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Eggs Source of Nationwide Salmonella Outbreak
by Dan Flynn | Aug 17, 2010
The Minnesota Department of Health (MDH) said Monday that seven Salmonella Enteritidis cases it has been investigating were linked to a multistate egg recall announced over the weekend, and the Centers for Disease Control and Prevention has counted hundreds more since May that are likely also linked to the consumption of contaminated recalled eggs.
That recall, by Iowa's Wright County Egg, which is located in Galt, was for a long list of brands, including Lucerne, Albertson, Mountain Dairy, Ralph's, Boomsma's, Sunshine, Hillandale, Trafficanda, Farm Fresh, Shoreland, Lund, Dutch Farms, and Kemps.
Wright distributed those egg brands to food wholesalers, distribution centers, and food service companies in California, Illinois, Missouri, Colorado, Nebraska, Minnesota, Wisconsin, and Iowa. These companies then distributed nationwide.
In an announcement yesterday, the CDC stated that it had seen a four-fold increase in the number of Salmonella Enteritidis infections with the same pulsed-field gel electrophoresis (PFGE) pattern, or genetic fingerprint, reported by states through PulseNet, the national network of public health and food regulatory agency laboratories coordinated by the agency, since May.
According to the CDC, "Approximately 200 isolates were uploaded to PulseNet on a weekly basis during late June and early July compared to an expected ~50 uploads a week on average during this same period in the previous 5 years."
MDH said the Salmonella Enteriditis cases were identified in two restaurant outbreaks in May and July, in which eggs were identified as the likely source. Eggs were traced back by the Minnesota Department of Agriculture to Wright County Egg.
Restaurant clusters with the same strain have been identified in Colorado and California, according to the CDC.
It is estimated that for every confirmed case of Salmonella, there are approximately 38 unconfirmed cases. Salmonella Enteriditis is one of the most common strains of Salmonella circulating, and is often associated with eggs.
The eggs affected by the Wright County Egg recall were distributed to food wholesalers, distribution centers, and foodservice companies in California, Illinois, Missouri, Colorado, Nebraska, Minnesota, Wisconsin and Iowa. These companies distribute nationwide.
The recalled eggs are packed in varying sizes of cartons (6-egg cartons, dozen egg cartons, 18-egg cartons) with Julian dates ranging from 136 to 225 and plant numbers 1026, 1413 and 1946. Dates and codes can be found stamped on the end of the egg carton. The plant number begins with the letter P and then the number. The Julian date follows the plant number, for example: P-1946 223.
To prevent illness, Kirk Smith with the Minnesota Department of Health said it's important for consumers to cook eggs thoroughly before eating to destroy any Salmonella or other bacteria. Consumers who believe they may have purchased these shell eggs should not eat them but should return them to the store where they were purchased for a full refund.
Restaurants should use pasteurized eggs in dishes where the eggs may not be cooked thoroughly, such as Hollandaise sauce or Caesar salad dressing, Smith said.
Salmonella is an organism that can cause serious and sometimes fatal infections, especially in young children, frail or elderly people, and others with weakened immune systems.
Persons infected with Salmonella often experience diarrhea, fever, and abdominal pain. Anyone who believes they may have become ill with Salmonella should contact their health care provider.

No Safety Advantage for Grass-fed Beef
Food (Safety) Fight
By: Richard Raymond

Or at least that is the conclusion reached by researchers who conducted a study of retail beef products comparing the levels of bacterial contamination in grass-fed and conventionally raised beef. That really is not a big news story to me, but some of the test results are perplexing, to say the least.
The researchers had their study reported in Foodborne Pathogens and Disease. A review of the study was just recently reported on July 20, 2010, in CIDRAP News (Center for Infectious Disease Research and Policy) at the University of Minnesota.
Investigators participating in the study were from Purdue University in Indiana and Zhejiang University in Hangzhou, China. The report says the researchers found no significant differences in total coliform bacteria, Escherichia coli or Enterococcus species in grass-fed vs. conventionally raised beef products.
That will not be surprising to many despite the marketing claims often made that grass-fed beef is safer. What may be surprising to most is that two-thirds of the samples were from solid cuts of beef, such as intact steaks, and only one-third were from ground beef and that there was no difference in coliform levels between the two products.
For E coli, the contamination rates were 44% for both sample sets. The ground beef samples that were from grass-fed cattle actually had a higher level of E coli than the conventionally raised product. Enterococcus species were isolated from 62% of the conventional samples and 44% of the grass fed samples, a difference the authors say did not reach significance (P=.07) No E coli 0157:H7 was found in any products.
Outlets where the samples were obtained included retail stores, farm stores and farmers¡¯ markets. Samples were washed according to standard protocols, and the rinsate was then tested for pathogens. None of the products were labeled as being Organic.
The samples were small, only 50 apiece for grass-fed and conventionally raised, but the percentages sure seem high to me. And even though no 0157 was found, the amount of evidence of contamination occurring somewhere along the process is problematic. And the fact that it was so high in solid cuts is especially bothersome to a guy who likes his steaks on the rare side and his prime rib penetrated with garlic cloves.
Grass fed steers may be more likely to be slaughtered in smaller facilities, with slower line speeds, but that is not always going to be the case. And cross contamination can occur in the transportation process, in the processing facility or in the retail shops.
My conclusion is that grass-fed, and sold in the local farmers¡¯ markets, does not infer that I do not need to safely handle and appropriately cook my beef, solid cut or fresh raw ground.
What is yours?

Antibiotics, HUS, and Gastroenteritis
by Bruce Clark | Aug 16, 2010
The issue of whether antibiotics used to treat Shiga toxin-producing E. coli increase the risk of the hemolytic uremic syndrome (HUS) has been a vexing one. But beyond E. coli, antibiotic use in general for treatment of infectious gastroenteritis poses conflicting risks and benefits. Since it is hard for even the most diligent medical practitioner to keep abreast of current medical research, consumers of medical services may find it helpful to review some of these issues.
The first study that looked at whether antibiotic use increased the risk of HUS in children was published in 2000. [1] The study found that antibiotic use was a strong and independent risk for the development of HUS regardless of the severity of the inciting infection. Two years later, a meta-analysis of nine pooled studies found no effect in the risk for HUS with antibiotic use. [2] But the analysis noted that limitations in the studies examined limited interpretation of the data.
More recent studies indicate that the risk of HUS is increased by the use of some antibiotics. The differing mechanisms of action in different antibiotics impact the production of Shiga toxin (Stx) differentially. [3]
In a study that used piglets as a model for human infection, ciprofloxacin (Cipro) increased the production of Shiga toxin 2 (Stx2) but not the production of Stx1. Azithromycin [4] caused no significant increase in Shiga toxin production. After treatment with ciprofloxacin, infected piglets had diarrhea and the severe fatal neurological symptoms associated with Stx2 intoxication. "Characteristic petechial hemorrhages in the cerebellum were more severe in ciprofloxacin-treated animals than in control animals. In contrast, azithromycin-treated piglets survived the infection and had little or no brain hemorrhaging." [5]
The study concludes that: "The increased in vitro toxin production caused by ciprofloxacin was strongly correlated with death and an increased rate of cerebellar hemorrhage, in contrast to the effect of azithromycin. The piglet is a suitable model for determining the effectiveness and safety of antibiotics available to treat patients." [6]
A just published study [7] assessed Stx production in the presence of different types of antibiotics. The authors report that: "Sub-inhibitory levels of antibiotics that target DNA synthesis [8], including ciprofloxacin (CIP) increased Stx production, while antibiotics that target the cell wall, transcription, or translation did not....Remarkably, very high levels of Stx were detected even when growth of O157:H7 was completely suppressed by CIP. In contrast, azithromycin (AZM) significantly reduced Stx levels even when O157:H7 viability remained high." [9]
So the evidence mounts that the class of antibiotic that includes Cipro (a fluoroquinolone) may drive the risk of HUS through increased Stx production. However, it is important to note that antibiotics are clearly indicated for some gram negative bacterial infections of the gut including infections such as Campylobacter jejuni and Shigella, which clinically resemble E. coli O157:H7 enteritis. Further, antibiotic use in the elderly, immune compromised, and those with co-morbidities may be indicated even if the face of a Shiga toxin-producing infection. Thus, wholesale avoidance of antimicrobials for infectious diarrhea is not prudent, but identification of the infectious agent before antibiotic administration is very helpful.
Antibiotics are often prescribed to patients who have presumed bacterial gastroenteritis without consideration of the effects beyond the acute illness. Because antibiotics can dramatically affect the native bacteria in the intestines, they have the potential to increase a patient's risk of infection. Persons who are already receiving antimicrobial treatment are more susceptible to infection with drug-resistant pathogens. [10]
Few of us consider the effects of bacteria on the natural flora of our intestinal tracts--unless one develops post-infection GI problems. But the use of antibiotics has effects well past the time of consumption and may leave the user vulnerable to opportunistic bacterial pathogens.
Experiments done with mice show that antibiotic treatment alters the gut flora but does not eliminate it. [11] The effects of antimicrobials on microflora vary with the type of antibiotic and the location--the small intestine versus the beginning and end of the large intestine. The graph below shows the recovery of aerobic bacteria after withdrawal of antibiotics in the mice. There was a rapid overgrowth of aerobic bacteria which steadily fell over the next three weeks.
The same study shows the relative numbers of Salmonella in the GI tract after antibiotic treatment of the mice for one week. Three days after Salmonella bacteria were inoculated in the gut of the mice they were sacrificed in order to assess the extent of introduction of Salmonella colonization. While results varied by antibiotic, all antibiotics used increased the presence of Salmonella versus controls. [12]
The disruption of intestinal mucosa, among other things, appears to increase host susceptibility to Salmonella infection. As the Discussion section of the study emphasizes, even careful use of antibiotics poses potential risks:
"Even routine and appropriate use of antibiotics may have a detrimental impact on the host microbial ecosystem, which is important for host mucosal protection....Oral Salmonella challenge of antibiotic-treated mice resulted in comparable increases in intestinal Salmonella colonization, enteritis, and invasion irrespective of the antibiotic combinations used.... Despite the rapid recovery of several measurable parameters of the biome, residual subtle alterations in bacterial composition can persist and result in profoundly enhanced susceptibility to bacterial enteritis." [13]
Cirpo is a widely prescribed antibiotic for bacterial infections of the GI tract. It is often prescribed as empirical treatment--treatment before a diagnosis is confirmed--which can be problematic if the diagnosis is infection with Shiga toxin-producing E. coli. Presented with a patient suffering bloody diarrhea, the clinician is probably advised to avoid Cipro and choose an antimicrobial with a different mechanism of action if antibiotic treatment is deemed necessary. A person suffering gastroenteritis who is offered antibiotic treatment is well-served to ask questions about potential deleterious effects.
And for those Cipro users who don't worry about the microbiotic flora of their intestines, you may want to watch your joints. In July 2008, the FDA directed the maker of Cipro to add a black box warning to the drug's label about increased risk of developing tendinitis and tendon rupture in patients taking fluoroquinolones.

1. Wong CS et al. The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. N Engl J Med 2000 Jun 29 342 1930 -1936. This cohort study found a 14 fold increase in the risk of HUS when antibiotics were used.
2. Safdar N, et al. Risk of hemolytic uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 enteritis. JAMA 2002;288(8):996-1001.
3. McGannon CM et al, Different classes of antibiotics differentially influence Shiga toxin production Antimicrob. Agents Chemother. doi:10.1128/AAC.01783-09. Published online ahead of print:
4. Azithromycin prevents bacteria from growing by interfering with their protein synthesis. It is a macrolide antibiotic chemically related to erythromycin and clarithromycin. It is among the more widely prescribed antibiotics in the US.
5. Zhang Q et al, Gnotobiotic piglet infection model for evaluating the safe use of antibiotics against Escherichia coli O157:H7 infection. J Infect Dis. 2009 Feb 15;199(4):486-93.
6. Id.
7. Supra, note 3.
8. Cipro kills bacteria by interfering with an enzyme (DNA gyrase) that causes DNA to unwind and duplicate and thus stops cell division.
9. Supra, note 3.
10. M©ªlbak K. Human health consequences of antimicrobial drug-resistant Salmonella and other foodborne pathogens. Clin Infect Dis. Dec 1 2005;41(11):1613-20.
11. Croswell A, et al, Prolonged Impact of Antibiotics on Intestinal Microbial Ecology and Susceptibility to Enteric Salmonella Infection. Infect Immun. 2009 July; 77(7): 2741-2753.
12. DSI = distal small intestine and LI = large intestine.
13. Id.

Small Farms Gain From Compromise on S. 510
by Helena Bottemiller | Aug 18, 2010
Though the recently-released Senate food safety bill didn't include a controversial bisphenol-A ban or an amendment by Jon Tester (D-MT) to exempt small producers from certain measures, the package did include several amendments aimed at easing the regulatory burden on small-scale farms and food facilities.
The manager's package for the FDA Food Safety Modernization Act (S. 510), released by a bipartisan group of Senators late last week, is the result of "a long and arduous set of negotiations," according to the National Sustainable Agriculture Coalition, the group leading the effort to tailor the legislation to prevent unintended harm to the burgeoning sustainable, local, small-scale food movement.
"Most sustainable agriculture and family farm groups think the Senate bill is a very significant improvement over the companion bill passed by the House of Representatives (HR 2749) last year," said the coalition in response to the latest version of the legislation. "We've been able to help make substantial improvements in the Senate bill through the [Committee] markup and in changes that will be adopted as part of the manager's amendment when the bill comes to the Senate floor."
According to the group, the new draft includes the following favorable changes for small-scale, sustainable agriculture:
-The amendment sponsored by Senator Bernie Sanders (I-VT) pertaining to farms that engage in value-added processing or that co-mingle product from several farms.
It will provide the Food and Drug Administration with the authority to either exempt farms engaged in low or no risk processing or co-mingling activities from new regulatory requirements or to modify particular regulatory requirements for such farming operations. Included within the purview of the amendment are exemptions or flexibilities with respect to requirements within S. 510 for food safety preventative control plans and FDA on-farm inspections.
-The amendments sponsored by Senator Michael Bennet (D-CO) to reduce unnecessary paperwork and excess regulation.
The Bennet language pertains to both the preventative control plan and the produce standards sections of the bill. FDA is instructed to provide flexibility for small processors including on-farm processing, to minimize the burden of compliance with regulations, and to minimize the number of different standards that apply to separate foods. FDA will also be prohibited from requiring farms and other food facilities to hire consultants to write food safety plans or to identify, implement, certify or audit those plans. With respect to produce standards, FDA will also be given the discretion to develop rules for categories of foods or for mixtures of foods rather than necessarily needing to have a separate rule for each specific commodity or to regulate specific crops if the real food safety issue involved mixtures only.
-The amendment sponsored by Senator Debbie Stabenow (D-MI) to provide for a USDA-delivered competitive grants program for food safety training for farmers, small processors, and wholesalers.
The training projects will prioritize small and mid-scale farms, beginning and socially disadvantaged farmers, and small food processors and wholesalers. The program will be administered by USDA's National Institute for Food and Agriculture. As is the case for all of the provisions in S. 510, funding for the bill and for this competitive grants program will happen through the annual agriculture appropriations bill process.
-The amendment championed by Senator Barbara Boxer (D-CA) to strip the bill of wildlife-threatening enforcement against "animal encroachment" of farms.
It will require FDA to apply sound science to any requirements that might impact wildlife and wildlife habitat on farms.
-An amendment proposed by Senator Sherrod Brown (D-OH) to amend the traceability and recordkeeping section of the bill that will exempt food that is direct marketed from farmers to consumers or to grocery stores and exempt food that has labeling that preserves the identity of the farm that produced the food.
The amendment also prevents FDA from requiring any farm from needing to keep records beyond the first point of sale when the product leaves the farm, except in the case of farms that co-mingle product from multiple farms, in which case they must also keep records one step back as well as one step forward.
The National Sustainable Agriculture Coalition and other groups continue to push for the inclusion of the Tester amendment, which would exempt certain food facilities with under $500,000 in gross annual sales from preventative control plan requirements and exempt direct-market farmers from the coming produce safety regulations. The measure, co-sponsored by Sen. Kay Hagan (D-NC), has been the subject of intense negotiations, but was ultimately not included in the final manager's package.
Carol Tucker-Foreman, a fellow at the Consumer Federation of America's Food Polity Institute, said last Thursday she was surprised that Tester's amendment wasn't included. She believes portions of the language will ultimately be added to the Senate bill.
"People don't want to hurt small farmers and farmers markets, but they also don't want to keep getting sick," said Tucker-Foreman in an interview with Food Safety News. "If you put aside the rants, the language of the bill will be there. They are really taking the middle course here."
If the Tester amendment is added, NSAC says they will support the Senate bill. "However, we strongly oppose the companion House measure, and stand ready to defend the Senate bill in conference with the House should that prove necessary," the group said in a statement.
Senate staff are also circulating a document, the S. 510 - FDA Food Safety Modernization Act Small Farm and Small Business Guide, which highlights a series of points addressing concerns over burdensome one-size-fits-all regulations.
With the bipartisan package ready to go, many food safety advocates, industry experts, and Hill staff believe the bill could come to a vote in September when the Senate reconvenes.

Despite being on Colbert the AMI opposes making non-O157:H7 STECS adulterants
Posted by Bill Marler on August 19, 2010
I just could not stay awake late enough to watch Colbert have fun with Pat Boyle the other night. To me it looks like Pat "meat" his match. Interestingly, the President just made a "recess appointment" of the person who will be part of making the adulterant decision:
Elisabeth Hagen, Nominee for Under Secretary for Food Safety, Department of Agriculture
Dr. Elisabeth Hagen is currently the USDA¡¯s Chief Medical Officer, serving as an advisor to USDA mission areas on a wide range of human health issues. Prior to her current post, she was a senior executive in the USDA¡¯s Food Safety and Inspection Service (FSIS), where she played a key role in developing and executing the agency¡¯s scientific and public health agendas. She has been instrumental in building relationships and fostering coordination with food safety and public health partners at the federal, state, and local level. Before joining the federal government in 2006, Hagen taught and practiced medicine in both the private and academic sectors, most recently in Washington, DC. She holds an M.D. from Harvard Medical School, and a B.S. from Saint Joseph¡¯s University. Dr. Hagen completed her specialty medical training at the University of Texas Southwestern and the University of Pennsylvania, and is board certified in infectious disease.

Below the video is the AMI's position on non-O157's as adulterants and mine. I would love to hear your comments.
Here is the AMI's position on non-O157's
Designating non-O157:H7 shiga-toxin producing Escherichia coli (STEC) as adulterants would result in a regulatory program that will do more harm than good, the American Meat Institute said in a letter to USDA Secretary Tom Vilsack.
There have been discussions within USDA and pressure from some legislators to broaden the adulterant criteria on E. coli in various ways, including expanding the list of pathogens considered adulterants on some beef products to include at least six of the many non-O157:H7 strains of E. coli.¡°Non-O157:H7 STECs in beef products may be a reason forpotential public health concern, but it is not a public health emergency,¡± AMI said in a news release in which it outlined eight actions it suggested USDA take to combat STECs in the beef supply.
1. Focus on Prevention: Any new regulatory programs that USDA contemplates should be addressed within the framework of the existing Hazard Analysis Critical Control Point regulation. USDA should commission a group of qualified experts to review the current science related to the development of a comprehensive farm-to-table preventative strategy for non-O157:H7 STECs in beef products and report their finding to USDA and other stakeholders.
2. Conduct a Comprehensive Public Health Risk Assessment: Conducting a public risk assessment that is subjected to public review before regulators embark on any regulatory program to control non-O157:H7 STECs in raw beef products will provide a better understanding of the public health issues association with non-O157:H7 STECs. For example, why have no confirmed outbreaks associated with beef products occurred in the U.S.? Why have non-O157:H7 STEC outbreaks occurred in other foods, but not in beef products? Why have non-O157:H7 STEC outbreaks associated with beef products occurred in other countries, but not in the U.S.?
3. Validate Analytical Laboratory Test Methods: USDA should openly share with the meat and poultry industry, testing laboratories and test kit manufacturers the sampling and analytical methods that the agency will use to implement any regulatory program and ensure that the analytical methods are peer-reviewed before any regulatory program is initiated. An accurate, validated rapid analytical test must be available to the industry to effectively implement any regulatory program that would make it illegal to enter product containing non-O157:H7 STECs into commerce.
4. Conduct a Baseline Survey of Non-O157:H7 STECs on Beef Products: It is imperative that FSIS conduct a baseline survey of beef products to include beef carcasses, ground beef and the raw materials used to manufacture ground beef in order to assess the impact of any new regulatory program that the agency may be contemplating. The baseline survey design and sampling and analytical methods should be published for public comment to solicit the advice and counsel of scientific and technical experts before proceeding with any such survey. A very limited amount of research has been conducted to assess the prevalence of non-O157:H7 STECs on beef products.
5. Measure Progress Based on the Public Health Outcome: If FSIS decides to further regulate non-O157:H7 STECs, it is prudent to evaluate the success or failure of any such initiative by actual illness reductions. In the case of beef, however, this is nearly impossible given that no non-O157:H7 STECs illness outbreaks have been confirmed in the U.S. This lack of documented outbreaks associated with beef products is remarkable given that approximately 95 percent of the public health laboratories reported in a recent survey that they are screening for non-O157:H7 STECs. If regulatory efforts to reduce non-O157:H7 STECs in beef products cannot generate measurable, positive public health outcomes, the underlying point of the exercise must be drawn into serious question.
6. Expedite Approval of New Microbial Interventions: USDA should convene a joint task force of all federal agencies that are involved in the approval of new microbial intervention technologies and the affected meat and poultry industry to identify approval roadblocks and to develop a better, expedited approval process that can rapidly move new technology to commercialization. New preventive technologies that are effective against all STECs are needed to control these pathogens before USDA considers making non-O157:H7 an adulterant on beef products.
7. Determine Impact on International Trade: USDA, the U.S. Trade Representative, and the Department of State should commission a study to determine the impact on international beef trade that would result from declaring non-O157:H7 STECs an adulterant on beef products. Such a policy shift will be viewed by our trading partners as erecting a non-tariff trade barrier to prevent entry of beef products into the U.S.
8. Provide an Open and Transparent Public Policy Process: If FSIS decides to further regulate non-O157:H7 STECs in beef products, it should only be done through notice and comment rulemaking. The questions surrounding non-O157:H7 STECs demand a disciplined, open, and transparent regulatory process. Any new regulatory program to control non-O157:H7 STECs will likely impose significant financial and regulatory burdens on the meat industry and these costs must be weighed against any public health benefit.
Here is my position on it:
It seems that any serious discussion of E. coli O157:H7 always has to start with one event: the 1993 outbreak associated with the Jack in the Box restaurant chain. This, of course, is with good reason. That outbreak left over 700 persons ill and 4 children dead. The ¡°9/11 for the food industry,¡± as a certain trial lawyer has occasionally referred to the outbreak, precipitated a whirlwind of events including media coverage, consumer outrage, lawsuits, and stricter federal regulations regarding meat safety. Though the swell of emotion that spiraled out of the Jack in the Box disaster dulls somewhat with each passing year, the federal regulations that sprung up in its wake continue to generate more questions.
To understand the significance of these regulations, a little background information is useful. The Food Safety and Inspection Service¡¯s (FSIS) stated mission renders it ¡°responsible for ensuring that the nation's commercial supply of meat, poultry, and egg products is safe, wholesome, and correctly labeled and packaged.¡± FSIS operates as part of the United States Department of Agriculture (USDA). To promote its mission, FSIS has the power?under the Federal Meat Inspection Act (FMIA)?to, among other things, seek the recall of products that have been deemed ¡°adulterated.¡± FSIS drastically shifted how it interpreted and enforced the FMIA in 1994 when, following the Jack in the Box outbreak, the agency declared E. coli O157:H7 to be an adulterant. This marked a dramatic change from its previous stance that pathogens in raw meat were not adulterants.
The declaration of E. coli O157:H7 as an adulterant was met with strong opposition from the meat industry. In a lawsuit filed soon after the 1994 declaration, the industry accused the USDA of not following proper rulemaking procedures and of acting in an arbitrary and capricious manner beyond its legal authority. The United States District Court held, however, that the USDA was allowed to interpret the FMIA and that the USDA has the power to declare substances to be adulterants with the intended purpose of spurring the meat industry to create and implement preventative measures.
During the early part of this decade, however, it became readily apparent that O157:H7 was not the only deadly pathogen in E. coli family?in fact, far from it. The Centers for Disease Control (CDC) recognized this fact when, in 2000, the agency made all Shiga toxin-producing E. coli (STEC) nationally notifiable. The CDC subsequently referred to non-O157 STEC as emerging pathogens that pose a significant health threat, with more strains reported every year. Still, FSIS remained steadfast in its stance that O157:H7 is the only enterohemorrhagic E. coli strain that should be deemed to be an adulterant.
So what¡¯s wrong with FSIS¡¯s position regarding E. coli O157:H7? The simple answer is this: the people of this nation do not deserve another Jack in the Box-sized catastrophe as a pre-requisite for currently needed agency action. The scientific and medical communities have recognized the dangers of all enterohemorrhagic E. coli, not just O157:H7, again and again. Representatives of the CDC estimate that non-O157 STEC causes 36,700 illnesses, 1,100 hospitalizations, and 30 deaths annually. Nearly two years ago today, on October 17, 2007, the CDC and FSIS even went so far as to hold a public meeting to consider the public health significance of non-O157 STEC. In the Notice of the meeting, FSIS referred to the ¡°growing awareness that STECs other than E. coli O157:H7 (non-O157:H7 STECs) cause sporadic and outbreak-associated illnesses.¡± Nevertheless, following the meeting, FSIS failed to re-interpret its policies.
This brings us to today. We¡¯re nearing the end of 2009, closing in on seventeen years since the Jack in the Box outbreak. Millions of Americans have suffered foodborne illnesses, injuries, and deaths in that time, thousands of them likely due to enterohemorrhagic E. coli other than O157:H7. It is on behalf of those persons that the law firm of Marler Clark has authored a petition to FSIS requesting the agency to issue an interpretive rule declaring all enterohemorrhagic STEC, including non-O157:H7 serotypes, to be adulterants within the meaning of the Federal Meat Inspection Act.
The petition details the scientific and legal bases for the requested action, but perhaps more importantly it details the suffering that food contaminated with non-O157:H7 enterohemorrhagic E. coli inflicted upon three individuals: June Dunning, Megan Richards, and Shiloh Johnson. Ms. Dunning, whose infection was caused by E. coli O146:H21, unfortunately succumbed to her illness, passing in 2006. Ms. Richards and Ms. Johnson endured lengthy hospitalizations, kidney failure, and will both endure a lifetime of medical complications as a result of their E. coli O121:H19 and E. coli O111 infections (respectively).
It would be naive to assume that a change to FSIS policy will immediately rid the world of all foodborne E. coli infections. It has been unequivocally proven, however, that all enterohemorrhagic E. coli are potentially lethal pathogens that we must fight tooth and nail to keep out of this nation¡¯s food supply. If we trust science, and do our part to push government agencies to enact regulations to require better monitoring, we can no doubt begin to prevent further harm. In the end, after all, the requisite wading through the mess of bureaucracy required to change federal regulation is all worth it, so long as the outcome prevents at least one more case like that of June Dunning, Megan Richards, or Shiloh Johnson.

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