Safety Project at Georgetown University. And that doesn’t begin to count the millions of dollars companies spend each year on recalls.

Some relief may come from Congress this fall, when the Senate is expected to take up a bill that passed the House in July. The new legislation would require food companies to adopt stricter standards and undergo more frequent inspections. The bill would also give the government the authority to order recalls of tainted food.

“This is a good bill because it changes the Food and Drug Administration’s whole approach. The F.D.A. can be more preventive to better ensure the food that arrives in our kitchens is safe to begin with,” said Christopher A. Waldrop, director of the Food Policy Institute at the Consumer Federation of America, an advocacy group.

Until that time, safe food buying, handling and preparation is the best defense — and some juggling may be needed to avoid breaking the budget. Here, food safety experts offer advice on the most important, but still cost-conscious, ways to germ-proof your kitchen.

USE PASTEURIZED EGGS If you are not willing to give up soft-boiled eggs or unbaked cookie dough, or you are using a recipe that calls for raw or partly cooked eggs, “pasteurized eggs are the easiest way to deal with the risk” said Dr. Michael Doyle with the Center for Food Safety at the University of Georgia.

Pasteurized eggs are heated in the shell to kill harmful bacteria and viruses but still taste and look like regular eggs. They are sold in most grocery stores and come with a red “P” stamped on the carton or on the eggs themselves.

PREPARE FOR STICKER SHOCK Pasteurized eggs can cost almost $5 a dozen, compared with about $4 for organic eggs and $3 for regular. You can soften the budget blow by using pasteurized eggs only when the eggs will be raw or partly cooked in the finished dish, like classic Caesar salad, especially since eggs keep in the refrigerator for three to five weeks.

“I buy farmer’s market eggs for hard-boiled and omelets, but I always have some pasteurized eggs on hand for baking because we all love to nibble the cookie dough,” Ms. McCleary said.

WASH ALL PRODUCE Even if you are going to peel a cucumber or melon, give it a good scrub so you don’t transfer bacteria from the knife or peeler to the part you are going to eat.

Most important, wash all lettuce, even if it comes in a bag that says triple washed. Better yet, skip the expensive bag and buy whole head lettuce, which is cheaper and less likely to be contaminated inside. Dr. Doyle recommends removing and discarding the outer leaves. After washing your hands, rinse the inner leaves thoroughly.

Invest in a salad spinner to make the job easier. There are lots of fancy models that cost $30 or more, but you can buy a basic plastic model that will get the job done for about $10.

LEARN TO LOVE WELL DONE Cooking thoroughly is the best way to eliminate harmful bacteria from meats and poultry. For a list of temperatures for various foods, check the Web site Foodsafety.gov, and don’t rely on your eye alone. Pick up an inexpensive meat thermometer (no need for a digital model) next time you are in the grocery store.

THE RIGHT CUTTING BOARDS Always prepare raw meats and poultry on one cutting board, using another for vegetables. Clean both with warm soapy water after each use. Every few days sanitize your cutting boards with a solution of one tablespoon bleach in one gallon of water. Allow the cutting board to stand in the solution for several minutes, then rinse with clear water. More tips are available at the Department of Agriculture’s Web site.

There is conflicting scientific evidence whether wood or plastic cutting boards are safer, said Nancy Donley, board president at Safe Tables Our Priority, a nonprofit advocacy group working to prevent foodborne illness. So use whichever you prefer or is on sale. The important thing is to keep boards clean and replace them when they become scored because pathogens can hide in the grooves.

UNDERSTAND ‘ORGANIC’ “Organic doesn’t necessarily mean safer,” Ms. Donley said. “The organic label means grown without pesticides, it has nothing to do with bacteria and other pathogens.” This became especially apparent in 2006, when some organic growers were involved in the recall of E. coli-tainted spinach.

On the other hand, there is something reassuring about buying from a small organic farmer at a local stand or farmers’ market, even if it does cost more. Like Ms. McCleary, most people can’t help but feel that food grown and raised on a small farm is a lower risk.

Even so, remember that you need to handle anything organic — meat, poultry, produce — the same as nonorganic, said Shelley Feist, executive director of the Partnership for Food Safety Education, a coalition of industry and advocacy groups. You should still keep meats and vegetables separate to avoid cross-contamination, wash all produce thoroughly and wash platters and other surfaces that come into contact with raw meat and poultry. Thoroughly cook meats, poultry and eggs. For more safe handling and cooking tips, go to the partnership’s Web site at www.fightbac.org.

BE SMART ABOUT LEFTOVERS Nothing suits a tight budget better than leftovers. But keeping food too long can pose a risk. “There’s a myth out there that if leftovers smell O.K., they’re O.K. to eat,” Ms. Feist said. “But you can’t smell, see or taste the bacteria that causes illness.”

Keep in mind this advice from the Center for Science in the Public Interest: Don’t leave food out longer than two hours, and use or freeze all leftovers within four days.

To avoid throwing out food (and wasting money), try to plan your week’s menu and shopping list with leftovers in mind — roast chicken one day, chicken salad sandwiches the next — to make sure leftovers get used quickly.

Finally, keep an eye on an elderly relative’s refrigerator. “The elderly are often likely to keep food too long,” Ms. Feist said. “But they are more at risk of getting seriously ill from tainted food.”

The Finnish National Institute for Health (THL) proposed suspending vaccinations for H1N1 swine flu, due to suspected links to increased narcolepsy in children and adolescents, the body announced this week.

Six cases of narcolepsy, a chronic disorder causing excessive daytime sleepiness and extreme fatigue, have been reported after patients had been receiving the Pandemrix vaccine.

Six cases of narcolepsy is consistent with annual averages, reports THL, but all of these patients were affected after being vaccinated, and there are nine additional cases that have not yet been confirmed.

The precautionary measure will take effect until the actual cause of the current health issue can be established. Preliminary results of the investigation will take several months to be known, says the THL.

“A number of different reasons may be behind the observed rise in the incidence of narcolepsy: A(H1N1) infection, vaccination, a compound effect of infection and vaccination, or some other factor entirely. Infections in general are known to cause narcolepsy,” said a THL press release.

In Sweden, the Medical Products Agency started a similar investigation on Aug. 19 for the same reason. Sweden has bought 18 million doses of the vaccine, sufficient for everyone in the country to have two injections. In Europe, about 30 million people have been vaccinated, and worldwide at least 90 million.

Last winter, 29 million children in the United States were given a seasonal influenza shot that incorporates the swine flu vaccine, but according to Tom Skinner, press officer of Centers for Disease Control and Prevention, narcolepsy associated with the vaccine has not been reported.

According to Marjo Renko, chairwoman of Finland’s national group of experts on vaccines, a substance was identified as possibly cause narcolepsy, but later denied it.

“There is no proof that the increase in narcolepsy would be linked with the vaccines. We do not suspect anything. This is mere speculation,” she said, according to Helsingin Sanomat.

(CNN) — Zemco Industries in Buffalo, New York, has recalled approximately 380,000 pounds of deli meat that may be contaminated with bacteria that can cause a potentially fatal disease, the U.S. Department of Agriculture announced Monday.

The products were distributed to Wal-Marts nationwide, according to the USDA’s website.

The meats may be contaminated with Listeria monocytogenes, which was discovered in a retail sample collected by inspectors in Georgia. The USDA has received no reports of illnesses associated with the meats.

Upon learning of the voluntary recall, Wal-Mart immediately told its stores to remove the meat from their shelves, the company said in a statement.

“Consumption of food contaminated with Listeria monocytogenes can cause listeriosis, an uncommon but potentially fatal disease,” according to the USDA. “Healthy people rarely contract listeriosis. However, listeriosis can cause high fever, severe headache, neck stiffness and nausea.

“Listeriosis can also cause miscarriages and stillbirths, as well as serious and sometimes fatal infections in those with weakened immune systems, such as infants, the elderly and persons with HIV infection or undergoing chemotherapy,” the USDA said.

The products subject to recall are:

– 25.5-pound cases of “Marketside Grab and Go Sandwiches BLACK FOREST HAM With Natural Juices Coated with Caramel Color” with the number 17800 1300.

– 28.49-pound cases of “Marketside Grab and Go Sandwiches HOT HAM, HARD SALAMI, PEPPERONI, SANDWICH PEPPERS” with the number 17803 1300.

– 32.67-pound cases of “Marketside Grab and Go Sandwiches VIRGINIA BRAND HAM With Natural Juices, MADE IN NEW YORK, FULLY COOKED BACON, SANDWICH PICKLES, SANDWICH PEPPERS” with the number 17804 1300.

– 25.5-pound cases of “Marketside Grab and Go Sandwiches ANGUS ROAST BEEF Coated with Caramel Color” with the number 17805 1300.

The meats were produced on dates ranging from June 18 to July 2, 2010. The “Use By” dates range from August 20 to September 10, 2010.

Wal-Mart noted the recall involves Marketside Grab and Go sandwiches, but not individual packages of deli meat. “We encourage customers who recently purchased this item to return it for a full refund,” the company statement said.

CNN’s Ashley Hayes contributed to this report.

By MIKE STOBBE and MARY CLARE JALONICK

ATLANTA (AP) – Hundreds of people have been sickened in a salmonella outbreak linked to eggs in four states and possibly more, health officials said Wednesday as a company dramatically expanded a recall to 380 million eggs.

The Centers for Disease Control and Prevention is working with state health departments to investigate the illnesses. No deaths have been reported, said Dr. Christopher Braden, a CDC epidemiologist involved in the investigation.

Initially, 228 million eggs, or the equivalent of 19 million dozen-egg cartons, were recalled by the company Wright County Egg of Galt, Iowa. But that number was increased to nearly 32 million dozen-egg cartons.

Minnesota, a state with some of the best food-borne illness investigators in the country, has tied at least seven salmonella illnesses to the eggs.

Other states have seen a jump in reports of the type of salmonella. For example, California has reported 266 illnesses since June and believes many are related to the eggs. Colorado saw 28 cases in June and July, about four times the usual number. Spikes or clusters of suspicious cases have also been reported in Arizona, Illinois, Nevada, North Carolina, Texas and Wisconsin.

Salmonella is the most common bacterial form of food poisoning. And the strain involved in the outbreak is the most common strain of salmonella, accounting for roughly 20 percent of all salmonella food poisonings.

Unfortunately, current lab tests do not allow health officials to fingerprint this form of salmonella as precisely as other kinds of food-borne illness. So determining the size of a salmonella enteritidis outbreak is a little more challenging, Braden said.

The Food and Drug Administration also is investigating.

Much of the investigation so far has been centered on restaurants in California, Colorado, Minnesota and North Carolina. They are not necessarily breakfast places – it’s possible some got sick from eating a salad dressing that had a raw egg in it, or eating soup with an undercooked egg dropped in, Braden said.

In North Carolina, a cluster of about 80 illnesses in April were linked to meringue-containing chocolate pie and banana pudding served at a Durham barbecue restaurant, health officials said.

Eggs from Wright County Egg were linked to illnesses in the four states. The eggs were distributed around the country and packaged under the names Lucerne, Albertson, Mountain Dairy, Ralph’s, Boomsma’s, Sunshine, Hillandale, Trafficanda, Farm Fresh, Shoreland, Lund, Dutch Farms and Kemp. It wasn’t immediately clear when the eggs were produced and distributed.

The initial recall was issued last week. Eggs affected by the expanded recall were distributed to food wholesalers, distribution centers and food service companies in California, Colorado, Minnesota, Arkansas, Arizona, Georgia, Illinois, Iowa, Oklahoma, Oregon, Missouri, Nebraska, Nevada, Texas, Utah, Washington and Wisconsin.

“We are undertaking this additional recall to further protect the safety of consumers – this voluntary measure is consistent with our commitment to egg safety, and it is our responsibility,” Wright County Egg officials said in a statement Wednesday evening.

In an earlier statement, company officials said the FDA is “on-site to review records and inspect our barns.” The officials said they began the recall Aug. 13.

The most common symptoms of salmonella are diarrhea, abdominal cramps and fever within eight hours to 72 hours of eating a contaminated product. It can be life-threatening, especially to those with weakened immune systems.

This form of salmonella can be passed from chickens that appear healthy. And it grows inside eggs, not just on the shell, Braden noted.

Thoroughly cooking eggs can kill the bacteria. But health officials are recommending people throw away or return the recalled eggs.

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Gene makes bacteria resistant to almost all antibiotics
Patients brought enzyme back from India and Pakistan

The NHS is on red alert to detect a ‘superbug’ resistant to the most powerful antibiotics which has been imported from India by health tourists.
There are fears that without vigilance a new gene that allows any bacteria to become a superbug could become widespread in NHS hospitals.
It has infected around 50 Britons so far, many of whom returned to the UK after undergoing surgery in India or Pakistan.

Vulnerable: Young and elderly patients will be particularly susceptible to the ‘superbugs’, which have emerged recently and are immune to almost all antibiotics (picture posed by model)
The Health Protection Agency (HPA) yesterday stepped up its warnings about the new gene called NDM-1, or New Delhi metallo-beta-lactamose after the place where it was first identified.
Dr David Livermore, director of antibiotic resistance monitoring at HPA, said resistance to one of the major groups of antibiotics, the carbapenems, is found throughout India.
‘This is important because carbapenems were often the last ‘good’ antibiotics active against bacteria that already were more resistant to more standard drugs,’ he said.

‘We have now also identified bacteria with this type of resistance – NDM – in around 50 patients in the UK.
‘Most not all, had previously travelled to the Indian subcontinent and many had received hospital treatment there.
‘International travel gives a great potential for spread of resistant bacteria between countries.’

Dr Livermore added: ‘Few antibiotics remain active against these bacteria.Their spread underscores the need for good infection control in hospitals both in the UK and overseas, and the need for new antibiotic development.’
The spread of the enzyme that makes any bug ‘super’
Rising levels of antibiotic resistance are a threat because there are few new drugs in the pipeline.

Infection experts are alarmed about the spread of multi-drug resistance facilitated by the gene NDM-1 that can easily jump from one strain of bacteria to another.

If it ends up in a bacterium which is already resistant to many other antibiotics then it could produce infections that are almost impossible to treat.

NDM-1-producing bacteria are resistant to many existing antibiotics including carbapenems – a class of drugs often reserved for emergency use and ‘last resort’ treatment.

So far two types of bacteria have been host to NDM-1 – the gut bug E.coli and another that can invade the lungs called Klebsiella pneumonia.

Both can lead to urinary tract infections and blood poisoning.

E.coli is among a group of ‘gram-negative’ bugs, and the proportion of antibiotic-resistant cases of E.coli infection has trebled since the turn of the century.

There are about 20,000 E.coli bloodstream infections each year in England, Wales and Northern Ireland, of which more than one in ten is resistant to antibiotics.

There are just two antibiotics in the pipeline against this group of infections.
This compares with several new medications for gram-positive infections like MRSA.

Figures suggest it costs between
£500 million to £1 billion to bring new drugs to market.

GSK, one of a handful of giant pharmaceutial firms actively investing in antibiotic research, said: ‘New antibiotics that work in different ways to existing medicines are desperately needed to tackle the rising incidence of antibiotics resistance.’
The HPA flagged up the problem last year but renewed its warnings after a study in journal The Lancet Infectious Diseases tracked the emergence of the ‘superbug’ gene in different countries.
The researchers found NDM-1 is becoming more common in Bangladesh, India and Pakistan and is starting to be imported back to Britain in patients returning from these countries.
Several of the British NDM-1 positive patients had recently travelled to the Indian subcontinent for hospital treatment including cosmetic surgery.
Timothy Walsh, professor of medical microbiology and antimicrobial resistance at Cardiff University, who led the study, said it was a ‘real concern’.
‘Because of medical tourism and international travel in general, resistance to these types of bacteria has the potential to tavel around the world very, very quickly.’
He said there are few drugs in development that can potentially combat the threat.
The resistant gene has also been detected in Australia, Canada, the US, the Netherlands and Sweden.
The NDM-1 gene alters bacteria, making them resistant to nearly all known antibiotics.
It has been largely found in E. coli bacteria, the most common cause of urinary tract infections, and on DNA structures that can be easily copied and passed onto other types of bacteria.
The researchers said the superbug gene appeared to be already circulating widely in India, where the health system is much less likely to identify its presence or have adequate antibiotics to treat patients.
Christopher Thomas, professor of molecular genetics at the University of Birmingham who was not linked to the study, said ‘We are potentially at the beginning of another wave of antibiotic resistance, though we still have the power to stop it.’
Prof Thomas said better surveillance and infection control procedures might halt the gene’s spread.
Although patients in British hospitals are unlikely to encounter the superbug gene, they should remain vigilant about standard hygiene measures like properly washing their hands, he added.
Enlarge ‘The spread of these multi-resistant bacteria merits very close monitoring’ wrote Johann Pitout of the division of microbiology at the University of Calgary, Canada, in an accompanying Lancet commentary.
He called for international surveillance of the bacteria, particularly in countries that actively promote medical tourism.
‘The consequences will be serious if family doctors have to treat infections caused by these multi-resistant bacteria on a daily basis’ he added.
The Department of Health spokesman said ‘We are working with the Health Protection Agency. The HPA alerted the NHS in January and July lst year to be vigilant about these bacteria and take appropriate action where necessary.
‘Hospitals need to ensure they continue to provide good infection control to prevent any spread, consider whether patients have recently been treated abroad and send samples to the HPA for testing.’
Superbug: New Dehli-Metallo-1, seen under the microscope could be untreatable for as long 10 years while scientists devise the right kind of antibiotics

This initiation allows health care professionals in the US to protect their patients well in advance of this year’s flu season.

The Fluvirin influenza virus vaccine has been approved by the US Food and Drug Administration (FDA) and recommended for patients four years of age and older, claimed the company.

Fluvirin will be available to health care professionals in both pre-filled syringes and multi-dose vials, added the company

Fraudulent ‘Generic Tamiflu’ Could Pose Danger
Contains an antibiotic, not Tamiflu’s active ingredient, FDA warns
A product sold as “Generic Tamiflu” on an Internet site does not contain the active ingredient of Tamiflu and could be dangerous to consumers, the U.S. Food and Drug Administration (FDA) warned. The product instead contains an antibiotic that could cause life-threatening reactions in people allergic to penicillin, the FDA said.

The FDA purchased the product without a prescription from an Internet site and received it in an envelope postmarked from India, according to a June 17 press release. The website, which claimed to be an online drugstore, is no longer operational, but the same product is likely to be available from other sites, the FDA said.

“Medicines purchased from websites operating outside the law put consumers at increased risk due to a higher potential that the products will be counterfeit, impure, contaminated, or have too little or too much of the active ingredient,” said FDA Commissioner Margaret A. Hamburg, MD, in a statement.

According to the FDA, the product did not contain oseltamivir, the active ingredient in Tamiflu (Roche; Basel, Switzerland), but rather cloxacillin, an antibiotic in the same class as penicillin. Cloxacillin could cause reactions, including anaphylaxis, in people allergic to penicillin. As of July 6, the FDA was not aware of any reports of adverse reactions related to the product, said spokeswoman Elaine Gansz Bobo.

The product delivered to the FDA contained two foil-backed blister packages, each containing 15 yellow and tan capsules containing white powder. The foil backing was labeled “Oseltamivir Phosphate 75mg. Capsules,” and the product name was listed as TM-FLU Capsules, manufactured by Trydrugs Pharmaceuticals Pvt. Ltd. The FDA advised consumers who encounter the fraudulent product not to use it and to contact the FDA’s Office of Criminal Investigations.

“Consumers assume that since bottled water carries a price tag, it is purer and safer than most tap water. Regulatory bodies do not specify a maximum limit for ‘heterotrophic microbial count’ in bottled water. … This study puts a question mark on the safety of the common public who consume unknown microorganisms in bottled water,” said Sonish Azam, PhD, in an e-mail to Food Quality.

Dr. Azam and colleagues, presented a poster describing their study at the American Society for Microbiology meeting last month (Azam S, Marino M, Khamessan A. A random study of the microbiological quality of bottled drinking water in Canada. Poster presented at: American Society for Microbiology meeting; May 23-27, 2010; San Diego).

While regulatory bodies, including the U.S. Food and Drug Administration, the Environmental Protection Agency, and Health Canada, have no set limits for microbial contamination in bottled water, USP standards for drinking water dictate that it should contain no more than 500 colony-forming units per milliliter (cfu/mL).

In randomly selected bottled water samples ranging from half-liter bottles to office-sized 20-liter jugs, the heterotrophic bacteria count ranged from less than 10 to 72,000 cfu/mL, reported researchers from the microbiology laboratory at C-crest Laboratories in Montreal. Seventy percent of samples exceeded the USP’s limit for drinking water.

The researchers called for limits for the heterotrophic microbial count in bottled water. “Labels on bottled water should disclose the purification/treatment procedure and special instructions/precautions for weak or immunocompromised individuals,” said Dr. Azam, microbiology laboratory coordinator at C-crest.
Most samples exceeded USP limits for drinking water
Most samples of bottled water tested in a Canadian study contained bacterial contamination in excess of limits for drinking water specified by the U.S. Pharmacopeial Convention (USP). The study authors called for standards to be set for bacterial levels in bottled water.

“Consumers assume that since bottled water carries a price tag, it is purer and safer than most tap water. Regulatory bodies do not specify a maximum limit for ‘heterotrophic microbial count’ in bottled water. … This study puts a question mark on the safety of the common public who consume unknown microorganisms in bottled water,” said Sonish Azam, PhD, in an e-mail to Food Quality.

Dr. Azam and colleagues, presented a poster describing their study at the American Society for Microbiology meeting last month (Azam S, Marino M, Khamessan A. A random study of the microbiological quality of bottled drinking water in Canada. Poster presented at: American Society for Microbiology meeting; May 23-27, 2010; San Diego).

While regulatory bodies, including the U.S. Food and Drug Administration, the Environmental Protection Agency, and Health Canada, have no set limits for microbial contamination in bottled water, USP standards for drinking water dictate that it should contain no more than 500 colony-forming units per milliliter (cfu/mL).

In randomly selected bottled water samples ranging from half-liter bottles to office-sized 20-liter jugs, the heterotrophic bacteria count ranged from less than 10 to 72,000 cfu/mL, reported researchers from the microbiology laboratory at C-crest Laboratories in Montreal. Seventy percent of samples exceeded the USP’s limit for drinking water.

The researchers called for limits for the heterotrophic microbial count in bottled water. “Labels on bottled water should disclose the purification/treatment procedure and special instructions/precautions for weak or immunocompromised individuals,” said Dr. Azam, microbiology laboratory coordinator at C-crest.