Friday, August 1, 2008

U.S. probe into salmonella outbreak criticized



http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/08/01/MN55123I43.DTL&tsp=1

Two days of congressional hearings this week into the nation's largest salmonella outbreak in a decade revealed a Keystone Kops government investigation that spanned more than two months and stretched from a false alarm about U.S. tomatoes to suspicions about peppers from Mexico.

State health officials and growers slammed federal officials for refusing to ask for help or use common sense.

Growers in California and Florida, reeling from losses for a contamination they had nothing to do with, want an investigation of the investigation. Testy federal officials claimed mom-and-pop operations left messy paper trails that slowed their work. The Centers for Disease Control refused to exonerate tomatoes, one of the most common foods in the U.S. diet, but the Food and Drug Administration said tomatoes now are safe to eat.

One thing is clear: The sprawling U.S. food chain, now delivering a billion meals a day every day, is no stronger than its weakest link. And there are plenty of weak links.

"The one great certainty," said Michael Osterholm, director of the Center for Infectious Disease Research at the University of Minnesota, "is that there will be a next time, and it could be as soon as tomorrow."

The exact source of the outbreak is still unclear. The rare Saintpaul strain of salmonella has sickened 1,304 people, although many more probably were affected. More than 250 were hospitalized, and two, an elderly man and a cancer patient, died. The outbreak has slowed, but the investigation continues, focusing now on serrano and jalapeno peppers from two widely separated farms in Mexico.

Federal officials said they do not know where the contamination occurred, although they are warning consumers to avoid Mexican-grown jalapeno and serrano peppers.

The peppers that traveled from Mexico to 43 states and Canada, picking up salmonella somewhere along the way, are the latest in a string of produce-related outbreaks, including a rare and lethal E. coli pathogen that devastated California's spinach industry two years ago.

Imports of fresh fruits and vegetables are soaring as consumers demand fresh produce year round. Much of those imports come from poorer countries where not all farms meet high sanitation standards.

15% of food imported
Food imports have risen 40 percent in the last decade, now making up 15 percent of the U.S. food supply, including 60 percent of fruits and vegetables and 80 percent of seafood, according to industry statistics. California is the nation's biggest producer of fresh produce.

William Hubbard, a former associate FDA commissioner, testified that the agency's investigative staff has fallen even as the number of food-borne illness outbreaks has doubled. Outbreaks now average 350 a year, he said, up from 100 in the early 1990s. The FDA can inspect the 120,000 U.S. food-processing facilities only once a decade, he said, and the 200,000 foreign facilities exporting food to the United States "are almost never inspected by the FDA."

A typical American meal, said Tennessee's top epidemiologist, Timothy Jones, includes foods from six countries. "Fresh produce travels a mean of 1,500 miles to get to our plates," Jones said. "Feedlots can hold 300,000 head of cattle. Outbreaks involving several hundred victims no longer shock us."

Fruits and vegetables are essential to a healthy diet yet are vulnerable to contamination by pathogens common in soil, carried in water and harbored in the fecal matter of birds, reptiles and mammals, including humans. Many produce items are picked by hand and transferred many times before reaching their final destination. Often that is the home kitchen, where studies have found the average dish sponge has more germs than a toilet.

Patchwork of agencies
Government regulators are sprawled across dozens of federal, state and local agencies. The top U.S. regulator, the Food and Drug Administration, according to testimony, could be the least capable. The Department of Agriculture is responsible for 20 percent of the food supply, mainly meat and poultry, but has many more investigators than the FDA, which oversees 80 percent of the food supply.

The FDA relies mainly on border inspections to prevent contaminated imports but inspects just 1 percent of imports and conducts analyses on just 0.2 percent, according to congressional testimony.

Food-borne contaminations go far beyond high-profile outbreaks. The Centers for Disease Control estimates that 76 million Americans get sick every year from food contamination, 325,000 are hospitalized, and 5,000 die. Most do not know they have food poisoning; outbreaks are noticed only when a patient seeks medical attention and the doctor orders the right diagnostic tests.

State health officials and growers faulted both agencies in the salmonella investigation for such things as blaming Florida tomatoes when only three of 18 million Floridians got sick and most of the illnesses were in Texas and New Mexico. They also said federal investigators at the two agencies failed to tap a wealth of state and industry information, and did not share what they knew with those who might have helped them, prolonging the investigation and the collateral damage.

States' help not sought
"Unfortunately, if FDA chooses to limit the information they share with states, we are likewise limited in how useful our assistance will be to them," said Florida Agriculture Commissioner Charles Bronson. "FDA failed to ask states to provide them with information we now know they needed, and we had no way of knowing what kind of data that was without them telling us."

The FDA associate commissioner for foods, Dr. David Acheson, faulted poor industry record keeping, especially at mom-and-pop operations, for slowing the agency's ability to trace back the source of the contamination.

Ed Beckman, president of California Tomato Farmers, said a random test for congressional investigators at a Sacramento Jack in the Box found the source of its tomatoes in 35 minutes. Another random test hatched over lunch at a Subway sandwich shop on Capitol Hill tracked tomatoes to Virginia's Eastern Shore in less than four hours.

Florida and California have so-called trace-back systems in place to allow quick identification of produce.

FDA's Acheson said the investigation process "is what it is. It worked. It was just slow."

Farmers seek recompense
Tomato growers are demanding compensation from Congress, with estimates above $100 million. Asked to exonerate tomatoes, Acheson said with some pique that the FDA has all but done so, but cannot overturn findings from the Centers for Disease Control, whose surveys of consumers pointed to tomatoes. The Centers' King responded, "We respectfully disagree that tomatoes weren't involved."

Minnesota health officials finally pinpointed the peppers in their own investigation, which took less than two weeks.

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