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Egg recall spreads to second Iowa producer

August 21, 2010 at 12:00 PM

The investigation of an outbreak of intestinal illnesses in 10 states pointed Friday to a second major Iowa egg producer as the possible source of contaminated food that has led to the near-tripling in salmonella cases in the past three months.

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Hillandale Farms of Iowa on Friday voluntarily recalled 170 million eggs produced since April 9 after epidemiologists in Minnesota linked its products to a salmonella outbreak in May. In two earlier recalls during the past eight days, another Iowa company, Wright County Egg, recalled 380 million eggs, some laid as long ago as mid-May.

The newly recalled eggs were distributed in 14 states in the West and Midwest. As with the previously recalled eggs, the vast majority are presumed to have already been eaten.

The latest recall grew out of an investigation by federal and state scientists into a sharp spike in infections caused by Salmonella enteritidis, the second-leading cause of foodborne illness. In May, June and July, the Centers for Disease Control and Prevention received samples from 1,953 S. enteritidis cases. Normally in that period it gets about 700.

Salmonella outbreaks are relatively common, and often the source of contamination is never found. It might be that the two egg-related outbreaks involving Iowa farms are coincidental and happened to have been caught because of increased investigative attention on the problem.

"The investigations are still in process to determine a potential commonality," said Sherri McGarry of the Food and Drug Administration's Center for Food Safety and Applied Nutrition.

One of the main things investigators are trying to determine is whether the two companies share a reason for their products to have become contaminated.

A spokeswoman for Hillandale Farms, Julie DeYoung, said Friday that the company and Wright County Egg do use some of the same suppliers. "One of those suppliers is Quality Egg LLC, which supplies [young chickens] and feed to both companies and is owned by the DeCoster family," she said. Wright County Egg is one of the DeCoster family's many agribusiness holdings.

Hillandale Farms of Iowa is part of a privately held national chain of poultry and dairy farms. It has 2 million hens in two towns in Iowa, Alden and West Union, DeYoung said. Its daily production is now being sent to a processing plant where the eggs are broken and the liquid whites and yolks are treated in a way that kills all bacteria. The same is true of Wright County Egg's products.

Testing is underway to see whether the farms apparently involved are harboring the bacterium in their birds, eggs, henhouses or chicken feed. The tests won't be finished until next week, an FDA official said.

In all, 26 outbreaks of salmonella linked to restaurant food are under investigation. In 15 of them, initial sleuthing by epidemiologists pointed to Wright County Egg of Galt, Iowa, as a supplier of at least some eggs to the places where people ate.

In five of those outbreaks, FDA scientists scoured records at restaurants, egg wholesalers, distributors, processors and farms and determined that Wright County products were, in fact, used by the restaurants, a CDC epidemiologist said Friday. Government and state health investigators are studying the other 11 outbreaks to see if the source of infection can be found.

It was the investigation of one of those outbreaks -- seven people who became ill after eating chili rellenos at a Minnesota restaurant in May -- that led to Hillandale Farms, said Josh Rounds, an epidemiologist at the Minnesota Department of Health. In two other Minnesota outbreaks, one involving three cases in mid-June and another involving four cases late last month, products from Wright County Egg appeared to be involved, he said.

Salmonella enteritidis infections can cause nausea, vomiting, abdominal pain, diarrhea and fever. The illness can be briefly severe but is rarely life-threatening. In people with depressed immune systems, such as AIDS patients, however, it can cause fatal bloodstream infections.

No deaths have been reported in the 26 outbreaks that are part of the national investigation.

In a report published this week, the CDC estimated there are 76 million food-borne illnesses in the United States each year. The vast majority, however, are never investigated by public health authorities.

In the most recent tabulate year, 2007, there were 1,097 investigated outbreaks causing 21,244 cases of illness and 18 deaths. Five of the deaths were caused by Salmonella.

The Hillandale Farms eggs recalled Friday were sold under that brand name and Sunny Farms and Sunny Meadow. The recalls altogether affect eggs sold under more than a dozen brand names. A way to identify the cartons of affected eggs can be found at http:/ / www.eggsafety.org.

For the homeless, federal changes promise better access to health care

August 20, 2010 at 12:00 PM

BALTIMORE -- Homeless and unemployed, Tianne Hill said she dreads getting mail at the city shelter on Guilford Avenue where she lives because it often includes medical bills she can't pay.

The 40-year-old former waitress and short-order cook owes about $6,000 for abdominal surgery. She's expecting another bill soon for emergency treatment of a seizure. And she has other conditions that require expensive care: asthma, arthritis, anxiety and depression.

Like many other homeless people, Hill is uninsured and ineligible for Medicaid, the state-federal program that covers millions of other poor Americans. But beginning in 2014, Medicaid greatly expands under the new health-care law to include adults without children, who generally have been excluded.

The Medicaid expansion also will enable agencies that serve the homeless to divert resources now spent on medical care to other services such as finding housing and jobs. The new law provides another boost through a five-year, $11 billion expansion of the community health center system that treats many in this population.

These benefits and President Obama's recently announced plan to prevent and end homelessness mark a watershed moment in federal efforts on this issue, advocates say. Among its goals, the plan calls for greater coordination among housing, medical care and behavioral health programs to help end chronic homelessness in five years and homelessness for families and children over the next decade.

In a June report to Congress, the U.S. Department of Housing and Urban Development found that 643,000 people were homeless on a given night in 2009 and that roughly 1.56 million people -- or one in every 200 Americans -- spent at least one night in a shelter last year.

But the new health law won't eliminate some daunting obstacles to improving health care. Locating and enrolling homeless people in Medicaid will be a challenge. Many also suffer from chronic, complex medical conditions, including mental illness and addiction. Low reimbursement rates for some services may lead to access problems. "Caring for this population is not so simple," said John Lozier, executive director of the National Health Care for the Homeless Council.

Hill had a job but no health insurance when she had emergency surgery for a hernia five years ago. After the operation, she had to leave her restaurant job because she could not stand on her feet for long periods.

The lack of income and foreclosure on a relative's house where she was staying helped cause Hill and her husband to become homeless. When they couldn't stay with friends or family members, they slept in abandoned houses. Both now live at the shelter, Hill on the fourth floor and her husband, Linia Jennings, 50, on the fifth.

A Maryland law that provides some preventive-care services to adults covers Hill's medications for depression and helped her get a pair of eyeglasses. But not having comprehensive health insurance means that Hill does not get all the medical care she needs.

"It is a worry when you see a bump or you have an ache or a pain or something just doesn't feel right," Hill said. "And you don't want to keep running to the emergency room because you're going to keep getting these bills."

Just a quarter of the 6,000 clients treated annually at Baltimore's Health Care for the Homeless are covered by Medicare, the federal program for seniors, or Medicaid. Sixty percent of the center's $12.5 million budget is from federal, state and local funds, and the rest is from corporations, foundations and individuals. The Baltimore program also gives grants to facilities in Frederick, Harford, Baltimore and Montgomery counties that provide medical care to the homeless.