Food Safety

Mystery E. coli O145 Outbreak Ends, No Source Found

EcoliPetriBrownMain.jpgBefore closing their investigation into a multistate outbreak of E. coli O145, health officials identified 3 more victims – bringing the case count up from 15 to 18 – but were unable to find the source of the bacteria.

The outbreak, largely concentrated in the southeastern United States, started in mid-April. The last reported illness began June 12. Out of the 18 victims in 9 states, 4 were hospitalized. A 21-month-old girl from Louisiana died from her infection.
Victims ranged in age from 1 to 79, with a median age of 33. Infections predominantly affected women, who constituted 73 percent of the victims, according to the final outbreak report from the Centers for Disease Control and Prevention, published Friday.

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FDA Warns Consumers Against Eating Shellfish from Oyster Bay Harbor

The Food and Drug Administration (FDA) is warning consumers to not eat raw or partially cooked oysters and clams with tags listing Oyster Bay Harbor in Nassau County, New York as the harvest area. Eight people in several states have been sickened with Vibrio parahaemolyticus food poisoning after consuming those foods.

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The New York Department of Environmental Conservation (DEC) closed Oyster Bay Harbor to shellfish harvesting on July 13, 2012. The FDA told shellfish harvesters, shippers, re-shippers, processors, restaurants, and retail food establishments to dispose of any shellfish that have identity tags showing Oyster Bay Harbor was the harvest area and harvest date on or after June 1, 2012. The map of the emergency shellfish closure is available at the New York web site. The area will remain closed until samples taken by the DEC indicate that shellfish are no longer a threat to consumers.

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Neff’s Lawn Care Ohio Picnic E. coli 0157 Outbreak Update

The Dayton & Montgomery County Health Department has updated their investigation into the Neff’s Lawn Care picnic E. coli 0157:H7 outbreak. As of July 23, 2012, 75 people have been sickened, 14 have been hospitalized, and three people are still hospitalized with hemolytic uremic syndrome (HUS). Those three with HUS include a 4-year-old girl, a 14-year-old male, and a 73-year-old male

As many as 300 people attended the picnic which was held on July 3, 2012. Because of cross-contamination after the original outbreak, two secondary cases of E. coli 0157:H7 have been reported. Public health officials are stressing the need for good hygiene practices, including washing hands thoroughly after visiting the bathroom, and before preparing food.

In fact, anyone who is ill with a diarrheal illness should not prepare food or serve food to others. Anyone who has been sickened in this outbreak should have a negative test before they cook or handle food.

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Portland Area Boil-Water Advisory Ends

The boil-water advisory has been lifted for people who live and work west of the Willamette River and have Portland city water. On Saturday, July 21, 2012,  Portland’s water bureau issued a ‘Boil Water Notice’  after a second test was positive for bacterial contamination in Reservoir 3 inWashington Park. An investigation into the source of the contamination is ongoing.

In addition to those living west of the Willamette River, customers in the Burlington Water District, Valley View Water District, Palatine Hills Water District, Lake Grove Water District, West Slope Water District and the City of Tigard were also affected. Customers in those areas were under the boil-water advisory for about 24 hours. In 2009, fecal contamination from a bird source caused a similar situation.

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60 Hospitalized in Denver After Eating Charity Dinner

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At least 60 people have been hospitalized after eating at a Denver homeless shelter Sunday night.

Less than an hour after eating a turkey dinner served at the Denver Rescue Mission at 7 p.m., dozens of meal recipients began to vomit and became dehydrated from fluid loss.

Emergency responders were called to both Denver Rescue Mission’s Lawrence Street Shelter – where the meal was served – and to the Samaritan House across the street, where some people who had eaten the meal were staying. A total of 54 people from the Lawrence Street Shelter and 6 from the Samaritan House were taken to the hospital, according to Alexxa Gagner, a representative from Denver Rescue Mission.
No deaths have been associated with the event thus far.

More Victims in Ohio E. coli Outbreak Linked to Picnic

74 ill; 14 hospitalized

PicnicBasketandBreadMain.jpgAn outbreak of E. coli O157:H7 thought to have originated at a picnic in Germantown, Ohio has expanded from 68 victims to 75, according to the local health department. The number of people hospitalized remained steady at 14 since the last report.

Three of those hospitalized, including a 4-year-old girl, a 15-year-old boy and a 73-year-old-man, remain in the hospital with hemolytic uremic syndrome (HUS), a complication of E. coli infection that leads to kidney failure and can be fatal.
“We’re hopeful that all three may still make it,” said Bill Wharton, a spokesperson for Public Health Dayton & Montgomery County, according to Dayton Daily News.
Stool samples from 18 of the victims have confirmed them to be part of the outbreak.
The picnic was a customer appreciation event at Neff’s Lawn Care in Georgetown, and was attended by approximately 300 people. Some food was provided by the company; other dishes were brought by guests.

Cargill Beef Tied to 33 Person, 7 State Salmonella Outbreak

A Salmonella Enteritidis outbreak linked to Cargill ground beef is affecting 33 people in 7 Northeastern states, the Centers for Disease Control and Prevention said Monday, a day after the company recalled nearly 30,000 pounds of product.

According to CDC, 11 of those connected to the outbreak have been hospitalized and no deaths have been reported. An investigation by state, local and federal public health agencies has zeroed in on ground beef processed by Cargill Meat Solutions at a single facility in Pennsylvania as the likely source of the outbreak. Authorities were able to conclusively link illnesses in five case patients to ground beef products produced at the Cargill meat establishment (EST. 9400) after state labs found the outbreak strain in two separate leftover ground beef samples from patient homes.

CDC said that the different agencies would continue coordinating with one another and using PulseNet to identify ill people connected to the outbreak. So far, the illness count for each state is: Maine (1), Massachusetts (3), New Hampshire (2), New York (14), Rhode Island (1), Virginia (2) and Vermont (10). Illness onset dates range from June 6 to June 26 and those sickened range from 12 years to 101 years old. More than half are female.

Though it’s likely most of the recalled meat has been consumed, health officials are urging consumers to check their refrigerators and freezers for any meat that might remain — consumers should return the product for a refund. Since some of the ground beef was repackaged into consumer-sized packages sold at retail, CDC urged consumers to visit the USDA’s Food Safety and Inspection Service website to view the list of stores that carried the beef, which may not bear the EST. 9400 mark.

Cargill Beef’s president John Keating said late Sunday he was “sorry or anyone who became sick from eating ground beef we may have produced.”

“Ensuring our beef products are safe is our highest priority and an investigation is underway to determine the source of Salmonella in the animals we purchased for harvest and any actions necessary to prevent this from recurring,” said Keating.

In a FAQ posted online about the outbreak, Cargill noted that they do not test for Salmonella Enteritidis: “This particular strain of Salmonella Enteritidis in beef has not been linked to a public health problem before, and no validated test for it in fresh beef is commercially available.”

Leading food safety expert David Theno, who helped Jack in the Box reform their practices after the historic 1993 E. coli O157:H7 outbreak, told Food Safety News that a regular Salmonella screen would have detected the strain. (Also, it appears that several companies, including DuPont, Roka Bioscience, Cell Biolabs, and BioControl offer relatively rapid testing technology for Salmonella Enteritidis in beef).

E. coli Infection from Ohio Picnic Kills 73-Year-Old Man

A 73-year-old man has died from complications of an E. coli infection he contracted at the Neff’s Lawn Care customer appreciation picnic. Montgomery County Health Commissioner Jim Gross said, “our hearts go out to his familiy and loved ones. This is a very difficult time for everyone. You may rest assured that Public Health will continue to examine all aspects of this foodborne tragedy.”

At least 75 people have been sickened by the outbreak linked to the picnic. Fourteen people have been hospitalized, and three, including the man who just died, developed hemolytic uremic syndrome. That complication of shiga-toxin producing bacterial infections, such as E. coli 0157:H7, can lead to kidney failure and other serious health issues.

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CDC Asks States to Regulate Raw Milk

Dr. Robert Tauxe, deputy director of the Center for Disease Control’s (CDC) Division of Foodborne, Waterborne, and Environmental Diseases, sent a letter to state public health departments, asking them place more restrictions on the sales of raw milk. The letter also asked those agencies to stress the dangers of consuming raw milk. In fact, public health experts say that pasteurization is one of science’s most effective food safety interventions.

Dr. Tauxe stresses the fact that raw milk and raw cheese caused 82% of all dairy-related outbreaks between the years 1973 and 2009. The CDC investigated 93 outbreaks linked to raw milk and raw milk products between 1998 and 2009. Those outbreaks caused 1,837 illnesses, 195 hospitalizations and 2 deaths. The CDC data shows the rate of raw milk outbreaks is higher in states where the sale of raw milk is legal than in states where the sale of raw milk is illegal.

The letter states, “to protect the health of the public, state regulators should continue to support pasteurization and consider further restricting or prohibiting the sale and distribution of raw milk and other unpasteurized dairy products in their states.” It continues, “adherence to good hygienic practices during milking can reduce, but not eliminate, the risk of milk contamination. pasteurization is the only way to ensure that fluid milk products do not contain harmful bacteria.”

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New Produce Regulations Won’t Be Final Until OMB Says So

PROVIDENCE–With implementing regulations held up at the White House’s Executive Office of Management and Budget (OMB), officials at the U.S. Food and Drug Administration (FDA) are finding themselves able to talk only in generalities about the nation’s new food safety law.
That’s disappointing to some attending the International Association for Food Protection (IAFP) meeting this week at the Rhode Island State Convention Center.

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The new U.S. Food Safety Modernization Act (FSMA) was passed by bipartisan majorities in Congress and signed by President Obama in January 2011, but implementation details have not been widely shared outside the federal government.
FDA’s James Gorny Tuesday spoke to IAFP on “preventive controls to local produce” under FSMA, but he had to start out by acknowledging that everything remains in a “deliberative phase.”
For the time being, Gorny said, there is “no implementing regulation for produce.”  He said OMB’s job is to coordinate federal regulations across the federal government and he suggested in this case the issue might be lining up FDA’s newly proposed regulations with USDA and the U.S. Trade Representative.
The produce safety rule should have taken effect last January, one year after Obama signed FSMA into law. It’s been in limbo at OMB ever since along with other implementing regulations.
Gorny says the draft is intended to be the “rules of the road” for the produce industry with three overall goals: reducing the public health burden of produce-related foodborne illness, eliminating disruptions for farmers and shippers and increasing consumer confidence.
“We understand that one size is not going to fit all,” Gorny said.
The so-called Tester-Hagen amendment language included in the new food safety law exempts small producers selling directly to the public through farmer’s markets, roadside stands and the like so long as those transactions are in the same state or within a 275 miles radius.
Small is defined as an operation with gross sales under $500,000 a year.
“We have no leeway,” Gorny said of the exemption. “It is what it is and it is nothing other than that.”

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Recalls

Fresh Cheese Recalled for Improper Pasteurization

WhiteCheeseBlockMain.jpgA New York company is voluntarily recalling a Columbian-style cheese product because it was made with milk that was not properly pasteurized.

Glendale, NY-based Productos Tita Corp issued the recall after a milk inspector from the New York State Department of Agriculture and Markets visited its cheese plant on June 17 and found that proper pasteurization procedures were not being followed.
Pasteurization is a heating process designed to kill harmful pathogens, such as Salmonella and Listeria, which are shed in animal feces and can contaminate milk during the milking process.

Undeclared Milk Brings Cookie Recall in Canada

The Canadian Food Inspection Agency (CFIA) and TWI Foods Inc. are warning people with allergies to milk not to consume the Crispy Just Baked Punjabi Cookies.
The affected product contains milk which is not declared on the label.

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All codes of the Crispy Just Baked Punjabi Cookies, sold in 800 g plastic clamshell packages bearing UPC 6 27265 00152 0, where milk is not declared in the list of ingredients, are affected by this alert.
This product has been distributed throughout Canada.

Wellements LLC Recalls Baby Prune Concentrate for Possible Salmonella

Wellements LLC is recalling Baby Move™ Prune Concentrate liquid dietary supplement, because one of the ingredients used to make the product may be contaminated with Salmonella. The ingredient supplier told the company about the problem.

Wellements Baby Move™ Prune Concentrate, in 4 ounce size, is sold in a glass bottle and packaged in an individual product carton. The UPC number is 729609019878. All product lots up to and including number 12179 are part of the recall. The product was distributed from January 2012 to July 2012 nationwide through retail stores and online retailers.

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Cargill Recalls Fresh Beef After 7-State Salmonella Outbreak Sickens 33

Hannaford Stores in Massachusetts, Maine, New Hampshire, New York and Vermont named as one retail outlet – Cargill and Hannaford linked to past Salmonella outbreaks.

Cargill Beef late Sunday recalled almost 30,000 pounds of 85 percent lean, fresh, ground beef, produced by the company at Wyalusing, PA on May 25, 2012.  The meat may be contaminated with Salmonella Enteritidis (SE) associated with an ongoing multiple state outbreak of SE.
USDA’s Food Safety and Inspection Service said it became aware of the the problem “during the course of an ongoing investigation of a multistate outbreak of Salmonella Enteritidis involving 33 case-patients from 7 states (MA, ME, NH, NY, RI, VA, and VT.)”  Hannaford Stores in those states have been named as a retail outlet for that meat by the FSIS.
The FSIS statement continued:
“Working in conjunction with the Centers for Disease Control and Prevention (CDC), Vermont Department of Health, New York State Department of Health, and New York State Department of Agriculture & Markets, FSIS was able to link illnesses in five case-patients to the ground beef products produced at this establishment based on epidemiologic and traceback investigations, as well as in-store reviews.

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“Illness onset dates among these five case-patients ranged from June 6, 2012 to June 13, 2012. Two of the five case-patients were hospitalized. Leftover product with no packaging information collected during the course of this investigation by the Vermont Department of Health tested positive for Salmonella Enteritidis with the outbreak strain. This outbreak strain of Salmonella Enteritidis is drug sensitive, meaning antibiotics can be effective in treating patients who need them. FSIS is continuing to work with CDC and public health partners on the investigation.”

Cass-Clay Creamery Recalls Ice Cream for Undeclared Allergens

Cass-Clay Creamery of North Dakota is recalling some varieties of ice cream because they may contain undeclared Brazil nuts, peanut oil, and soy lecithin. Tree nuts such as Brazil nuts are one of the major food allergens. Peanuts are another allergen, and so is soy.

The flavors recalled for Brazil nuts are Cass-Clay Maple Nut ice Cream in one gallon containers (3.78 liters) with UPC number 70422-03404; Cass-Clay Premium Light Maple Nut Ice cream in one gallon containers with UPC number 70422-23404; and Hornbacher’s Maple Nut Ice Cream in half-gallon containers (1.89 liters) with UPC number 41130-21666. Cass-Clay Premium Light Double Chocolate Fudge Ice cream, in half-gallon containers, UPC number 70422-24061 is being recalled for undeclared peanut oil and soy lecithin

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Articles of Interest

Some Duluth Beaches Still Contaminated with Fecal Bacteria

As we told you on July 3, 2012, some Lake Superior beaches in the Duluth area were closed because of high levels of E. coli bacteria. A few of those beaches are now safe to use, but some remain closed. Flooding in the Duluth area in late June most likely washed bacteria from sewage systems into water around the area.

According to the Lake Superior Beach Monitoring Program, the Minnesota Point 15th Street Harbor Side Beach has high bacteria levels, along with Hearding Island Canal Beach/Park Point 20th Street, and the Park Point Sky Harbor Parking Lot Beach. The 42nd Avenue East Beach, and Brighton Beach in East Duluth now have acceptable water.

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Another Salmonella Hatchery Outbreak: 37 Ill in 11 States

The Centers for Disease Control and Prevention announced Monday that 37 people in 11 states have reportedly been infected with the same strain of Salmonella Hadar.

chickadies_iphone.jpgThe number of ill persons identified in each state is as follows: Arizona (2), California (1), Colorado (3), Idaho (5), Illinois (2), Oregon (5), Tennessee (2), Texas (1), Utah (5), Washington (9), and Wyoming (2).

Of those known to be sick, eight have been hospitalized and no deaths have been reported. Health authorities said 37 percent of those sickened are children 10 years of age or younger.

“Epidemiologic, laboratory and traceback findings have linked this outbreak of human Salmonella infections to contact with live poultry from Hatchery B in Idaho,” said CDC in a release Monday. “Mail-order hatcheries, agricultural feed stores, and others that sell or display chicks, ducklings, and other live poultry should provide health-related information to owners and potential purchasers of these birds prior to the point of purchase. This should include information about the risk of acquiring a Salmonella infection from contact with live poultry.”

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Might Food Become a Vehicle for Tropical Disease?

PROVIDENCE–It’s highly unlikely, but if high in an African mango tree a bat dropped its guano on fruit and it was harvested and went unwashed on a 747 to America, you could end up with a deadly tropical foodborne illness characterized by bleeding through the eye socket.
These are the possibilities that are considered at the International Association for Food Protection, which is meeting this week at the Rhode Island State Convention Center. It’s where food professionals come to learn about the World Health Organization’s (WHO’s) Global Foodborne Infections Network, or PulseNet International, which keeps track of threats most of us don’t even want to think about.

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It’s where you come to learn about “unusual Salmonella serotypes” emerging out of Southeast Asia or new foodborne pathogens like E. coli O104:H4. These are the sessions attended by the people from the Centers for Disease Control and Prevention in Atlanta who will show up in bug suits if anything really goes badly in America.
Thankfully, it all ends with Dr. Daniel Bausch, associate professor of tropical medicine at Tulane University, telling us there is not really that much to worry about.   Hopefully. His talk is called  ”Foodborne Viruses–What Else is Out There?”
Bausch provided more assurance than alarm regarding the likelihood that any of us will be stuck by an exotic and scary foodborne illness. Yet he also welcomed us to his world.
He’s seen what these diseases can do. Bausch was on the SARS team sent to Vietnam ten years ago. Severe acute respiratory syndrome (SARS) is caused by a virus from small mammals originating in China. The SARS virus can then spread like the common cold. It cases a pneumonia so severe that it can lead to death.
There are a number of exotic pathogens out there that in the right circumstances may be spread by food or water, Bausch said. Among these are Lassa fever, Rotavirus, Ebola, Hepatitis E and Nipah virus.
The following is a brief description of each of them:

EU Might Block Parts of Food Safety Modernization Act

PROVIDENCE– In implementing its new Food Safety Modernization Act (FSMA), the United States wants to boldly go where no government has gone before in protecting food imports, but the European Union (EU) doesn’t like it.
Carlos Alvarez Antolinez, an EU food safety official stationed in Washington D.C., told the International Association for Food Protection (IAFP) Monday that the 27 member EU countries he represents has some significant issues with FSMA.

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Third party auditing, inspections, and foreign supply verification procedures top the list of the EU’s concerns with the new U.S. law.  With governmental authority for a continent of 500 million people speaking 28 languages, the EU is also in a position to stop what it does not like.
“We have been very grateful to the U.S. Food and Drug Administration (FDA),” Antolinez said. He said the EU has remained in constant dialogue with FDA since President Obama signed the new food safety law in January 2011, and seemed to suggest somewhat humorously that the U.S. and the EU might be more at impasse if the American government were further along in implementing the new law.
FDA has drafted the implementing regulations, but the White House’s Executive Office of Management and Budget (OMB) have held those up for months.
The EU is concerned that with the FSMA, the U.S. will be reaching out to individual companies in its member countries rather than maintaining a “government-to-government” approach for ensuring food safety, Antolinez says.
“Our concern is about duplication of controls,” he says.
He suggested that U.S. plans for third party auditing are going to run up against some immediate limitations involving both the physical and institutional environment.  He said the EU’s system is based on national authorities and official controls.
“We honestly feel this is how it should be,” Antolinez added.

NFL Linebacker Joins Antibiotics Briefing on Capitol Hill

Congresswoman Louise Slaughter (D-NY), a constant advocate for reining in the use of antibiotics in agriculture, hosted another congressional briefing on the issue Tuesday — this time featuring an NFL linebacker.

Will Witherspoon, who plays for the Tennessee Titans and owns Shire Gate Farm, joined Frank Reese of Good Shepherd Poultry Ranch cooperative and veterinarian and medical expert Dr. Michael Blackwell on panel to brief staff on raising livestock without using antibiotics.

According to Rep. Slaughter’s office, Witherspoon’s Shire Gate Farm applies high-welfare, sustainable farming techniques that almost entirely rule out the need for antibiotics. “By following these techniques, Witherspoon doesn’t need to rely on routine antibiotic use to keep animals healthy or prevent disease.”

At the briefing, Slaughter emphasized her platform: that the U.S. needs to reduce its antibiotic use in food animals and address the growing public health threat of antibiotic-resistant pathogens.

European E. coli Outbreak Sheds New Light on Treatment Strategies

It is an accepted fact among medical experts that an E. coli infection should not be treated with antibiotics, as these drugs may worsen illness. But a new review of strategies used to treat victims of last year’s European E. coli outbreak shows that a combination of two or more antibiotics may have helped patients recover from hemolytic uremic syndrome (HUS) – a potentially fatal complication of E. coli infection.

The 2011 outbreak, centered in Northern Germany, was characterized by an unusually high number of HUS cases. Out of more than 4,000 people sickened by the E. coli O104:H4 bacteria, 22 percent developed this life-threatening condition. By contrast, E. coli O157:H7, the most common Shiga toxin-producing E. coli (STEC) in the United States progresses into HUS in 5 to 10 percent of patients.
HUS occurs when the Shiga toxins released by E. coli bacteria damage blood vessels, preventing adequate blood flow as red blood cells get clogged in the vessels. Deprived of blood, the kidney cannot perform its function of expelling toxins through urine.
Antibiotics are thought to increase a patient’s chance of developing HUS by increasing bacterial death and triggering the release of more Shiga toxins. But a study published this week in BMJ suggests that some antibiotics may actually help treat the kidney disease.
Scientists reviewed 298 cases of HUS treated at 23 hospitals in Northern Germany during the 2011 outbreak, finding that patients treated with at least two antibiotics were less likely to experience seizures, did not require intestinal surgery and exhibited no signs of toxic shock. The death rate among these individuals was lower than among other patients.
“As antibiotics seem to improve, but definitely do not worsen, the course of the infection we believe that they are beneficial in the later stages of the disease when the prodromal phase with diarrhoea has nearly subsided,” conclude the authors – a team of 62 medical and microbiological experts.
The two antibiotics used most commonly were meropenem and ciprofloxacin. Rifaximin was given to patients in the intensive care unit. All of these drugs were administered at only one hospital included in the study. Other treatment centers did not use antibiotics.
Researchers also found that stool samples from these patients tested negative for the bacteria an average of 8 days before those of other patients.
These findings are similar to those of a previous study which found that the antibiotic azithromycin also shortened the time that individuals shed E. coli O104:H4 after infection.

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Research on the effect of antibiotics on individuals with E. coli O157:H7 infections, on the other hand, has overwhelmingly suggested that these drugs are harmful, not beneficial, to HUS patients. A study from the Washington University Medical Center in St. Louis published in March found that children who were administered antibiotics while infected with E. coli O157:H7 were more likely to develop HUS.

UK Bans Dangerous Sports Supplements

The Medicines and Healthcare products Regulatory Agency (MHRA) in the UK warned the public of potentially dangerous sports supplements available for sale. The agency said that “illegal sports supplements might contain dangerous ingredients that could cause kidney failure, seizures, and heart problems.”

Eighty-four illegal products that are marketed as energy and muscle gain enhancers are part of the warning. They contain high risk chemicals such as Ephedrine, Synephrine, and Yohimibine that can cause serious health side effects. The products may also contain steroids, stimulants, and hormones. Retailers have been told to remove those products from store shelves.

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