Rhode Island case illustrates poor food handling practices

Introduction

CRANSTON, R.I. – World War II Navy veteran Frank Castelli Sr. dedicated his life to family and faith. After 30 years as a prison guard, “he just wanted to live his life nice and quiet,” said Frank Jr., who told of his father’s final days in March when, at age 84, he could no longer fight the salmonella infection that had ravaged his body.

After eating zeppole, an Italian pastry purchased at a bakery to celebrate St. Joseph’s Day, Castelli Sr. suffered flu-like symptoms for three days and then collapsed at home. He was hospitalized and never regained consciousness. He was taken off life support March 23.

The outbreak that killed Castelli Sr. and another elderly man sent 28 others to hospitals and sickened 78 people in Rhode Island and one in Massachusetts.

Rhode Island’s largest salmonella outbreak in more than a decade, according to the federal Centers for Disease Control and Prevention, has drawn attention to poor food handling practices by the now-closed DeFusco’s Bakery, which also distributed the zeppole to senior centers and churches, and to lack of oversight by the understaffed and underfunded state health department.

Salmonella is the deadliest foodborne pathogen in the U.S. and, according to the food safety advocacy group Center for Science in the Public Interest, the second most common cause of outbreaks in restaurants and food establishments. More than a million Americans will be sickened by salmonella this year, the CDC projects, and Castelli Sr.’s death is one of 400 expected from the illness.

State Reactions How states handle foodborne illness often depends on budget and staff, and this is reflected in Rhode Island.

The Rhode Island Department of Health has lost 11 state health inspectors since 2006 – there is no local or county enforcement – leaving seven people to monitor the 8,000 establishments that prepare, store or serve food to consumers. By contrast, North Carolina’s Food and Drug Protection Division has 35 inspectors for 7,700 establishments.

The Washington, D.C.-based nonpartisan Center on Budget and Policy Priorities reported this year that 42 states are experiencing budget shortfalls for the 2012 fiscal year, with 31 states cutting health services as a result.

“The inspection workforce is totally overwhelmed,” said Tony Corbo, senior lobbyist for the food campaign at the nonprofit Food and Water Watch in Washington.

Rhode Island uses U.S. Food and Drug Administration risk categories to prioritize inspections. High-risk establishments – hospitals, preschools and nursing homes – are supposed to get quarterly inspections, but some go years without one, according to Dr. Ernest Julian, chief of the Office of Food Protection at the Rhode Island Department of Health.

Food service outlets with a history of problems and new establishments also are at the top of the inspection priority list, but they’re lucky to get one inspection yearly because of budget cuts, he added.

DeFusco’s Bakery was simply not a priority.

Just before the salmonella outbreak, the bakeries in Johnston and Cranston, owned by Stephen and Lori DeFusco, were inspected. However, the Cranston location went from February 2009 to January 2011 without an inspection. According to health department reports, inspections took an hour, sometimes less. After the suspected outbreak, inspections took three or more hours.

Inspectors found unrefrigerated calzones and pizza strips, and pastry cream was cooling at room temperature in 5-gallon buckets on the floor. Julian said health officials closed one DeFusco’s location, recalled products at both sites and issued a press release warning of the problem within four hours.

Bakery employees were violating other safe food practices, including storing ready-to-eat pastry shells in cardboard boxes that had contained raw eggs. Health officials later found traces of dead salmonella on the boxes, meaning the pathogen wasn’t active but was still present. They suspect this caused the outbreak.

“The cooking … should have killed [the bacteria], but then if it’s cross-contaminated … now you’re allowing a lot of growth to occur which can cause serious illness, and in this case we had deaths,” Julian said.

At the same time, inspectors found other bakeries across the state reusing egg crates, and the health department ordered them to immediately discontinue the practice.

“People … thought that the government would help them and protect them,” said Castelli Jr.

Castelli Sr. and his wife, Gloria, were married 56 years and raised three children. He was active in his retirement, driving his wife to work, doting on their grandchildren, attending church regularly, growing tomatoes and cooking. “He was … just the basic, unpretentious guy who went to work every day for 30 years [and] supported his family,” Castelli Jr. said.

The family is still struggling to understand how a celebration turned into tragedy.

“It was a tremendous shock because my father was in very good health,” Castelli Jr. said.

And the family was stunned to learn of another outbreak in May near Castelli Jr.’s home, at Uncle Sushi and Grill in Cranston. The health department found at least eight people who ate at the restaurant were infected with norovirus, often mistaken for the flu. Norovirus is the most common foodborne illness, according to the CDC, accounting for half of all reported outbreaks.

Investigation An inspection found rodent feces in the kitchen and vinegar stored in a used detergent bottle. Julian said the restaurant was closed for eight days while violations were corrected.

Uncle Sushi and DeFusco’s both lacked kitchen safety managers, required by the state. DeFusco’s was found in violation of the rule during three separate inspections between 2009 and 2011. DeFusco’s also failed to renew a food processor retail license at the Johnston location, and it was suspended in November 2010.

“Why would you allow untrained people in your kitchen to put your industry, your business, at risk?” said Rhode Island Hospitality Association CEO and President Dale Venturini, whose group has worked with restaurants, tourism venues and hotels for nearly 30 years.

Tina Ricci, owner of Tina’s Italian Kitchen in North Providence, agreed. “You have to take a certified course on food safety,” she said. “If not, that’s how you’re gonna run into some problems.”

Mary Chappron, 87, knows. She spent five days in the hospital with salmonella after eating a tainted zeppole at the nursing home where she lives. “Everyone told me I looked like death warmed over,” she said.

The infection left Chappron concerned about what she eats. “Anything with cream on it I am very very nervous,” she said tearfully.

Multiple attempts were made to contact DeFusco and his attorney, Thomas Plunkett, in person, through social media and by phone, but neither was available for comment.The DeFusco’s outbreak has been widely discussed by area food service operators, including Del’s lemonade franchise owner Cory Sukaskas, who sells his product at events around the state from a mobile stand.

Sukaskas said the bakery was “trying to save money … but there are ways and places to save money where it’s not going to jeopardize the safety of people that are coming to your store.”

Sukaskas believes the outbreak provides a lesson to other food service operators. “Food safety and health safety isn’t something you want to skimp on,” he said. “All it takes is one thing like that to happen, and your business is ruined.”

In the wake of the outbreak, the state is reviewing food inspection procedures, Julian said. Even if the state does a better job, all the problems won’t be solved. Establishments should develop food safety plans and stick to them, Julian said, adding:

“Regulatory agencies cannot be the industry’s food safety system.”

Joanne Ingram wrote this story while a Carnegie-Knight News21 fellow from Arizona State.

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