Salmonella
18 Salmonella is a general term for a group of some 2,000 different types of bacteria. It is a cause of food poisoning in humans. They grow in the intestines of animals. They are usually spread to humans through the human coming into contact with the faeces of vermin or birds, or through the human eating food that has come into such contact. The bacteria must be ingested in sufficient numbers so that some will survive the acidity of the stomach. Those that do survive will breed in the intestine, producing toxins. Symptoms include vomiting, diarrhoea, nausea, dizziness, fever and chills. Usually the symptoms last for two to three days, but there are relatively rare cases where the symptoms are more serious and may be life threatening.
19 Salmonella bacteria are colourless and odourless. They can only be detected by microbiological testing. They need oxygen for growth. They grow best at around body temperature, but will do quite well at room temperature. In optimal conditions salmonella can reach enormous populations in only a few hours.
20 Salmonella infections are notifiable diseases in all States and Territories. The numbers of notifications have been increasing steadily in recent years. There are generally 300 to 400 cases notified in Australia each month.
21 ST 135a is a specific type of bacteria within the salmonella group. It is relatively rare.
22 The growth of salmonella is retarded by cold. Growth almost stops at refrigeration temperatures (0-4°C). However, the cold does not kill the salmonella.
23 Chlorine added to water would prevent the build up of salmonella in the water, at least in the doses that one would usually find (for example) in a properly maintained swimming pool. Even at those concentrations spraying a chlorine solution on an orange may not kill salmonella already on that orange. As Mr Tugwell pointed out in his evidence, the purpose of chlorine is to keep the water clean, rather than to kill bacteria on fruit sprayed or immersed in the chlorine solution. In any event, salmonella would not be destroyed by the amount of chlorine normally added to drinking water.
24 Most importantly for the purposes of this case salmonella bacteria are also destroyed by high acidity. The pH levels typically found in orange juice would not be conducive to the survival, let alone growth of salmonella. Indeed, before the outbreak involving Nippy's Fruit Juices there had been very few occasions anywhere in the world where people were infected with any bacteria from orange juice. What cases there were involved the person who actually squeezed the juice (usually in a shop) being a carrier of the disease, or instances where contaminated water or ice had been added to the juice. The only exception to this would appear to be a case in 1995 in the United States where unpasteurised orange juice had been infected with salmonella. That case involved 'environmental contamination from factory surrounds' which apparently involved rat infestation of the factory producing the juice. Details of these outbreaks were given in the report of Professor Parish of the University of Florida which was tendered before me.
25 The issue was clearly dealt with by Dr Bentham in his evidence:
'In your report you mention that an acidic environment is not conducive to the growth of the salmonella bug? --- Around the pH 4 or below it becomes very hostile to growth.
And indeed it goes further than that: the bug will actually die in acidic conditions? --- That's right.
And as you observe, if the bug is in orange juice it will die because of the
acidity of the juice? --- That's right.
Prior to being instructed in this matter, had you ever heard of salmonella in conjunction with oranges or orange juice? --- I heard it through being a microbiologist and living in South Australia. The Nippys outbreak that we're talking about got a fair bit of press in biological terms.
Prior to the Nippys outbreak, had you ever been conscious of the fact that salmonella might be an issue to consider in the context of making orange juice or packing oranges? --- No, I hadn't prior knowledge of that.'
26 Professor Parish is apparently of the opinion that a prudent producer of unpasteurized orange juice would have been aware of the risks from that product from the various outbreaks that had occurred previously. To an extent this may be so and Mr John Knispel, who managed Nippy's Fruit Juices, gave evidence that he was aware of the risks and that he took appropriate safeguards in terms of the cleanliness of his factory and of requiring proper hygiene by his workers and so on. As he described it in his evidence:
'You were also asked questions by my learned friend Mr Anderson about your knowledge of risk prior to the salmonella outbreak in 1999, and you have told his Honour you were aware of some risks? --- Yes.
Other things you said you underestimated. You also said you weighed the risks of which you were aware against the advantages that you perceived in selling your fresh product? --- Yes.
I just want to ask you to tell us what were the things that you took into account in that weighing exercise - that balancing exercise - between the risks of which you were aware on the one hand, the advantages to you on the other hand?
--- Your Honour, we had a long track record at the time of no significant problems - nothing of this scale anyway. We had a purpose-built factory that we were operating in, which you've seen. We were soaking the oranges before scrubbing and washing them with un-recirculated water - in other words, one pass only, and then water down the drain. We were using hot caustic cleaning for our plant, which was not only a cleaning operation, but also a sanitising operation. We have pest control. We have insect control. We have acid-resistant, well-drained, impermeable, well-maintained floors, specially selected for the purpose for which they were being used. Our plant is predominantly stainless steel, at least in areas of product contact and, if not stainless steel, other materials which are approved for food manufacturing. We have a stable workforce of people who know what they're doing - at least we always have at least 50 per cent old hands, some of them - I can think of three that had been with us at the time for more than 18 years. Although we did not have documented or formal training in food handling, I made use of my experiences at Moorook, when I was operating the UHT juice plant at Moorook, and also the course I did in Germany, and also general knowledge of personal health habits to have informal discussions with the staff while they were having their lunch, talking about such subjects as how easily it is to contaminate one's hands. I pointed out that most people contaminate their hands almost immediately after they have washed them by turning off the tap; just doing that recontaminates your hands. Leaving the bathroom you can re-contaminate your hands as you open the door. I emphasised for their own welfare, if not for the welfare of the product, to avoid holding food directly in their hands, unless they were able to wash them in a hands-free sink. We have two such sinks - and we had two such sinks in the factory at the time. We have rapid-roll doors, which you observed on your visit - automatic rapid-roll doors - to minimise the amount of time that the interior of the factory is exposed to outside contamination. These are some of the things that come to mind that inspired me to have confidence in what we were doing, your Honour.
HIS HONOUR: I think you have already given evidence that you were shocked? --- Most definitely, your Honour.'
27 Professor Parish has shown that salmonella may become 'acclimatised' to high acidity in which case it would not be destroyed by orange juice. Of course, I accept that this is possible. On the other hand, as Dr Bentham pointed out, there is no evidence whatever that that is what occurred in this case. In this case it would seem clear that it was the chilling of the juice, rather than acclimatisation, which explained why the salmonella survived in the orange juice. Further, it does not seem to me that the possibility identified by Professor Parish in his writings had the effect that persons in the position of the Constas brothers should have been aware of the potential problem.
28 The reports of the incidents overseas (such as they were) also do not seem to me to be such that a person in Australia should have assumed that orange juice was a high risk product. Indeed, they were entitled to assume, and did assume, the very opposite - that the low pH level of oranges and of orange juice meant that food poisoning was very unlikely from oranges or from orange juice. This assumption was shared by those involved in Nippy's Fruit Juices, by those involved in Packing and by the Constas brothers. And indeed, read in context almost all literature dealing with the effect of microorganisms in fruit juice seems to have been directed to the shelf life and saleability of the product, rather than any health risks to the ultimate consumers. For example, Mr Tugwell gave evidence of the changes in cleanliness of packing sheds over the last 15 years or so, but it is perfectly clear that those changes were directed to prevent the spoiling of fruit through 'blue and green mould' and other microorganisms, rather than any health fears for ultimate consumers. His evidence as to the reasons why hygiene was improved in packing sheds was:
'And have you observed an improvement in the hygiene in sheds, well, in your experience, or has it been consistently at a relatively high standard right through? --- Over my career there were a lot of changes that occurred in relation to improved fungicides and practices that meant contamination of sheds was reduced and the sheds did become much cleaner and tidier, both as a result of having improved chemicals for sanitation - so you didn't get spores on the fruit, you know, sort of mouldy fruit around the shed; but also during that time the emphasis on sanitation was very strong because there was a problem that emerged, called fungicidal resistance. Resistance to fungicides nearly - well, it resulted in quite high losses in the industry at one stage because through lack of other hygiene and other practices, the fungicides became ineffective. During that time, the emphasis was on hygiene - in other words, clean up your act, otherwise you're history, until we got new fungicides that could cope with it. From that point onwards, the emphasis was on hygiene, because we didn't want to rely on just one fungicide and we didn't want to rely on chemicals alone. So the whole emphasis became one of hygiene plus chemicals and fungicides. That's sort of what applies in the food industry, too. You've just got to make sure that you have a low level of inoculin in the shed before you use the materials that will give you protection. If you don't do that, you're in trouble. So the emphasis on hygiene was extreme.'
29 Mr John Knispel gave evidence that he was aware that the acidity of orange juice (and indeed other fruit juices) meant that its risk of spoiling was much less than for other products, such as milk. Similarly, Mr Jeff Knispel gave evidence that the understanding in the industry was that microorganisms were unlikely to be present in orange juice in significant numbers to cause any problem and, even if they were, the effect was to make the juice unpleasant to drink, not to make it harmful to health. More specifically, he gave the following evidence:
'HIS HONOUR: Did you understand any of those to go to the health of the fruit or fruit juice when drunk by a person? --- Sorry, just say that again.
Did you understand those problems - yeast, et cetera - to be problems with the fruit itself rather than the health of the person who drank it or drank the juice from it? --- Yes, it's more - our concern at that time was that that kind of fruit can have an off flavour, and also it has very poor keeping qualities. So the system within our organisation is to rotate fruit through a cold room, therefore we need to know that fruit might keep - or needs to be able to have a shelf life in a coldroom prior to juice production of perhaps up to three or four weeks. It becomes a problem if there's fruit within a container that's only got a seven-day shelf life, because that starts a chain reaction within the good fruit basically. So, apart from the off flavour, it does create stock rotation problems.
MR ANDERSON: Would it be fair to say that prior to March of 1999, the object in all of the things that you've just been telling us about was to ensure that the juice tasted okay? --- Yes.
And you really hadn't given any serious concern, I suggest, to the possibility of there being serious contamination in the oranges which could cause the sort of problems that it did cause? --- No, there would be no reason for us to have those sorts of suspicions or concerns.'
The evidence of Mr Theo Constas was more general, but to the same effect:
'Before the alleged contamination of oranges in 1999, I had never heard of oranges or orange juice being infected with salmonella. I had heard of the word salmonella from publicity about Garibaldi Small Goods but I did not think that it applied to fruit.'