Debate over U.S. food safety system heats up

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09:37 AM CDT on Sunday, March 15, 2009

By SHERRY JACOBSON / The Dallas Morning News

You can't taste it or smell it. It is undetectable to the human eye.

Nonetheless, a hearty menu of food-borne pathogens is appearing on the plates of unsuspecting Americans, leaving behind illness and, in some cases, death.

The latest sampling for the U.S. palate is an unusual strain of salmonella found normally in the intestinal tracts of cows, pigs and chickens.

Somehow, this bacterial strain has contaminated peanuts in two processing plants – one in Texas and another in Georgia – before they were added to thousands of tasty products such as cookies, brownies and ice cream.

As the federal government scrambles to contain this widening salmonella outbreak, health experts believe this could be a turning point in:

•Renewing the debate over irradiating foods to eliminate deadly pathogens.

•Encouraging scientists to work more closely with the government to assure the safety of the food supply.

•Awakening the public to the dangers of eating tainted food.

This comes at a time when salmonella cases are drastically increasing in Dallas County and throughout the state.

Since September, the salmonella outbreak involving peanuts has sickened nearly 700 people in 46 states, possibly caused nine deaths and triggered a nationwide food recall.

"The wakeup call is here," said Dr. Herbert L. DuPont, director of the Center for Infectious Diseases at the School of Public Health, which is part of the Health Science Center at Houston.

For years, he has been a proponent of improved food-inspection standards and better surveillance of food-borne diseases.

"The government does not do enough," Dr. DuPont insisted. "But I'm not just blaming the government. Scientists need to work with the government to figure out how to tackle this thing. It's almost unbelievable."

Frustrations are growing as the number of diseases transmitted by food now exceeds 250, including E. coli bacteria, often found in ground beef; hepatitis A, a virus linked to shellfish and fruits; and the ever-persistent Norwalk virus, which also starts in raw shellfish or water and can spread rapidly from person to person.

Dr. Dennis Maki, professor of medicine at the University of Wisconsin at Madison, said it's time for the government to become more proactive in stopping food-borne illnesses.

"You have to consider that this is the second very large, multistate outbreak involving peanut butter, and we've just had the 12th outbreak due to contaminated tomatoes or peppers since 2000," Dr. Maki said. "When is another outbreak going to make a difference?"


Food-borne diseases account for an estimated 76 million illnesses, 350,000 hospitalizations and 5,000 deaths every year in the U.S., according to the Centers for Disease Control and Prevention.

Dr. Maki and others are advocating wider use of irradiation to protect fresh food against disease-causing microbes. The idea has not been embraced by Americans, who worry about the safety of eating food that's been zapped by gamma rays, X-rays or electron beams.

Since 1983, the Food and Drug Administration has allowed certain foods to be irradiated – a list that now includes chicken, eggs, beef, pork and lamb. Last year, fresh spinach and iceberg lettuce were added in hopes of ridding them of microorganisms such as E. coli and salmonella.

Americans, however, seem reluctant to buy irradiated products, and manufacturers tend to avoid the process. The treatment also makes products more expensive.

"We already have the capacity to improve food safety by adopting a technology that can protect against safety breakdowns during production or cooking," Dr. Maki argued in a recent issue of The New England Journal of Medicine.

"Instead of having to pick up all these food outbreaks, I'd much rather use irradiation to improve the safety of food preparation and processing."

Source of outbreak

The current food-borne outbreak involves two peanut plants operated by the Peanut Corporation of America. One plant in Blakely, Ga., apparently shipped peanut butter and other products after they tested positive for salmonella. It was closed in January.

The company's West Texas plant was never licensed as a food manufacturer, according to state officials, and went without inspection for four years. The Plainview operation closed in February after salmonella was detected in its product line.

So far, only a handful of peanut-related illnesses have been reported in Texas, but many more could have been sickened without being diagnosed. For every food-borne infection investigated by the government, 38 go unreported, the CDC says.

"What we receive is just the tip of the iceberg," agreed Dr. Wendy Chung, Dallas County's chief epidemiologist, whose staff tracks local food-related infections. "We are completely dependant on cases being reported to us."

Despite the underreporting, Dallas County is seeing a major jump in salmonella-related illnesses.

The number of cases reported here jumped by 90 percent in the last two years, according to local laboratories and hospitals that perform such tests. The 337 cases investigated by the county's Department of Health and Human Services in 2008 was up from 177 reported in 2006.

Statewide, salmonella cases totaled 4,573 last year, a 53 percent increase over 2006.

However, state and local health officials caution against assuming that any surge in reports means more people are getting sick. It could mean that more people are seeking a diagnosis for their illness.

"With all the publicity about salmonella outbreaks, the public is a lot more aware of seeing a physician when they have diarrhea, and they're having their stool tested," Dr. Chung said. "Physicians also are being made more aware."

Typically, salmonella causes diarrhea, abdominal cramps, fever and headache that last up to a week. In more serious cases, particularly among infants and elderly people, the infection can spread to the blood stream and require hospitalization.

Most salmonella infections are related to food preparation, such as cross-contamination of uncooked meat with vegetables or other items.

"Nine times out of 10, the reason why we have salmonella cases is improperly cooked foods," said Dr. John Carlo, the county health department's medical director.

When someone is diagnosed with salmonella infection, finding the source is not easy. Trained professionals, including nurses who work for the county health department, interview patients to try to pinpoint what they ate and where they ate it.

"It's difficult because we're contacting people two weeks after they actually became ill and asking them to remember," Dr. Chung said. "If they're part of a genuine outbreak, the call might come months later."

Interviewers are always on alert for an outbreak related to a tainted food product because it could affect people in several states.

"It's important to be looking for the bad actors out there," Dr. Carlo said. "These illnesses could be intentional, so you have to be ready with surveillance measures."






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