State Health Department Issues Interim Advisory on Raw Alfalfa Sprouts

August 31, 1998

The California Department of Health Services (DHS) is advising consumers who are at high risk for severe foodborne illness to avoid eating raw alfalfa sprouts until methods are fully implemented to improve their safety. High risk consumers include the very young, the elderly, and those with compromised immune systems. Raw alfalfa sprouts should not be served in day care centers, preschools, nursing homes, and hospitals.

The International Sprout Growers Association (ISGA) has initiated a scientifically-based food safety program to reduce the risk of contamination. This food safety program includes specific measures to improve the safety of sprouts by disinfecting seeds, microbiological sampling of sprout growing equipment and water used for growing sprouts, and strict adherence to current state and federal good manufacturing practices and other food safety laws. ISGA has worked vigorously with state and national working groups of regulators and academicians to assist with the implementation of these food safety programs and research priorities for the industry. The U.S. Food and Drug Administration is issuing a "talk paper" addressing these concerns and the actions being taken at the federal level.

Raw alfalfa sprouts are of concern to high risk individuals because:

• Alfalfa sprouts are generally eaten raw with no additional treatment, such as cooking, which could kill pathogens.
• Conditions required for growing sprouts are ideal for bacterial growth.
• Consumers may unknowingly be exposed to raw alfalfa sprouts on sandwiches or salads purchased at restaurants and delicatessens.

Because sprout seeds may be a source of contamination, CDHS is working with other state agencies to expedite approval to use calcium hypochlorite for treatment prior to germination and growth of sprouts. Calcium hypochlorite is a close chemical relative of household bleach. This procedure has the potential to reduce the risk of foodborne illness.

Recent outbreaks of diarrheal disease associated with raw alfalfa sprouts have occurred in California and elsewhere. Since 1995, the Centers for Disease Control and Prevention has received eight reports of sprout-associated outbreaks of illness from several states in the U.S.involving the consumption of raw alfalfa sprouts. California was involved in four of these outbreaks either as the only state with illnesses or as part of a multi-state outbreak. Pathogens responsible for these outbreaks in California were Salmonella (several different serotypes) and E. coli O157.

Individuals infected with Salmonella or E. coli O157 may develop illnesses ranging from mild self-limiting diarrhea to severe, life-threatening complications. Young children are of particular concern. If they become infected with E. coli O157, they are at increased risk of developing hemolytic uremic syndrome, which can lead to chronic kidney failure, stroke, and even death.

DHS is continuing intensive inspections of sprout growing facilities in California, and is taking appropriate enforcement actions when growers are not in compliance with good manufacturing practices and other food safety laws. Until a method of reliably producing sprouts free of contamination is developed, raw alfalfa sprouts should not be consumed by high-risk individuals.