To: Local Boards of Health From: MA Department of Public Health Date: May 28, 2004 Public Health Advisory on Flour Tortillas The Massachusetts Department of Public Health is again issuing an advisory concerning flour tortilla products served in Massachusetts schools. Consumption of meals served with flour tortillas has been associated with five Massachusetts outbreaks since last year including a recent outbreak in Revere. The outbreaks are characterized by mild gastrointestinal symptoms including nausea, abdominal cramps, and vomiting. In most cases, illness began within one hour after consuming the suspected tortillas and lasted less than one day. At this time the exact cause of the illness has not been determined and is still under investigation by the MA Department of Public Health in coordination with the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration. It is recommended that school nurses be advised to immediately report clusters of similar symptoms to their local health department. Clusters of illness occurring after the first lunch rotation should be reason to evaluate whether or not the same foods should be served to subsequent rotations of students. The suspect products appear to be flour tortillas manufactured by Del Rey Tortilleria, Inc. in Chicago. The most recent outbreak involved the Del Rey Tortilleria brand 10 inch flour tortilla/burrito stamped in ink with a date code of May 5 or 6, 2004 on the back of the plastic packaging. Del Rey also produces flour tortillas under the label "Pan De Oro". The Department recommends that anyone who has any size and/or code of these products in their freezer or refrigerator discard it or return it to the vendor. Please note that this recommendation pertains only to flour tortilla products manufactured by Del Rey Tortilleria, Inc. labeled either "Del Rey Tortilleria" or "Pan De Oro". For further information, please contact the Massachusetts Department of Public Health Food Protection Program at 617-983-6712 or the Division of Epidemiology and Immunization at 617-983-6800. Priscilla J. Neves, MEd, RS, CFSP |