KEY POINTS:
On wednesday February 13, Josie* ate a roast beef sandwich. The mother of two, 16 weeks pregnant, stopped at the new cafe across the road to grab lunch. There were three choices on display - ham, chicken and roast beef. Being pregnant she knew it was wise to avoid ham and chicken, so she opted for the freshly made roast beef bap.
A week later, on February 22, Josie saw a TVNZ news item about a batch of roast beef sent to hospitals and Auckland cafeterias that was contaminated with listeria.
What followed was a nightmare four days of wondering whether the sandwich she ate was a potentially disastrous mistake. "It's given me a hell of a scare. It was awful to sit there over the weekend and think, 'Hell I could have killed my baby'."
Matters weren't helped when Josie began to feel unwell with a fever, chills and a cough and then, when that cleared up, diarrhoea and vomiting. She was desperate for information and went to the New Zealand Food Safety Authority website. But there was nothing there about the listeria contamination. Even if she had been able to find the press release buried on the Auckland Regional Public Health Service site, she would have been mystified. The notice makes no mention of the name of the supplier of the contaminated food, nor the names of the 31 Auckland cafeterias where the food was consumed.
The notice quoted Dr Greg Simmons, Auckland region medical officer of health, who sounded reassuring: "Once the presence of listeria was suspected, the product was immediately withdrawn." What he neglects to say is that by the time the press release went out on February 21 - three days after Waikato Hospital had confirmed listeria monocytogenes (the bacteria's disease-producing strain) in its roast beef - there was little meat left to recall from the other cafeterias. Almost all the contaminated food had been eaten. Thanks to its routine food safety testing, Waikato had found a suspected presence of listeria in a roast beef salad on February 8 and immediately withdrew the food from its patient menus and cafeterias while it carried out more tests.
Lack of public information and a tardiness to respond to the contamination were the first of several blunders both Food Safety and Public Health would make over the next week. Meanwhile Josie was trying to stay calm. She now knew, thanks to pressure by TVNZ on health officials, the name of the supplier - Leonard's Superior Smallgoods. But the cafe where she'd bought her sandwich didn't know if the roast beef had come from Leonard's.
By now Josie had visited her GP and submitted to the unpleasant process of testing for listeria - anal swabs, stool samples and blood taken from both arms. Her GP outlined the risks. "The statistics are, if I contracted listeriosis, there's only a 50 per cent chance my baby will survive," she says. A course of antibiotics would be safe for her developing baby, but she could still end up with a miscarriage or stillbirth.
On Tuesday morning - four days after she had learned of the listeria contamination - Josie got some good news. The cafe's food distributor did supply some Leonard's product to the cafe, but roast beef wasn't one of them. Also, other family members who had not eaten at the cafe also came down with a tummy bug. Yesterday there was more relief - her first test results came back negative.
The question that has to be asked is why did the organisations charged with protecting public health and the safety of our food not name the locations where contaminated food was consumed. Why did they keep people like Josie in the dark about information that is so obviously relevant to their health? Surely, for anyone who might have eaten from the batch of contaminated Leonard's roast beef in, or around Auckland, from February 1-20, the information about where contaminated food was consumed is vital.
What about those who, at the time of innocently eating a roast beef sandwich, didn't know they were one of the at-risk groups for listeriosis - didn't know, for example, they were pregnant, or that their immune system had become compromised?
When the Herald asked for the locations where contaminated food was consumed, our request was refused. Simmons says the public don't have a right to know this information because it would dilute the public health message that at-risk groups shouldn't be eating cold sliced meats full stop. How exactly is the message diluted? "Basically people will say I didn't eat in that cafe so there's nothing to worry about and they'll eat whatever they like and those people may well be pregnant," says Simmons.
It's a strange logic that smacks of doctor knows best. Josie is flabbergasted. "If they actually listed the cafes and made a big deal about it, they'd bring attention about listeria, and who is at risk, to more people," she says. "I was desperately searching the papers on Saturday and Sunday for information and there was nothing - that's what dilutes the message." New Zealand Food Safety Authority director of compliance and investigation Geoff Allen has a similar stance to Simmons about releasing the names of the places where contaminated food was sold. "What would it achieve?" It would give people information to help them decide if they might have eaten contaminated food. "Yes, but would it materially increase or improve the food safety outcomes?" It would make the facts about a significant food contamination transparent. "It's like crying wolf. If we required people to do that in every instance of untoward food issues, there would be notices everywhere." Again, the logic is perplexing. Saying that contaminated food was consumed on certain premises over a certain period isn't crying wolf. It's stating facts. Telling the truth. If, as Allen says, doing so would mean there would be "notices everywhere", what other facts are the public not being told?
The public didn't have long to wait to find out. A second contamination was confirmed on Monday, February 25 - this time in a batch of Leonard's corned silverside, sent to 18 outlets, including North Shore Hospital. By now the Waitemata District Health Board, which had only just got over dealing with the fallout of the first contamination at both North Shore and Waitakere hospitals, had clearly had enough. It removed not just Leonard's, but all processed and cold meat products from all hospital cafes and patient menus and is undecided whether it will stock them again. The DHB's press release tersely pointed out that it had been advised by the Auckland Regional Public Health Service that the risk of cross-contamination of product lines at Leonard's was minimal. Advice that was clearly wrong.
For the second time in two weeks, Leonard's food safety programme and testing procedures for listeria contamination - approved by the Food Safety Authority and the Public Health Service - had failed. And for the second time the contamination was discovered by the diligence of another party ordering extra tests - in this case food service provider Wilson Hellaby which had held on to its Leonard's product. Once again the Public Health Service and Food and Safety refused to say where the second batch of contaminated food was sent.
Besides North Shore Hospital, the Herald has learned of two locations where the corned silverside was consumed: The ASB National Support Centre where just one slice of a 500g pack was eaten; and, more worryingly, Lexham Gardens retirement home where 500g of a 1kg pack was eaten before the food was recalled. Simmons says all locations in Auckland where food was consumed now have Health Service notices on display with information about listeria. Notices for the cafeterias in the Waikato region began being posted on Thursday.
In support of the public's right to know about where these contaminations have occurred and how they may have affected them, the Herald has laid a complaint with the Office of the Ombudsmen. Unfortunately our Official Information Act grinds awfully slow and lacks the teeth to force intransigent health officials to give up information they have no right to withhold.
What remains a worry is that contaminated food has been consumed by possibly thousands of people over a three-week period and the public have been kept in the dark about several key points. We still don't know how bad the contamination was, where (other than the hospitals who quickly fessed up) the food was sold, and whether the contamination is yet under control. People like Josie shouldn't be disadvantaged by health officials who seem more concerned about protecting commercial interests than doing the job they are charged with - protecting the public.
* Name changed to protect privacy.
LOCATING THE SLIP-UP AND REBUILDING A REPUTATION
To say that Richard Kornman has had a bad few weeks is an understatement. The director of Leonard's Superior Smallgoods is under siege by media. "The level of publicity we have received over this is absolutely unbelievable." The company has bravely fronted to every media request.
But Kornman questions whether the contamination warrants such attention - pointing out that just 200kg of meat is involved and that a recall in November by Sanford of 280 tonnes of green-lipped mussels, suspected to be contaminated by listeria, didn't get nearly as much publicity.
He also points out that compared to campylobacter (11,425 cases notified in 12 months to the end of January), invasive listeriosis is a much lower risk (just 27 cases notified in the same period).
But if that sounds like making excuses for a disease that has a mortality rate of about 20 per cent associated with its invasive form, he also makes it clear that his company is doing everything it can to put things right. "It's our product, we take ownership of it and, basically, the buck stops here."
For Leonard's, which has supplied cold meats to hospitals through Wilson Hellaby for 10 years without a problem, the contaminations have come out of left-field.
The company operates a comprehensive food safety programme, regularly doing environmental swabs on key pieces of equipment and around its factory for indications of listeria. It also sends samples of different food product lines (about seven a week) to laboratories for further testing. The company spent $3000 on such tests last month. "We spend a lot of money every month trying to find something that we don't want to find."
Kornman says when news came from Food Safety via Waikato Hospital that it had discovered listeria monocytogenes in its roast beef, the company contacted everyone supplied with the meat. But he admits by that time most of the product had been eaten. "The instruction was basically dump it - why would we want it back?"
The company's focus now - with assistance from health protection officers contracted to Food Safety - is on finding where the slip-up occurred. Attention has zeroed in on the slicing machine. Both batches of meat - roast beef and corned silverside - were sliced at similar times. The machine gets a clean down after each product run, and products sliced after those batches have tested negative for listeria.
"We have determined that the contamination has to have occurred in our slicing department, but how it's happened we're still trying to figure out." Kornman suspects human error. The company fired a staff member on Tuesday. "He took a shortcut from the high care area through the bacon and ham area, which he's not allowed to do. He did it twice. We fired him because this is how it happens."
But Kornman doesn't believe it's necessary to name the places where the contaminated food has been consumed, pointing out the Public Health Service has put up notices in each location. "If you owned a little cafe in Ponsonby and someone sold you some meat that was contaminated and your name was on the front page of the Herald, what effect would that have on your business? And is it your fault?"
THE MEAT OF THE MATTER
What is it?
Listeria is a common bacterium found in soil, water, plants and the faeces of animals and humans. It's unusual because it doesn't mind the cold and doesn't need air. It comes in several forms - lysteria monocytogenes being the disease producing variety - survives freezing and grows quite well in refrigerators and vacuum packs.
What does it do?
Listeria can contaminate almost any food - but the riskier food groups are stored salads and coleslaw, uncooked, smoked or pre-cooked fish or seafood products that are chilled or frozen (unless reheated thoroughly and eaten hot), paté, cold pre-cooked chicken, ham and other chilled pre-cooked meat products, raw (unpasteurised) milk, and surface-ripened soft cheese (eg, brie, camembert).
Who gets listeriosis?
The invasive form is a notifiable disease which is quite rare (about 20-30 cases a year in New Zealand). It occurs in a group referred to as YOPIs - young, old, pregnant or immuno-compromised. Ministry of Health advice to these groups is that it's unsafe to eat the riskier foods. The non-invasive disease is not notifiable and can occur in anyone if a high number of listeria monocytogenes cells is consumed.
Symptoms and dangers?
The invasive disease can result in death. It can take up to 90 days to incubate, but on average shows up in 30 days. It can have flu-like symptoms (e.g. fever, headache), diarrhoea and vomiting and can develop into meningitis and septicaemia. In pregnant women it can cause miscarriage or stillbirth, and can cause infection and severe illness of their baby. Listeria is susceptible to a number of antibiotics.
Non-invasive listeriosis can incubate for up to seven days but usually shows up in 18 hours. Symptoms include diarrhoea, fever, muscle pain, headache and, less frequently, abdominal cramps and vomiting.
