The Food and Drug Administration has always been one of my favorite targets for critical examination of its actions, because what it does or doesn’t do can result in lives destroyed. Now, the agency is clearly caught between a tomato and a hard place. Angry state agriculture officials are demanding FDA announcements that the salmonella-contaminated food didn’t come from their state. The public just wants its favorite food item back.
In a teleconference Wednesday, FDA’s top food cop, Dr. David Acheson, and Dr. Ian Williams, the head of the outbreak tracking operation for the Centers for Disease Control and Prevention, faced the press.
Compared to most of Washington’s cover-your-fanny sessions they did a pretty good job of fielding the expected questions on who knew what and when did they know it. And there was a lot they didn’t know, which became more understandable as they explained the intricacies of chasing a dubious harvest.
The bottom line, they said, “was that even though we are several weeks out from when the food was first consumed, new cases are still showing up.”
As far knowing where the offending tomatoes came from, Acheson, FDA’s associate commissioner for foods, said “We’re not quite there but we’re getting very close. At this point today, we don’t know where they’ve come from.”
So why don’t government health sleuths know more?
Even the flashlight-waving forensic superstars on CSI need some clues to work on.
Acheson explained that tracing food that made people sick can be a breeze or a nightmare.
If a group of picnickers get sick from eating America’s favorite casserole — canned green beans covered in mushroom soup and fried onions or tubs of potato or macaroni salad, the cans and plastic tubs offer immediate clues to their origin. Stamped, printed or embossed on all containers are unique numbers and letters which can, for those who know the code, tell precisely where and when the food was processed and packaged. Often, there’s even a batch number. With this information, food safety investigators may be able to have the manufacturer document every step the ingredients took from field to package.
At least that’s how the system is expected to work.
Even with the massive E coli-tainted spinach recall last year, there were important and obvious clues. On the bagged spinach there were universal product codes � those black lines of varying widths above a series of numbers � which quickly led investigators to the farm and even the field where the contamination occurred.
“Tomatoes don’t t show up with bar codes,” Acheson said.
Even if they knew where the Salmonella endangered fruit was purchased, that supermarket may buy its tomatoes from two or more distributors, who may have purchased from several different suppliers who had contracts with many, many farmers. (NEW) Here’s a link to an FDA chart showing how this tracing works.
“There is not one single restaurant chain or supermarket associated with this,” said CDC’s Williams.
The first case, tracked back to April 16, was soon followed by clusters of 39 more in New Mexico and 56 in Texas. The CDC was able to run the genetic or DNA fingerprint and found it was a rare strain of Salmonella called Saintpaul.
There are just about 200 cases of the Saintpaul strain reported across the entire country in an average year.
Salmonella is painfully common in the United States. Last year, the CDC reported about 1.4 millions cases of all strains of Salmonella, close to 16,000 of the food poisoning victims required hospitalization and 400 died.
It is likely that there are many more people infected each year that the CDC never hears about, explained Williams.
To round out the 167 victims with the Saintpaul species there are 12 in Arizona, two in California, one in Colorado, one in Connecticut, two in Idaho, 27 in Illinois, seven in Indiana, five in Kansas, two in Michigan, three in, the same in Oregon, one in Utah, two in Virginia, one in Washington state, and three in Wisconsin.
(NEW) However, by late today, FDA had hiked the case count to 228 and added Florida, Georgia, Missouri, New York, Tennessee and Vermont to the list of states where Salmonella Stpaul has been identified.
As of yesterday, health investigators had only interviewed 76 of those sickened. They aged from 1 to 87 and were split about evenly by gender.
There are many more people out there who were exposed to the bacteria but didn’t seek medical treatment, Williams said, or there were no stool samples collected, a necessity to confirm the species and the strain.
To the consternation of epidemiologists and other disease trackers, food poisoning is often unreported with people attributing the very unpleasant symptoms to something like stomach flu.
The federal health experts say that the system for ensuring food safety is not in crisis � but rather, FDA is just doing a better job of getting the word out. Acheson said if his agency doesn’t tell the public of dangerous food, people, will get sick. If they do vigorously spread the word, the cry is, “The system is broken.”
We can overflow this blog arguing this point. There are very significant deficiencies in FDA’s surveillance programs and many agency watchers don’t believe that the $250 million or more that Congress and president want to shovel into FDA will make a difference unless there is an agency-wide attitude change in acknowledging the importance of their mission.
This morning, at a House hearing examining the FDA’s “Food Protection Plan,” Rep. John Dingell addressed the tomato contamination this way: “Sadly, a common theme of each major food recall or outbreak of illness (is) linked to the FDA’s inadequate resources or incompetent management.”
I’d feel a bit better about what Acheson said if there was any indication at all that his agency and the USDA were doing anything to ensure that MRSA in pigs and other commercially raised livestock isn’t the next public health crisis that consumers will face.