Food Safety News

La Fiesta Food Products of La Mirada, CA, is recalling Cinnamon Ground .87oz because it has the potential to be contaminated with lead.

The affected product was distributed in California as well as Arizona, Washington and Texas through distributors to retail stores from April 20, 2023, through May 3, 2023. It has a long shelf life so consumers are urged to check their homes for the product.

The impacted Cinnamon Ground products are identified below:
La Fiesta Brand Cinnamon Ground .87oz UPC#032327000449

La Fiesta Food Products became aware of the issue after the Food and  Drug Administration collected samples of the product and lab analysis revealed elevated concentrations of lead.

Consumers who have purchased this product are advised to dispose of it or return to place of purchase for refund. Anyone concerned about an injury or illness should contact a healthcare provider. Consumers with questions can contact 408-326-0487 or qualityassurance@lffp.com.

About lead poisoning
Short term exposures to very low levels of lead may not elicit any symptoms. It is possible that increased blood lead levels may be the only apparent sign of lead exposure. Additional signs and symptoms of lead exposure are more likely with acute exposure to higher levels of lead or chronic exposure to lead. While lead can affect nearly every bodily system, its effects depend upon the amount and duration of lead exposure and age/ body weight. 

If a child is exposed to enough lead for a protracted period of time (e.g., weeks to months) permanent damage to the central nervous system may occur. This can result in learning disorders, developmental defects, and other long-term health problems. For adults, chronic lead exposure is associated with kidney dysfunction, hypertension, and neurocognitive effects.

Exposure to large amounts of lead can cause lead poisoning. While lead can affect nearly every bodily system, its effects depend upon the amount of and duration of lead exposure and age of the person exposed.

(To sign up for a free subscription to Food Safety News,click here)

The Food and Drug Administration is requesting 7.4 percent more for certain aspects of its budget for fiscal year 2025 than it received for the current year, which began on Oct. 1, 2023, and runs through Sept. 30 this year.

The FDA’s request is less than 1 percent of President Biden’s proposed $7.3 trillion budget announced Monday. The FDA requests an increase of $495 million above its current funding level. The requested amount is generally less than the allocated amount.

“The FDA’s request reflects the agency’s top priorities in key areas of importance for human and animal health,” according to a Monday statement from the agency.

“This funding will allow the agency to enhance food safety and nutrition, advance medical product safety, help support supply chain resiliency, strengthen the agency’s public health and mission-support capacity, and modernize the FDA’s infrastructure and facilities.”

A small part of the FDA’s $702 billion request would go toward food safety. The vast majority of the FDA’s budget goes to the operations on the drug side of the agency.

In a $15 million slice of the FDA’s request pie, specific food safety efforts include modernizing the ability to prevent or manage foodborne illness outbreaks by investing in tools and processes to strengthen root-cause investigations. That aligns with some of the goals set by Jim Jones, the first-ever Deputy Commissioner for Human Food Programs. Also earmarked out of the same $15 million slice of the agency’s wish pie would be working on the public health burden of diet-related chronic diseases.

For a $12.3 million portion of its request, the FDA says it will improve supply chain disruptions and support supply chain resiliency. 

“Through an agency-wide crosscutting initiative, the FDA will advance its capabilities to help prepare for, build resilience to, and respond to shortages through improved analytics and regulatory approaches. Amongst other initiatives, the agency will hire additional investigators to fulfill inspectional needs associated with increased supply-chain disruptions and consequent human food and medical product shortages in recent years.”

On the food side of the agency, supply chain issues were brought to the forefront in 2022 when an infant formula production plant had to be closed because of an outbreak of cronobacter infections linked to it. Multiple products and locations in the plant were found to be contaminated, though none of the positive tests precisely matched the outbreak strain.

The plant’s closure resulted in parents having to drive for hours to find infant formula because shelves were left bare of products.

A former employee of the implicated plant reported that some products had tested positive for contaminants. Still, the FDA mailroom misdirected that report, and it did not come to light until months after it was received.

The FDA’s budget proposal says it wants to provide new authority to help ensure the safety of foods, including infant formula, medical foods, and foods marketed for infants and young children. Part of that authority would include setting binding contaminant limits by administrative order, requirements for contaminant testing of final products, more frequent environmental monitoring for pathogens in certain facilities, and mandatory reporting when certain products test positive for pathogens. 

A $1 million portion of FDA’s request would expand foreign offices and strengthen imported product oversight. The funding would expand agency resources to facilitate timely inspections of foreign facilities in specific countries. Additional deployed personnel would also improve oversight of imported products, according to the agency’s budget request. 

Problems with inspections related to imported food came to light in the fall of 2023 when it was discovered that cinnamon applesauce marketed for children in the United States and imported from Ecuador was contaminated with lead. It was found that the cinnamon had more than 2,000 times the levels of lead considered safe.

Traceback’s efforts discovered that a third-party supplier in another country sold the contaminated cinnamon to the Ecuadoran applesauce manufacturer. Questions have been raised about the FDA’s authority to inspect foreign food supplier operations and also the agency’s ability to test foods at the border. Some FDA records have shown that testing samples of all food imports is impossible because of limited staffing and laboratory capacity.

A $43.6 million portion of the FDA’s request would go toward ensuring the optimal functioning of the FDA’s offices and labs. The money would allow the FDA personnel at facilities across the country to carry out its mission, including evaluating food safety and medical products, continuing to expand laboratory operations, and supporting inspections at points of entry to reduce the flow of adulterated and illicit imported products and respond to emergencies.

Part of a $2 million slice of the FDA request pie would increase support of agency modernization activities. Although the agency did not specify how much, if any, of the $2 million would go toward the food side of its operations, modernization has been a priority of food administrators in recent years.

The agency did say that the targeted investments would be used to improve the efficiency of its operations by centralizing planning, implementation, and governance of high-priority business process improvement efforts. In creating the Deputy Commissioner for Human Food Programs post, FDA Commissioner Robert Califf said streaming operations and simplifying the chain of command was a goal.

The agency’s budget request states that modernization efforts would include the continuation of the critical inspections platform implementation and expansion efforts to implement common business processes and data optimization across the agency. The budget also proposes a new two-year spending authority to support such investments.

$114.8 million of the proposed budget would support the FDA’s “public health employee workforce,” though the agency did not specify how much money would go toward food operations. The funding would help the FDA cover estimated inflationary pay costs and cost-of-living adjustments to “minimize reductions to hiring capabilities and maintain the agency’s highly qualified, specialized staff crucial to carrying out its public health mission.”

$8.3 million is requested to modernize data infrastructure to support agency operations. The money would allow the agency to continue building the FDA’s centralized data-modernization capabilities and strengthen its common data infrastructure. Still, again, the agency statement did not indicate how much of this portion of its budget request would go to food programs. The budget request proposes a new two-year spending authority to support these investments.

In addition to the specific spending areas mentioned above, the FDA’s proposed budget includes money to fund a “package of legislative proposals designed to support better agency efforts to protect American consumers and patients.” Those proposals deal with:

• additional oversight tools, such as expanding authorities for information-sharing with states, broadening authority to request records or other information in advance of or instead of inspections of all FDA-regulated commodities, and requiring importers to destroy products that present a significant public health concern,
• various medical devices and food;
• regulations for animal food;
• timely competition for new drugs;
• meeting tobacco program public health mandates;
• additional authorities to increase oversight of dietary supplements and
• modernizing the tobacco user fee framework.

(To sign up for a free subscription to Food Safety News,click here)

Every so often, somebody tries to make a partisan issue about raw milk. That happened again when Colorado was supposed to be “poised to defy this growing partisan divide” with a bill to allow direct sales to consumers.

The problem with SB24-043 is that the bill has gone precisely nowhere in the Colorado Legislature in the first two months of the current session. There are no hearings, no testimony, and no movement off the dime for the bill allowing the sale of raw milk directly to consumers from registered dairy farmers who follow certain new rules around labeling, storage, and transportation.

Iowa, a state dominated by Republicans, passed a similar bill last year. Colorado, where the Legislature is in the hands of Democrats, is a different kind of test for raw milk advocates.

SB24-043 is sponsored by Democrat Sen. Dylan Roberts, elected from the 8th District in 2022. Also on the bill are the Democratic House Speaker Julie McCluskie and Republican Sen. Byron Felton of the 1st District.

Prospects for SB24-043 seemed good when the session began because of Gov. Jared Polis, Colorado’s second-term Democrat.

Last summer, Sen. Roberts and others noticed Polis’s statements on the record about his support for liberalizing raw milk law.

Those comments did not surprise anyone who has followed Jared Polis’s career. During his five terms in Congress, Polis was an active member of the bipartisan “Food Freedom” caucus led by Rep. Thomas Massie, R-KY.

Since being elected to Congress in 2012, Massie has forced Congressional votes on “Food Freedom” measures involving raw milk and custom slaughter.

Polis was an enthusiastic recruit to those causes, even hosting Massie in Denver for a “forbidden food” tour.

Roberts introduced SB24-043 because dairy farmers in his district say raw milk sales would be an economic boost. He remains hopeful that his bill will emerge by the end of April when the Colorado Legislature adjourns.

Roberts says nothing in his bill will impact anyone who does not drink raw milk. When not serving in the State Capitol, Roberts is an attorney.

Under current law in Colorado,  the sale of raw, unpasteurized milk is prohibited. SB24-043 would legalize the sale of raw cow or goat milk when it is sold directly to consumers at the point of production, the consumer’s residence, or at a farmer’s market or roadside market.

Raw milk sales require a producer to be registered with the Colorado Department of Public Health and Environment (CDPHE) and meet specific handling and labeling requirements. CDPHE, like other public health agencies, has long warned consumers about the dangers of raw milk. There is a federal law making it illegal to sell unpasteurized, raw milk across state lines.

Under the bill, The Colorado Department of Agriculture (CDA) may establish handling, storage, labeling, and transportation requirements to sell raw milk by rule in consultation with CDPHE. 

CDA may also investigate raw milk producers and apply a civil penalty to or seek civil court action against a producer violating the program’s requirements.

The Colorado Legislature convened on Jan. 10 and will adjourn by May 8.

(To sign up for a free subscription to Food Safety News, click here.)

Experts have assessed prevention and intervention methods to tackle foodborne viruses in different products.

In February, the Joint FAO/WHO Expert Meeting on Microbiological Risk Assessment (JEMRA) on viruses in foods took place in Geneva, Switzerland, after a related request by the Codex Committee on Food Hygiene in 2022. The committee is meeting in Kenya this week.

The event focused on prevention and intervention measures. The findings have been summarized, and the full report will be available later.

The first part of the meeting in September 2023 in Rome, Italy, covered food attribution, analytical methods, and indicators. The virus-commodity combinations of highest priority were human norovirus and hepatitis A virus in shellfish, fresh and frozen produce, prepared and ready-to-eat (RTE) foods, and hepatitis E virus in pork and wild game.

At the second meeting, experts reviewed the scientific literature published since the 2008 JEMRA report on foodborne viruses and control measures to protect the supply chain from contamination.

Since the 2008 report, awareness of the public health importance of these virus-commodity combinations has increased, resulting in changes to some food supply chain management strategies, said scientists.

Shellfish and produce
Human fecal matter and vomit from infected individuals are the primary sources of contamination for norovirus and hepatitis A. The main contamination routes are fecally-impacted waters, food handlers carrying viruses, and surfaces. Microscopic amounts of the contaminants are enough to cause illnesses in humans. The zoonotic hepatitis E virus is in the meat, organ tissues, and excretions of infected swine and some game animals.

Experts say that prevention remains vital to control foodborne viruses because they are environmentally persistent and resistant to many treatments commonly used to inactivate pathogens.

For shellfish, sanitary surveys are increasingly used to evaluate human fecal pollution status in growing areas and can determine conditions in which harvesting can occur safely. Using more effective wastewater treatment can reduce viral loads in effluent but requires infrastructure investment. Climate change is expected to result in heavier rainfall in some locations, which may increase the likelihood of sewage overflows or runoff. Contaminated products are discarded or diverted to processing such as depuration or heat treatment.

Fresh and frozen produce are usually contaminated pre-harvest by sewage sludge, human fecally-impacted source waters, and infected food handlers. Frozen produce, especially berries, dominate outbreaks, aided by the fact that freezing preserves virus infectivity and results in globally distributed products with a long shelf-life. Production-related interventions should focus on the water source, location, method, and application timing. According to experts, Emerging water treatments, such as ozone, ultraviolet, and ultrafiltration, show potential but require infrastructure investment.

RTE food and pork meat
Prepared and infected food handlers usually contaminate RTE foods. Prevention focuses on the exclusion of infected workers, surface disinfection, and attention to personal hygiene, including handwashing. Policies exist, and handwashing is promoted, but compliance is often poor.

Hepatitis E exposure can occur by consuming raw or inadequately cooked meats and direct contact with infected animals on farms or slaughterhouses. Studies suggest control measures should focus on preventing animal infection at the pre-harvest phase via biosecurity measures and disinfection and post-harvest interventions like preventing cross-contamination and virus inactivation by heat.

Experts said one issue was the limited ability to routinely cultivate wild-type foodborne viruses in the lab, which complicates the chance to validate interventions, compare studies, and interpret monitoring data.

They added that early identification of contamination hotspots may be a useful control tool, the usefulness of indicator organisms in predicting virus occurrence and infectivity could be better understood, and novel interventions should be validated using the relevant viruses before wide application in real-world situations.

(To sign up for a free subscription to Food Safety News, click here.)

Belgium has joined a pilot project looking at the accuracy of Salmonella testing in poultry flocks.

The Netherlands received permission from the European Commission to study to what extent initial positive Salmonella results can be confirmed during verification testing.

Belgium is adopting the protocol from the trial in the Netherlands to achieve comparable results, said Animal Health Care Flanders (DGZ).

Since the beginning of 2020, a confirmation test may no longer be carried out in European countries such as Belgium because of a stricter interpretation of the regulations. Previously, this could be requested when a flock tested positive for one of the target serotypes in laying or breeding poultry. A confirmatory test can now only be done where the positive result of the control sample is considered unreliable.

Past verification testing regularly found no Salmonella during additional sampling. The Dutch study is trying to see if the initial results could be false positives and if the second test findings are reliable. The aim is to obtain more certainty about the presence or absence of Salmonella.

Conditions for taking part
The poultry sector has called for the reintroduction of verification testing because of the major impact a positive finding and related control measures can have.

In the Netherlands, poultry farmers who find specific types of Salmonella and have not given antibiotics to the affected flock can participate in the project under certain conditions. Additional samples will be taken and tested; if they are negative, the suspicion of Salmonella will be lifted. If they are positive, standard procedures will apply.

If the farmer chooses to participate, an NVWA inspector will visit the site to take samples from the suspected area and all other houses at the company. The first sampling occurs immediately after the report, and the second sampling occurs 14 days later. Samples are examined for Salmonella by Wageningen Bioveterinary Research (WBVR).

In Belgium, if a selected type of Salmonella is found on a farm, a local control unit of the Federal Agency for the Safety of the Food Chain (FASFC) will inform the poultry farmer about the project and conditions for participation.

After agreeing to participate in the first investigation, an officer from DGZ will sample all stables at the location, which will be repeated two weeks later. The subsequent sampling is carried out by the company veterinarian, who sends samples to the DGZ laboratory.

(To sign up for a free subscription to Food Safety News, click here.)

Jen’s Breakfast Burritos, LLC, of Auburn, WA is recalling approximately 144 pounds of ready-to-eat (RTE) breakfast burrito products that may be adulterated with Listeria monocytogenes, according to the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA FSIS).

The problem was discovered after FSIS performed routine product testing and the results indicated the product may be contaminated with Listeria monocytogenes.

FSIS is concerned that some product may be in consumers’ refrigerators or freezers.

The RTE breakfast burrito items were produced on Feb. 29, 2024. 

Recalled products:

• 7-oz. individual wax paper packages containing “Smoked Bacon Breakfast Burrito” with lot code 060-1 on a sticker on the back of the package.
• 7-oz. individual wax paper packages containing “Ham Breakfast Burrito” with lot code 060-2 on a sticker on the back of the package.
• 7-oz. individual wax paper packages containing “Seasoned Pork Breakfast Burrito” with lot code 060-3 on a sticker on the back of the package.

The products subject to recall bear establishment number “EST. 1826” inside the USDA mark of inspection. These items were shipped to “to-go” kiosk locations in Washington. Product labels can be viewed here.

As of the posting of this recall, there have been no confirmed reports of adverse reactions due to consumption of these products. Anyone concerned about an illness should contact a healthcare provider.

Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase.

About Listeria infections
Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause severe and sometimes life-threatening infections. Anyone who has eaten any recalled product and developed symptoms of Listeria infection should seek medical treatment and tell their doctors about possible Listeria exposure.

Also, anyone who has eaten recalled products should monitor themselves for symptoms during the coming weeks because it can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop. 

Symptoms of Listeria infection can include vomiting, nausea, persistent fever, muscle aches, severe headache, and neck stiffness. Specific laboratory tests are required to diagnose Listeria infections, which can mimic other illnesses. 

Pregnant women, the elderly, young children, and people such as cancer patients who have weakened immune systems are particularly at risk of serious illnesses, life-threatening infections, and other complications. Although infected pregnant women may experience only mild, flu-like symptoms, their infections can lead to premature delivery, infection of the newborn, or even stillbirth.

(To sign up for a free subscription to Food Safety News, click here.)

The World Health Organization (WHO) is to create a network to help countries with surveillance of foodborne diseases.

The first meeting of the WHO Alliance for Food Safety is scheduled in Geneva, Switzerland, in May with support from the Centers for Disease Control and Prevention’s (CDC) Division of Foodborne, Waterborne, and Environmental Disease (DFWED).

The WHO Global Strategy for Food Safety 2022 to 2030 was adopted at the World Health Assembly in May 2022. Countries committed to advance food safety through five priorities and adopted targets to guide action and track progress toward reducing foodborne infections.

For one of the indicators — Multisectoral collaboration mechanism for food safety events — the International Food Safety Authorities Network (INFOSAN) will be the platform to build capacity and ensure reporting. INFOSAN was created in 2004 and has more than 800 members in 187 nations.

However, for the indicator called ‘Surveillance of foodborne diseases and contamination” there is no similar structure to align efforts and support countries. This indicator uses the International Health Regulations Joint External Evaluation tool. As of 2022, the score stood at 1.5 and the aim by 2030 is a global average capacity score of 3.5.

Help from collaborating centers network
WHO looked at reactivating the Global Foodborne Infections Network (GFN) as well as tapping into its network of collaborating centers. These are institutions such as research institutes, parts of universities or academies, which are designated to carry out activities in support of WHO programs. 

Between 2000 and 2015, GFN served as a capacity-building network of institutions and individuals working in veterinary, food and public health trying to enhance the capacity of countries to detect, control and prevent foodborne and other enteric infections. GFN promoted integrated, laboratory-based surveillance and outbreak detection and response, and helped collaboration and communication among microbiologists and epidemiologists in human health, veterinary, and food-related disciplines.

More than 20 collaborating centers were identified as having terms of reference related to areas of the food safety strategy. An analysis of work plans revealed it was necessary to better align their capacity building activities with the targets of the WHO Global Strategy for Food Safety. Examples of such centers are the National Institute for Public Health and the Environment (RIVM), Singapore Food Agency, Institut Pasteur, and Technical University of Denmark.

WHO and DFWED are holding the meeting to create the food safety alliance including setting terms of reference and identifying its value in foodborne disease surveillance. The aim is to include WHO Collaborating Centers and other institutions to support the implementation of the strategy in the area of foodborne disease surveillance.

The WHO Foodborne Disease Burden Epidemiology Reference Group (FERG) is also in the process of updating estimates of the global, regional, and national burden of foodborne diseases by 2025. The first figures were published in 2015.

World Food Safety Day theme
Meanwhile, the theme for this year’s World Food Safety Day has been revealed as: “Food safety — prepare for the unexpected.”

The campaign will explore unexpected food safety incidents, which can range from a power cut at home to an international food safety alert or outbreak, and how people can better prepare for such events to ensure access to safe food.

The sixth World Food Safety Day will take place on June 7. This year also marks the 20th anniversary of INFOSAN.

Corinna Hawkes, FAO’s director of the agrifood systems and food safety division, and Francesco Branca, WHO’s director of the department of nutrition and food safety, said unexpected food safety incidents can range from mild events to major crises but there is always something that can be done to keep food safe.

“Anticipating the kinds of events that might occur, whether it be a natural disaster like flooding, or a volcano eruption or a power outage can ensure the risk to food safety is minimized. And at home, consumers’ food safety knowledge can avert problems in unexpected situations,” she said.

(To sign up for a free subscription to Food Safety News, click here.)

As part of its enforcement activities, the Food and Drug Administration sends warning letters to entities under its jurisdiction. Some letters are not posted for public view until weeks or months after they are sent. Business owners have 15 days to respond to FDA warning letters. Warning letters often are not issued until a company has been given months to years to correct problems.

Barsotti Juice Company Inc.
Camino, CA

The FDA has warned a juice processing company in California about serious violations of the Hazard Analysis and Critical Control Point regulation, and the Current Good Manufacturing Practice, Hazard Analysis, and Risk-Based Preventive Controls for Human Food regulation.

In a Jan. 30 warning letter, the FDA described Nov. 20-21 and Dec. 1, 2023, inspections of Barsotti Juice Company, Inc.’s processing facility in Camino, CA.

The FDA’s inspection revealed that the firm was not in compliance with federal regulations, which resulted in the issuance of an FDA Form 483. Some of the significant violations are as follows:

1. The firm’s HACCP plan does not include control measures that will consistently produce a 5-log reduction in the most resistant microorganism of public health significance that is likely to occur in the juice, for a period at least as long as the shelf life of the product, as required.

Specifically, their HACCP / HARPC Plan Q2-2023 dated 25 April 2023 lists the following Critical Limits identified at the Pasteurization Critical Control Point (CCP) (redacted) limit). The firm has defined Organic Carrot Juice as a Category III product with a (redacted). The (redacted) is not sufficient to inactivate the spores of Clostridium botulinum in carrot juice.

The firm provided an FDA investigator with a challenge study entitled “(redacted)” to support their critical limit and biological hazards identified for the Pasteurization CCP during the current inspection. The firm’s written response included a justification which explained that “the current thermal processing eliminates all vegetative cells effectively.” Further, it explained “In the event of temperature abuse the growth of aerobic organism competitively prevents C. botulinum spore germination and growth, if present, and other undesirable biochemical changes cause the quality of the Carrot juice to degrade rapidly before the expiration date making the product undrinkable.”

FDA reviewed their challenge study and written response and find them inadequate. The critical limits specified at the Pasteurization CCP (redacted) is insufficient in ensuring control over any types of strains of C. botulinum, posing a serious risk to consumers due to the potential for spore growth and toxin production. (Redacted) for at least (redacted).

The firm’s challenge study does not provide scientific rationale and sufficient data to demonstrate that C. botulinum is not a hazard in their carrot juice. Historical outbreak data demonstrates that C. botulinum is the pertinent microorganism in refrigerated carrot juice. Furthermore, the study does not support the shelf-life of the product which is defined as 28 days.

2. The firm’s HACCP plan does not list the critical control points for each of the identified food hazards that is reasonably likely to occur as required.

Specifically, their HACCP / HARPC Plan Q2-2023 dated 25 April 2023 for fresh, refrigerated Organic Carrot Juice does not identify CCPs at labeling for maintaining product refrigeration, and of finished product refrigerated storage, to control the hazard of Clostridium botulinum growth and toxin formation in Organic Carrot Juice.

As part of their written response, they provided a revised HACCP/HARPC Plan Q4-2023 for Processed Organic Carrot Juice which identifies Pasteurized Storage Tanks, Finished Food Storage and Labeling steps as critical control points for “biological.” The biological hazard is not defined to identify the pertinent microorganism of C. botulinum.

Further, the current Juice HACCP Hazards and Controls Guidance, First Edition, states control measures for Low-acid juices, such as carrot juice “are likely to involve multiple measures, e.g., a combination of a process step to destroy the non-proteolytic spores and measures to ensure that “Keep Refrigerated” labeling is used for the juice if the juice does not receive a treatment sufficient to destroy the proteolytic spores. As explained above, their pasteurization process is insufficient to destroy the non-proteolytic spores; therefore, these additional control measures alone do not adequately control the C. botulinum hazard.

The full warning letter can be viewed here.

(To sign up for a free subscription to Food Safety News, click here.)

To become a better food safety leader, it’s important to have strong communication skills, be able to collaborate with cross functional partners and inspire trust from the team.  Learn this and more from a seasoned group of food safety professionals at the opening workshop Advancing Food Safety Business Leaders to Drive Results for Maximum Impact on Tuesday, May 7 at the Food Safety Summit. 

Targeted tools and resources will be discussed during this three-hour educational and interactive workshop, which can be applied at every level of the professional journey.

John Crabill, Chipotle Mexican Grill; Jorge Hernandez, The Wendy’s Company; Cindy Jiang, McDonalds – Retired; Deb Kane; J&J Snack Foods Corp; Spir Marinakis, Maple Leaf Foods; and Gillian Kelleher, Kelleher Consultants LLC and formerly with Wegmans, will share their insights as to why food safety leadership is critical to a successful career path and to the overall business. Topics that will be addressed include delivering messages that are crisp, clear, and powerful regardless of audience, storytelling, active listening, having difficult conversations, influencing without authority, understanding different cultural backgrounds and how to build a personal brand.  

The workshop will include two breakout sessions. The first will be led by Emma Gometz, Digital Editor with Science Friday heard weekly on NPR.  Gometz will lead an interactive session on how to communicate science to a non-technical audience. Attendees will learn how to apply the communication fundamentals to talk about food safety to various audiences from the company’s CEO to a line worker. Learn about the importance of active listening, how best to guide the conversation and walk away with tips to apply back at the office. 

Linda Manning, a leader in talent and organizational development and human resources who focuses on team dynamics will lead the second breakout session on navigating difficult conversations and tools that can be applied. Learn how to influence without authority and other development skills to become a good leader. After each breakout session, an executive summary will be provided to attendees and there will be a recap from the panelists sharing their insights as well. 

This workshop is perfect for the whole team or individuals who are actively looking to develop their leadership skills to advance in the food industry. This three-hour workshop is a wonderful professional development opportunity for food safety professionals in all sectors of the industry to learn from experts who will share their experiences, advice and lessons learned to help build up the food safety leaders of the future. 

Food safety professionals rely on strong leadership to navigate the complexities of the industry and uphold the highest standards of safety and quality. Make plans to join the Advancing Food Safety Business Leaders to Drive Results for Maximum Impact opening session from 8.30 a.m. to 11.30 a.m. on Tuesday, May 7 at the 2024 Food Safety Summit at the Donald E. Stephens Convention Center, Rosemont, IL from May 6 to 9.  

The authors: Gillian Kelleher, CEO of Kelleher Consultants LLC and Spir Marinakis, Vice President of food safety, quality and technical services for Maple Leaf Foods.

(To sign up for a free subscription to Food Safety News,click here)

Very high levels of sodium nitrite have been detected in samples of meat sent for analysis as part of investigations into the death of one person in Poland.

The National Veterinary Research Institute in Puławy examined products provided by investigators.

They are suspected to be behind the death of a 54-year-old from Ukraine and the hospitalization of two other people, aged 67 and 72, with food poisoning symptoms.

Stanisław Winiarczyk, director of the veterinary institute in Puławy, told local station Radio Lublin that the concentration of sodium nitrite ranged from 16,000 to 19,000 milligrams per kilogram of product.

It is believed the substance was added to the products by mistake. Sodium nitrite is used in cured meat, but not in such a high concentration. Nitrite is added to certain foods to prevent the growth of Clostridium botulinum, which causes botulism poisoning.

Scientists also examined meat provided by investigators. Although trace amounts of sodium nitrite were found, the concentration was not dangerous to humans. Other results from the analysis for a range of other substances are still pending.

Two people are facing charges in connection with the incident. They are a married couple, aged 55 and 56, who sold pig meat products they made at home at the market.

The Government Centre for Security (RCB) warned people not to eat meat from unverified sources bought at a market in Nowa Dęba in Tarnobrzeg County over one weekend in February due to a health risk.

 The District Prosecutor’s Office in Tarnobrzeg is also investigating the incident.

(To sign up for a free subscription to Food Safety News, click here.)

The Food and Drug Administration continues using import alerts to enforce U.S. food safety regulations for food from foreign countries. The agency updates and modifies the alerts as needed.

Recent modifications to FDA’s import alerts, as posted by the agency, are listed below. 

Click here to go to the FDA page with links to details on specific alerts.

(To sign up for a free subscription to Food Safety News,click here)

It’s been said that recent outbreaks of illness in the United States are raising renewed concerns about selling and consuming raw milk and raw milk products.

One defense is a federal law prohibiting raw milk product shipment for human consumption across state lines. And FDA regulations prohibit raw milk from interstate commerce.

Those prohibitions were upheld in 2012 by a federal court.

Yet Amos Miller is asking the state judge handling his case in Pennsylvania to permit him to sell raw milk in other states.

In the civil case filed on Jan. 24,  the Pennsylvania Attorney General is suing  Miller on behalf of the state Department of Agriculture for not having permits to sell raw milk products nor having a required retail license

Pennsylvania’s Department of Agriculture has 114 raw milk farms with these routine licenses and permits.

Lancaster Judge Thomas Sponaugle, who is hearing the Miller matter, has clarified that it is a case about the lack of permits and licenses, not raw milk.

The current injunction prohibits Miller from commercial raw and raw milk product sales until he gets the required paperwork from the state Agriculture Department.

“Nothing in this order is to detract from the sincerely held beliefs of individuals who believe in the benefits of raw milk products,” according to the judge’s order.

Sponaugle said Miller could resume raw milk sales quickly once he gets the same licenses and permits that Pennsylvania’s other 114 raw milk dairies operate under.

Miller claims he and his customers will face “substantial irreparable injury” if he cannot resume sales outside Pennsylvania.

Earlier, his attorney asked the judge to lift the injunction against all of Miller’s raw milk-related sales, and the request was denied.

Last month, the FDA urged consumers not to eat Raw Farm brand Raw Cheddar blocks and shredded cheese products responsible for a multistate outbreak of E. coli O157:H7. Also, by the end of February, the FDA said 11 confirmed infections had been reported in five states: California, Colorado, New Jersey, Texas, and Utah. Five patients were hospitalized, with two developing hemolytic uremic syndrome (HUS) that can result in kidney failure. No one has died.

(To sign up for a free subscription to Food Safety News, click here.)

According to officials, the outbreak strain was found at a farm that supplied milk used to make unpasteurized cheese, which was linked to an E. coli outbreak in the UK.

In total, 36 confirmed and one probable Shiga toxin-producing E. coli (STEC) O145 infection have been reported, with 29 in England and eight in Scotland since late July 2023, with most falling ill in November. The last reported primary patient had symptom onset on Dec. 23, 2023.

Twenty patients were female, with ages of all cases ranging from 7 to 81. Of the 31 patients with available information, 20 had bloody diarrhea, 15 were admitted to the hospital, and four also attended the hospital for their symptoms. One person developed hemolytic uremic syndrome (HUS) and later died.

An investigation into the outbreak by the UK Health Security Agency (UKHSA), the local authority, Public Health Scotland, Food Standards Agency (FSA), Food Standards Scotland (FSS) and the Animal Plant Health Agency (APHA) is nearly completed.

Cheese on a train
Based on epidemiological, food chain, and microbiological investigations, Mrs Kirkham identified the vehicle as an unpasteurized cheese produced in North West England. A recall was issued in December and updated in February.

Interviews and analyses by UKHSA and PHS found that 16 out of 17 patients had consumed a menu item that contained unpasteurized cheese while on board trains operated by the same company. In another case, those who had not traveled by train consumed the same brand of unpasteurized cheese bought from a local shop.

UKHSA said STEC transmission could also occur through person-to-person contact and contact with animals and/or their environment, which likely explains why not all interviewed cases reported eating the implicated cheese. Four people acquired the infection through either person-to-person or environmental transmission.

STEC DNA was detected in two of 43 cheese samples, but only one could be cultured and sequenced. The strain was E. coli O109: H16 and did not match human cases. No STEC was detected in the bulk milk tank or filter samples used by the business when producing cheese.

Significance of negative result
During an APHA visit to the farm, 28 environmental samples were collected, including fresh and aged cattle feces from various locations on site, and two water trough sediment samples. Two cattle fecal samples tested positive for STEC O145. These isolates were genetically indistinguishable from the outbreak strain detected in human cases.

“While the outbreak strain was not detected in the milk tank or cheese samples, this is not unexpected considering the limitations of microbiological sampling during outbreak investigations. A negative test does not prove that raw ingredients or a specific food is not contaminated,” said UKHSA.

“The detection of the outbreak strain in the feces samples from the dairy herd (on the premises which supplied the milk used to make the unpasteurized cheese) provided additional evidence in support of the epidemiological and food chain investigation findings on which the food safety and health protection actions taken in December 2023 were based.”

Tina Potter, head of incidents at the FSA, said: “After a thorough response carried out by multiple agencies and the business to identify the possible source of the outbreak, microbiological evidence from samples taken from the dairy herd has proven a microbiological link between Mrs Kirkham’s Cheese and the outbreak of E. coli. This is in addition to the epidemiological and food chain links already identified early on that were relied upon and led to the initial precautionary food safety action being taken.”

Mrs Kirkham was recently allowed to resume selling batches of five raw milk cheeses made on or after Oct. 1, 2023. The company said it worked with technical experts at the Specialist Cheesemakers’ Association to review milk production and food safety management systems.

FSA urged consumers to follow the advice in the recall notice and told people not to eat the implicated items. Raw or unpasteurized milk products may contain harmful bacteria that can cause food poisoning. Hence, the message is essential for groups of vulnerable people, including pregnant women and individuals with impaired immunity.

(To sign up for a free subscription to Food Safety News, click here.)

The Food and Drug Administration has issued a warning about certain mussels from Allen’s Fisheries in Newfoundland, Canada, that were imported to the United States.

On March 1 the New Jersey Department of Health advised the FDA of an outbreak of illness associated with consumption of the mussels. The patients experienced symptoms including nausea, vomiting and diarrhea. 

The advisory includes mussels from Allen’s Fisheries (NL0047SP) in Newfoundland, Canada, harvested on Feb. 7 (Julian date 24038), from harvest area AQ # 15 Newfoundland, with final harvest date of Feb. 18 (Julian date 24049) and shipped to distributors in Connecticut, Florida, Maryland, Massachusetts, New Jersey, New York and Pennsylvania on or around Feb. 21 (Julian Date 24052).

The FDA is advising restaurants and food retailers not to serve or sell and consumers not to eat the implicated mussels because of possible pathogen or biotoxin contamination. The FDA is awaiting further information on distribution of the mussels and will continue to monitor the investigation and provide assistance to state authorities as needed. 

“Contaminated shellfish can cause illness, especially if eaten raw, particularly in people with compromised immune systems. Food contaminated with pathogens or biotoxins may look, smell, and taste normal. Consumers of these products who are experiencing food poisoning symptoms such as diarrhea, stomach pain or cramps, nausea, vomiting or fever should contact their healthcare provider, who should report their symptoms to their local health department,” according to the FDA Warning.

Restaurants and retailers should dispose of any products by throwing them in the garbage or contacting their distributor to arrange for return and destruction.

Restaurants and retailers should also be aware that shellfish may be a source of pathogens and should control the potential for cross-contamination of food processing equipment and the food processing environment. They should follow the steps below:

• Wash hands with warm water and soap following the cleaning and sanitation process.
• Retailers, restaurants, and other food service operators who have processed and packaged any potentially contaminated products need to be concerned about cross-contamination of cutting surfaces and utensils through contact with the potentially contaminated products.
• Retailers that have sold bulk product should clean and sanitize the containers used to hold the product.

(To sign up for a free subscription to Food Safety News,click here)

Castle Importing, Inc. of Fontana, CA is recalling certain cheese products because of potential Listeria monocytogenes contamination.

According to the details posted online by the Food and Drugs Administration (FDA), the recall was initiated on Feb. 5, 2024, and is ongoing.

The recalled products were distributed in California, Ohio, Connecticut, Florida, Texas, Washington and Illinois.

Recalled products:

Crumbled Cotija Net Wt. 5.6 lbs (300/0.3oz), Net Wt. 7.5 lbs (300/0.4 oz) Fontana, CA 92336 Plant #06-00333

Classic Castle Brand Crumbled Cotija Net Wt. 20 lbs, Net Wt. 5 lbs Fontana, CA 92336 Plant #06-00333

Classic Castle Brand Grated Cotija Net Wt. 20 lbs, Net Wt. 5 lbs Fontana, CA 92336 Plant #06-00333

• Product Quantity: 8,886 cases
• Recall Number: F-1038-2024
• Code Information: CASTLE CRUMBLED COTIJA 4/5LB 00791-24IN4/5-PH2 56006 Customer Lot # 23285 23285 23296 23306 23306 23317 23317 23338 23338 23338 23338 23349 23356 23356 23356 23360 23361 24011 24017 24017 24018 24018 24018 24031 24032 24922 CRUMBLED COTIJA 300/.3oz 00791-7LNRS300/.3oz-PH2 76002 Customer Lot # 23299 23300 23300 23304 23307 23313 23313 23320 23320 23333 23333 23342 23342 23347 23348 23349 23352 23352 23354 23355 23355 23356 23360 23361 24011 24012 24015 24016 24017 24022 24023 24024 24029 24030 24534 CRUMBLED COTIJA 300/.4oz 00791-7LNRS300/.4oz-PH2 76023 Customer Lot # 23333 23334 23361 23362 24012 24015 24015 24016 24026 24029 24029 24030 24031 24032 24033 CASTLE GRATED COTIJA 4/5 00650-7-24IN4/5 76036 Customer Lot # 23313 23320 23332 23333 23361 24017 24024 24030 CASTLE GRATED COTIJA 4/5lbs 00650-0-24IN4/5 76034 Customer Lot # 23293 23296 23355 23356 24011 24029 24030 24031 24032

Classic Castle Brand Shredded Three Cheese Blend Net Wt. 20 Lbs, Net Wt. 5 lbs. Fontana, CA 92336 Plant #06-00333

• Product Quantity: 667 cases
• Recall Number: F-1039-2024
• Code Information: CA SHR 3 CHS BLND 4/5lbs 00754-2-24IN4/5 70095 Customer Lot # 23290 23312 23325 23354 23354 23355 24003 24033

Recalled products should be thrown out or returned to their place of purchase.

About Listeria infections
Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause severe and sometimes life-threatening infections. Anyone who has eaten any recalled product and developed symptoms of Listeria infection should seek medical treatment and tell their doctors about possible Listeria exposure.

Also, anyone who has eaten recalled products should monitor themselves for symptoms during the coming weeks because it can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop. 

Symptoms of Listeria infection can include vomiting, nausea, persistent fever, muscle aches, severe headache, and neck stiffness. Specific laboratory tests are required to diagnose Listeria infections, which can mimic other illnesses. 

Pregnant women, the elderly, young children, and people such as cancer patients who have weakened immune systems are particularly at risk of serious illnesses, life-threatening infections, and other complications. Although infected pregnant women may experience only mild, flu-like symptoms, their infections can lead to premature delivery, infection of the newborn, or even stillbirth.

(To sign up for a free subscription to Food Safety News, click here.)

Salm Partners, LLC, of Denmark, WI, is recalling approximately 35,430 pounds of Johnsonville turkey kielbasa sausage that may be contaminated with foreign materials, specifically pieces of rubber, according to the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS).

The problem was discovered after the firm received complaints from consumers reporting they found pieces of rubber in the ready-to-eat turkey kielbasa products.

FSIS is concerned that some product may be in consumers’ refrigerators.

The turkey kielbasa sausages were produced between Oct. 30-31, 2023.

These items were shipped to retail locations nationwide.

Recalled products:

• 12-oz. vacuum-packed packages containing a single piece of “Johnsonville POLISH KIELBASA TURKEY” sausage and best by dates “05/17/24” and “05/18/24” printed on the side of the packaging.

The products subject to recall bear establishment number “P-32009” printed on the side of the packaging.

As of the posting of this recall, there have been no confirmed reports of adverse reactions or injury due to consumption of these products. Anyone concerned about an injury should contact a healthcare provider.

Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase.

(To sign up for a free subscription to Food Safety News, click here.)

Finnish officials are investigating the connection between a hepatitis E-positive meat product and a rise in infections in the country.

Between January and February, 81 hepatitis E cases from different parts of Finland have been reported to the infectious disease register. Half of these people have required hospital treatment. 20 and 60 hepatitis E cases are reported to the Infectious Disease Register annually. In 2023, there were 30 cases. In January 2023, only one Hepatitis E infection was reported in the register.

In laboratory tests by the Finnish Food Authority (Ruokavirasto), the hepatitis E virus was found in a product made by a domestic manufacturer. These items have been recalled and are no longer on sale.

Kotivara withdrew six products sold since early November 2023 in retail stores and wholesalers. Most items have passed their shelf life date, but two last until March 19, 2024.

Of 30 patients interviewed by the National Institute of Health and Welfare (THL), 27 mentioned consuming different brands of mettwurst or salami before they got sick. However, meat products are commonly consumed foods, so clarification was needed on the significance of this finding. This was why the Finnish Food Agency examined various food samples based on the brands recorded in THL’s reports.

From 44 patients, the median age of those affected is 64 and 70 percent are men.

THL is in the process of genotyping the hepatitis E viruses found in samples from patients to compare them with the recalled positive product.

Ruokavirasto, THL, and local food control authorities are looking into the source of hepatitis E infections. This includes determining how many patients the recalled products may have caused and if there are other contaminated items.

THL has typed the hepatitis E viruses found in the samples of 13 patients. The most common genotype was HEV-3f, which formed three clusters. HEV-3f was last detected in Finland in 2019. Between 2019 and 2022, HEV-3e and HEV-3c were the most common genotypes in patient samples.

Wider EU issue
In February, the European Centre for Disease Prevention and Control (ECDC) said it monitored the situation after some countries reported a spike in hepatitis E infections.

More patients than usual had been seen in January in Belgium and the Czech Republic. More than 350 patients were recorded in Germany, 63 in the Czech Republic, and 36 in Belgium.

In January 2024, 520 hepatitis E virus infections were noted in 10 countries. No connection had been established between all these cases. In Belgium, genotype 3c was the most frequently identified among patients with available information. Genotyping of the virus was ongoing in Spain.

Hepatitis E infection is a liver disease caused by the hepatitis E virus (HEV). Advice to avoid infection includes thoroughly cooking all meat, especially pork, before eating it and washing hands after touching uncooked meat or meat products.

The mean incubation period for HEV is five to six weeks, with a range of two to nine weeks, and can persist for one to four weeks. Symptoms include fatigue, poor appetite, stomach pain, nausea, and jaundice. However, some people, especially young children, have no symptoms.

(To sign up for a free subscription to Food Safety News, click here.)

The dismissed federal case of The Humane Society of the United States (HSUS) v. Sonny Perdue is returning. The U.S. District Court for Northern California has scheduled a case management conference for June 13.

Around that date, look for the non-profit’s plaintiff activists, the Humane Society of the United States, Animal Outlook, the Government Accountability Project, Mercy for Animals, and Marin Humane, to join in an amended complaint against USDA.

In the meantime, poultry plant evisceration lines will continue to operate at speeds up to 175 birds per minute under USDA waivers. Certain food safety inspections take place on the lines.

Those higher line speeds expire at the end of March, but Secretary of Agriculture Tom Vilsack recently said extensions will be granted.

Vilsack promised the Senate Agriculture Committee that the extensions were in the offering and would help determine whether increased line speeds contribute to worker injuries or safety.

Vilsack said he wants to make decisions based on the facts, but he does not yet have all the facts.

Some in Congress, however, are questioning why the Biden Administration continues to study the line speed issue. Rep. David Rouzer, R-NC, suggested in a House Agriculture Committee meeting that the University of California study is biased against the poultry industry.

The 175 per minute line speed, up from 140, has existed for 25 years. At present, 47 poultry plants operate at the higher speeds.

Rouzer points out that existing line speed waivers were granted only if an “opt-in” to the ongoing worker safety study was accepted.

The USDA will use the study of increased poultry line speed in future rule-making.

(To sign up for a free subscription to Food Safety News, click here.)

The latest data showing levels of residues from veterinary drugs and other substances in animals and animal-derived food in 2022 in Europe has been published.

The European Food Safety Authority (EFSA) report looks at hormones, antibacterials, environmental contaminants, prohibited substances, and other veterinary drugs. It includes data reported by EU member states, Iceland, and Norway.

The presence of unauthorized substances, residues of veterinary medicinal products or chemical contaminants in food may pose a risk to public health.

In 2022, the percentage of non-compliant samples was 0.18 percent, comparable to 0.17 percent in 2021.

The level of non-compliance in targeted samples, which are taken to detect illegal use or check non-compliance with maximum permitted levels, was 0.27 percent, slightly higher than 0.24 percent in 2021.

Example violations
A total of 600,320 samples were reported to the European Commission. They were mainly targeted samples, but almost 4,000 were suspect samples. Others were collected at import, and over 250,000 were collected as part of programs developed under national legislation.

The 919 non-compliant targeted samples were found in bovines, pigs, poultry, sheep, goats, and horses. For beta-agonists, there were six non-compliant samples, three for clenbuterol and salbutamol and two for ractopamine, all in bovines. The clenbuterol and ractopamine results were in Portugal. Four suspect samples were also positive for clenbuterol in Portugal.

Targeted sampling revealed phenylbutazone once each in bovines in Northern Ireland and Spain and horses in Germany.

Prohibited substances identified included chloramphenicol, semicarbazide, metronidazole, furaltadone, and nitrofurazon.

The highest frequency of non-compliant samples for antibacterials was found in honey. Of the 3,056 honey samples analyzed, 42 were non-compliant, with 97 non-compliant results. Ten countries reported them. Glyphosate was found in two samples – one in Austria and the other in Lithuania.

In other substances and environmental contaminants, chemical elements had the highest overall percentage of non-conforming samples, with cadmium, copper, lead, total mercury, and zinc most frequently identified.

Results for food
For mycotoxins, 30 non-compliant samples were reported for bovines, horses, milk, pigs, and poultry, with those identified being zearalenone, aflatoxin M1, ochratoxin A, aflatoxin (sum of B1, B2, G1, G2), and aflatoxin B1.

For dyes, 20 problem samples were reported for aquaculture by six countries. Substances found were the sum of malachite green and leucomalachite green, the sum of brilliant green and leucobrilliant green, and the sum of crystal violet and leucocrystal violet.

Of the 20,974 milk samples analyzed, 47 were non-compliant, leading to 203 non-compliant results. 14 countries reported them. Of the 12,035 egg samples analyzed, 35 were non-compliant, giving 52 non-compliant results. 14 countries reported them.

Of the 1,928 samples analyzed for wild game, 123 were non-compliant, with 150 non-compliant results. 11 countries reported these. For the farmed game, 21 of the 1,426 samples tested were non-compliant. Four countries reported them.

(To sign up for a free subscription to Food Safety News, click here.)

Raja Foods LLC of Skokie, Il, is recalling its 3.5-ounce packages of “Swad Cinnamon Powder” because it has the potential to be contaminated with lead. 

The products included in this recall are, Swad Brand Cinnamon Powder in clear plastic 3.5 OZ bags, UPC 0-51179-34280-4, from either of the following two batches and Best Before Dates: Batch KX21223 Best Before July 2026 and Batch KX08123 Best Before March 2026.

Product was distributed through retail grocery stores in the Midwest, Northeast, and Southeast regions of the United States, according to the recall notice from the company and posted by the Food and Drug Administration. The recall is the result of a routine sampling program by the FDA.

Consumers who have purchased “Swad Cinnamon Powder 3.5OZ” are urged to return it to the place of purchase for a full refund. Consumers with questions may contact the company at 847-972-2865.

The sampling program that discovered the elevated levels of lead in the Swad brand ground cinnamon is in response to the problem with elevated levels of lead in cinnamon in children’s applesauce and recalls of products in the fall of 2023. The FDA issued warnings on March 6 about the Swad cinnamon and several other brands, some of which are being recalled.

The products are not targeted toward children, but are used as ingredients in foods that consumers may make and serve to children.

“Consistent with the agency’s Closer to Zero initiative, which focuses on reducing childhood exposure to lead, the agency is recommending voluntary recall of the products because prolonged exposure to the products may be unsafe. Removing the ground cinnamon products in this alert from the market will prevent them from contributing elevated amounts of lead to the diets of children,” according to the FDA warning.

About lead poisoning
Parents and caretakers should consult a healthcare provider and ask for blood tests if they suspect a child may have been exposed to the recalled cinnamon applesauce products. 

Short-term exposure to lead could result in the following symptoms: headache, abdominal pain/colic, vomiting, and anemia. 

Longer-term exposure could result in additional symptoms: irritability, lethargy, fatigue, muscle aches or muscle prickling/burning, constipation, difficulty concentrating/muscular weakness, tremors, and weight loss. 

Permanent consequences can lead to developmental delays and brain damage.