Salmonella Outbreak Exposes Food-Safety Flaws

Lack of Preparation And Poor Records Cause Delays, Errors

(Wall Street Journal)



The twisting road that led federal investigators to announce Monday that they found a single contaminated jalapeņo pepper grown in Mexico and sitting at a distribution center in McAllen, Texas -- the smoking gun in the continuing salmonella outbreak long blamed on tomatoes -- has exposed problems in the U.S. food-safety system.


After weeks of trying to get to the bottom of the outbreak, it occurred to investigators in late June that they had to look beyond fresh tomatoes. In at least two large clusters of illnesses, tomatoes weren't a factor, and cases kept piling up after the government had warned consumers to avoid eating fresh tomatoes.


Hurdles to the probe ranged from poor record-keeping for tracking fresh produce to some overwhelmed state health departments to the fact that jalapeņos had never before been implicated in a salmonella outbreak.


"It's a mess -- that's part of the problem with the food-safety system we have today," said Michael Doyle, director of the University of Georgia's Center for Food Safety. "When folks get together at the table, no one is officially in charge. Sometimes one person talks over another."


The federal Centers for Disease Control and Prevention, one of 12 federal agencies responsible for food safety, relies heavily on state health departments to test stool samples. But some states don't have the money or resources to handle that task quickly. Delays in reporting -- Texas, with the largest number of cases, had a backlog -- slowed the probe.


In early stages of the investigation, jalapeņo peppers weren't in the picture. The peppers, never before linked to a salmonella outbreak, weren't on the questionnaire health officials used to interview early patients. Officials in New Mexico and at the CDC decided raw tomatoes were the source of the outbreak because 86% of patients ate them before becoming ill. History also played a part: Tomatoes had caused at least a dozen prior salmonella outbreaks.


But the Food and Drug Administration's hunt for contaminated tomatoes was hampered by poor record-keeping and the common practice of mixing and processing tomatoes from many different farms together. Also, many tomato fields were no longer in production, and all 1,700 samples tested negative for salmonella.


What the federal government and the food industry learn from the investigation could help improve the system. Already, a system to enhance the FDA's ability to trace the source of contaminated food has gained support among some prominent lawmakers and the FDA.


Agricultural producers have been leery of such systems because they could bring liability to their doorstep, but Kathy Means, a vice president at the Produce Marketing Association, said that is changing since recent outbreaks of food-borne illnesses have been so costly for farmers and food companies.


The trade group last year began crafting a plan to set up a global, electronic tracking system. "We need to be able to trace produce in minutes or hours, not days or weeks," Ms. Means said.


Officials at the CDC still haven't ruled out tomatoes as the culprit, though the FDA did lift its warning against eating them, but are also doing some soul-searching. "We are asking ourselves: Could you have caught peppers? Was there a pepper component missed in earlier stages?" said Robert Tauxe, deputy director of the CDC's division of food-borne, bacterial and mycotic diseases. He added later: "We want very much to learn what we can do better."


As of Monday, the CDC had reported that 1,256 people in 43 states, the District of Columbia and Canada had been sickened, and that two deaths were linked to the outbreak. The number may be higher, because many people recover without seeing a doctor or having a stool sample analyzed. Salmonella is a feces-borne bacterium that can cause diarrhea, fever and cramps.


The outbreak was first identified May 21, when New Mexico's state laboratory confirmed three cases with the genetic fingerprint of the rare and virulent Saintpaul strain of salmonella.


The next day, with more cases confirmed, state officials immediately alerted the CDC. Also that day, the CDC told Texas officials that similar salmonella cases had cropped up there.


By May 23, Texas had 14 cases, said William Ayres, a spokesman for the Texas Department of State Health Services.


Both states started asking patients what they ate before they got sick. The state questionnaires had more than 200 food items including peppers but not specifically jalapeņos. The surveys found a strong link with tomato consumption, a disproportionately high 86%, and less than half of the ill people who were surveyed remembered eating salsa, Dr. Tauxe said.


By late June, investigators were focusing on ingredients in salsa and other dishes that contained fresh tomatoes. Health authorities were scrutinizing two Texas clusters involving Mexican-style restaurants and another in Minnesota. In each of the Texas clusters, about 30 people became ill, Dr. Tauxe said. In one, people ate a dish with fresh jalapeņo and fresh tomatoes, and in the other, fresh jalapeņo peppers and canned tomatoes, which are considered safe.


In Minnesota, the restaurant had already tossed out tomatoes after the FDA warning, said Kirk Smith, supervisor of the foodborne diseases unit at the Minnesota Department of Health. Among the 20 patrons and seven food workers sickened, jalapeņos were the common item.


Jalapeņos are hard to pinpoint because they are used in many dishes, and people often don't remember eating them, Dr. Tauxe said. "How do we detect something people don't remember eating."


Last week, the FDA lifted its warning on tomatoes, but still said they could have been to blame for some of the cases. Regulators still held out the possibility that cilantro or serrano peppers might be the cause of some of illnesses, too. 7-23-08


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