Outbreaks Put Worry on the Table (New York Times) By ANDREW MARTIN and GARDINER HARRIS Every few
weeks, it seems, deadly germs turn up in the food supply. Heather
Whybrew, a college student in Washington State, became gravely ill after
eating a salad in her school cafeteria. Carl Ours, of Ohio, was temporarily
paralyzed after eating chili dogs and drinking beer. Mari Tardiff, of
California, spent three months on life support after she drank unpasteurized
milk. Is it
becoming more dangerous to eat? Public
health experts cannot give a definitive answer, largely because the
historical figures on food-borne illness are spotty. But most of them believe
the nation’s food supply is markedly safer now than it was 100 years ago, and
probably safer than a decade ago. Yet, even
if fewer people over all are getting sick, the big recalls and outbreaks of
recent years, like the discoveries of the industrial chemical melamine in
infant formula and salmonella in peanut butter, are still worrisome to many
health experts and safety advocates. (Swine flu,
despite its name, is not contracted from food.) While there
are more recalls and known outbreaks as a result of more sophisticated
techniques for tracking illness to its source, some incidents have revealed
new problems developing in the food supply. New
products like bagged salads require extra handling, increasing the risk of
contamination. Foods once considered safe, like spinach and peanuts, are now
seen as risky. And more food is coming from abroad, posing unique problems. Many safety
advocates say the recent problems highlight the inadequacy of government
oversight, particularly at the Food and Drug Administration. The agency
regulates 80 percent of the food supply, but to safety advocates the agency
lacks adequate money or authority. “Those are
warning signs that we need to get a better system in place rapidly,” said
Caroline Smith DeWaal, director of food safety at the Center for Science in
the Public Interest, an advocacy group. “The trends clearly show that
consumers should be more worried about the food supply because the hazards
are becoming more pronounced.” The Obama
administration has promised an intensive focus on food safety. On Capitol
Hill, crackdowns are under consideration. And the food industry, reeling from
costly recalls, is more open to change. Robert E.
Brackett, senior vice president for the Grocery Manufacturers Association,
said major food companies have made strides. But the recent outbreaks have
shown that a single sloppy ingredient supplier can damage large segments of
the food industry. “I think
we’ve come to realize that until you raise the bar for everyone, we are not
going to make much progress,” he said. Food has
always contained germs, and it has always posed a risk of illness. An
estimated 76 million Americans, a quarter of the population, contract
food-borne illness each year, but the vast majority of the cases are so mild
that victims do not realize where the germs came from. Starting in
1996, the government started collecting better figures on these illnesses.
Figures before that are incomplete. But Dr. Robert Tauxe, deputy director of
food-borne diseases at the Centers for Disease Control and Prevention, said
there was no doubt the food supply is safer now than in the days before
municipal sewer systems, refrigeration and milk pasteurization. A century
ago, it was common for food to come into contact with human sewage, picking
up germs. For instance, in 1900, typhoid fever killed 31 people out of
100,000. As sanitation improved and such diseases largely disappeared, new
ailments, many associated with animal waste, took their place. Salmonella
infections increased steadily in the United States from 1942 through 1990 before
beginning a gradual decline, the C.D.C. reported. Another 13 pathogens,
including a toxic strain of the intestinal bacterium Escherichia coli, have
been identified since 1976. Since the
C.D.C. began its improved tracking in 1996, cases tied to some major germs
have decreased significantly. Authorities cite better oversight of the meat
and poultry industry. Ailments
caused by the toxic strain of Escherichia coli have dropped 25 percent.
Campylobacter cases are down 32 percent and listeria cases, down 36 percent.
A few relatively rare diseases have increased, and rates of salmonella, a
common food-borne illness, are largely unchanged. (Most salmonella cases are
mild.) The paradox
is that even as food has grown safer, contamination scares and recalls keep
coming to light. William Marler, a lawyer in Seattle who specializes in
representing victims of food-borne illness, said that every time his business
appeared to slow from a dropoff in cases, some new type of contamination
would crop up. “It’s like
the Dutch boy putting his finger in the dike,” Mr. Marler said. “When you put
your finger in one hole, another emerges.” Part of the
explanation, public health experts say, is that the technology for
identifying multistate outbreaks has improved greatly. Decades
ago, the burden of illness was probably higher, but foods were not recalled
as often, simply because investigators could not implicate them in a given
outbreak. Now, modern genetic techniques can often link cases of food-borne
illness, even in different parts of the country, allowing investigators to
pinpoint the tainted food. “If you are
half-asleep, you are going to have less outbreaks because you don’t recognize
them,” said Dr. David Acheson, associate commissioner for foods at the Food
and Drug Administration. He cited
the recent salmonella outbreak in peanut products. Authorities tracked the
salmonella to an open jar of peanut butter in Minnesota, identified victims
in 46 states and determined that it came from a plant in Georgia with poor
maintenance and hygiene. The peanut
case also reflected the growing complexity of the food supply: a small
Georgia plant sold peanuts or peanut paste to several hundred customers who
used them to manufacture thousands of products. To date, 3,913 distinct types
of products related to this incident have been recalled. Food
manufacturing is also growing more complicated. Bagged salads, developed in
the 1980s, provide a convenient solution for eating leafy greens. But where a
contaminated head of lettuce might have made one family ill, bagged salads,
which combine leaves from dozens of heads, have the potential to spread the
germs. Ms.
Whybrew, the college student, ate a salad last May in the cafeteria at
Pacific Lutheran University in Tacoma, Wash. It was tainted with E. coli. She
spent a month in the hospital with severe diarrhea and pneumonia. “It was
weird for me to get that sick from eating vegetables, which is something you
are supposed to eat,” Ms. Whybrew said. Public
health experts say the complexity of the food supply illustrates the need for
tougher government oversight, including more field inspectors. Mr. Ours,
for instance, ate a hot dog topped with chili made at a factory in Georgia
where the equipment was malfunctioning. The chili had not been cooked well
enough to kill a germ called botulinum. Mr. Ours, a
40-year-old furniture mover, woke up the next morning with double vision and
went downhill from there. “It nearly killed me, I know that,” said Mr. Ours,
who now has little faith in the safety of the food supply. “I was a prisoner
in my own body for a month. The only thing I could do is lay and blink.” Some people
are tempted to opt out of the modern industrial food system altogether. But
doing so can put them at risk of the very diseases that were banished from
the food supply decades ago. Concerned
about health, Ms. Tardiff, the California nurse, bought organic and less
processed foods whenever possible. She decided to try raw milk, believing the
unpasteurized product would supply helpful organisms. Instead,
she got a dose of an unhelpful germ: campylobacter, easily killed by
pasteurization. The ensuing intestinal illness caused a debilitating nerve
disease. Ms. Tardiff communicated by blinking for months, and still cannot
stand or use her hands. “This has
been life-altering,” she said. “All I want to say is, ‘Be careful.’” 5-11-09 http://www.nytimes.com/2009/05/11/health/11food.html?_r=1&scp=4&sq=milk&st=cse |
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