Pigs have MRSA but feds can’t say if pork is safe.

<![CDATA[It’s official now. Many of the pigs and the farmers who raise them in Iowa and Illinois have MRSA.

It was just about six months ago that I reported on preliminary research done by Dr. Tara Smith, a significantly dedicated epidemiologist who found that pigs at several different Midwest farms had MRSA, as did many of the farmers raising them.

The reaction to her study and my earlier blog item – which broke the news – was enormous. She was swamped with calls and I got hundreds of email from here and abroad. Many came from public health workers – mostly government – praising the efforts of her’ and her team at the University of Iowa’s Center for Emerging Infectious Diseases.

Many of those health professionals, especially several connected with FDA, USDA and CDC, were passionate in their anger that the government was not taking the presence of Methicillin-resistant Staphylococcus aureus in our food supply anywhere near seriously enough.

Little porker about to be swabbed for MRSA. Photo T. Smith

Some members of Congress expressed outrage and demanded that the federal health agencies determine whether Smith’s findings in pigs also meant that pork in our grocery and butcher shop coolers also carried the sometimes lethal bacteria.

So today, Smith’s final study was published on PLoS ONE, an online journal for peer-reviewed scientific and medical research.
It said that Smith and her five students tested 446 pigs and 29 workers from pig farms in Iowa and Illinois and found MRSA in 45 percent of the animals and in 45 percent of the humans caring for them.

So I called some disease detectives and food safety specialists in agencies responsible for ensuring that our food supply is safe. You could almost hear them cringe over the phone. And, no, to the best of their knowledge, neither the FDA, USDA nor CDC had launched systematic testing of the U.S. meat supply for MRSA. One physician said that a study was being done on the MRSA strain (ST398) that Smith had found on the pigs but added, “I don’t think it has anything to do with meat.”

They did mention that some testing – but far from enough – was being done by the academic community and gave me the names of researchers at Louisiana State University and the University of Minnesota. I’ll try to chase them down over the weekend.

Next I called staff members of some of the same congressional committees that were so upset and promised action last June when Smith’s initial results were released. Two senior people said almost the identical thing “We’ll get to it when we get the economy under control.” A lawyer on the third committee said she was embarrassed that nothing had happen, but would “contact Dr. Smith soon.”

OK. We’ll see.

Smith said her group has a number of ongoing projects examining MRSA in food and in rural communities, including examining the presence of MRSA on both conventional and organic farms.

The feds have a large role to play, she says.

“The studies should be expanded nationwide to examine hundreds of farms in Iowa and other swine-farming states and see how common MRSA is on a national level.”

But she agrees with many others that a national survey of meat products should be conducted and other animals like beef, poultry, lamb and goat should also be checked out for MRSA.

Smith added that her study just reinforces the importance of vigilance in food handling and cooking procedures.

“It’s likely that cooking will kill any MRSA present on the surface of meats, but anyone handling raw meats should be careful about cross-contamination of cooking areas or other food products, and should make sure hands are washed before touching one’s face, nose, lips, etc.,” the scientists said.

]]>

The tomato case: Hunting dangerous food

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.

These tomatoes-on-the-vine are one of the four types of the red fruit that FDA says is safe to eat. Photo by Andrew Schneider

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.

Researchers find U.S. pigs carrying MRSA

An effective way to say there isn’t a problem is never to look. That seems to be precisely what most U.S. government food-safety agencies are doing when it comes to determining whether the livestock in our food supply is contaminated with MRSA and if so, whether the often-fatal bacterium is being passed on to consumers who buy and consume that meat.

We know that some strains of MRSA � methicillin-resistant Staphylococcus aureus � are extremely dangerous. Dr. Monina Klevens, of the federal Centers for Disease Control and Prevention, examined the cases of the disease reported in hospitals, schools and prisons in one year and extrapolated that “94,360 invasive MRSA infections occurred in the United States in 2005; these infections were associated with death in 18,650 cases.”

Earlier his year, Dr. Scott Weese, from the Department of Pathobiology at the Ontario Veterinary College told those attending the International Conference on Emerging Infectious Diseases at the CDC that there was a problem. He and his colleagues had found MRSA in 10 percent of 212 samples of pork chops and ground pork bought in four Canadian provinces.

“I think it is very likely that the situation is the same in the U.S.,” he told me in a phone interview.

“We’ve proven MRSA is in pigs and the marketed pork in Canada, and we know that it’s also in U.S. pigs. It’s inconceivable that it wouldn’t also be found in the pork products from those pigs.”

This raised a bunch of obvious questions, such as, who exactly is checking to see if antibiotic-resistant staph bacteria is in the 762 million pounds of Canadian pork that’s imported into the U.S. each year?

The answer appears to be no one.

It should be the USDA. Dr. David Goldman is in charge of the agency’s four laboratories that examine imported food.

“Any pathogen or hazard that’s transmitted through the foods we regulate is a potential issue for us, and so you know, certainly we are aware of the study (Weese) did,” Goldman told me during an interview at a recent food-safety meeting in Seattle.

“There is no indication MRSA has been identified in swine going into the retail market. Not in this country. Not in swine or other livestock being sold for food in this country,” the doctor added.

But, none of the USDA labs that he runs are checking for MRSA in imported meat.

“We just don’t have a test for it,” Goldman said.

So, do we have MRSA in our American grown pigs?

The Food and Drug Administration says it doesn’t know.

Mike Herndon, an agency spokesman, said FDA scientists have been “following the emergence of MRSA from humans and animals in Central Europe and Canada and are monitoring the situation very closely.”

The FDA is aware of Weese’s study, but “we do not yet have similar data with regards to the MRSA situation among food animals and retail meats,” Herndon said.

There is no indication that FDA has tested meat for MRSA.

But the FDA and USDA eagerly pointed to a group called the National Antimicrobial Resistance Monitoring System as the protector of food and humans from foodborne bacteria. The coalition of scientists from several federal agencies primarily target salmonella, campylobacter and E. coli.

But the group does not currently screen for MRSA.

The National Pork Producers Council in Washington is sure there’s no problem. They told me “there is nothing to worry about; MRSA (in pigs) has not been found this side of the border” and “USDA and CDC has given our pigs a clean bill of health.”

A CDC spokeswoman told me that she could find “no indication we made that statement.”

Interestingly, the pork lobbyists have said their industry would oppose any attempt to test all livestock for MRSA, calling the testing “unnecessary to protect public health.”

Whereas our government apparently doesn’t see the need nor have the ability to see if pigs in the U.S. are carrying MRSA, Tara Smith, an assistant professor for the University of Iowa department of epidemiology, and her graduate researchers have done what is apparently is the first testing of swine for MRSA in the U.S.

Dr. Tara Smith

They swabbed the noses of 209 pigs from 10 farms in Iowa and Illinois and found MRSA in 70 percent of the porkers.

Today, in Boston, at the annual meeting of the American Society for Microbiology, Abby Harper, one of Smith’s graduate assistants, presented the results of a study that she and Michael Male did on 20 workers at the Iowa swine farms. Harper reported that 45 percent of the workers carried the same MRSA bacterium as the pigs.

Smith told me last night that she will be working with collaborators in Minnesota, Ohio, North Carolina and perhaps other areas to examine more swine farms.

“We’re going to be looking at conventional, free-range and organic or antibiotic-free pigs,” Smith said.

“We will be paying special attention to the antibiotics that are being used because there are indications that the tetracycline used in swine farming may be the cause of the spread of MRSA,” she explained.

All of Smith’s important work raises the question that Weese raised in Canada: Is MRSA-contaminated meat being sold in the U.S. market?

It is believed that proper cooking will kill the MRSA bacterium. The health threat for butchers and cooks alike, if there is one, will come from improperly handled meat.

“If people wash their hands after handling raw pork and prevent cross-contamination, risks should be very low,” Weese said from Canada.

“The main possible concern is that people could get MRSA on their hands from raw pork, then touch their nose. The nose is the prime site for MRSA to live,” he told me.

Some public-heath experts worry that butchers and professional and home cooks may be infected if MRSA bacteria on their hands entered a cut or a wound.
An understanding of the risk from MRSA in meat becomes more urgent in view of a report yesterday from the United Kingdom.

Scientists reported that three patients in separate hospitals in Scotland were infected with the ST398 strain of MRSA, the same strain that Smith and her researchers found in Midwest farms. And it’s the same strain that FDA’s Herndon says is of particular concern in the veterinary medicine and food safety arenas.

What makes this particularly important is that doctors reported that none of the patients worked on a farm nor had a close association with farm animals, raising the possibility that the superbug has entered the food chain in the U.K., according to an article by Martin Hickman in The Independent, a U.K. publication.

And, as you mull over this all-too-long post, be advised that Weese warns that MRSA could also be in beef, chicken and lamb, but no one is checking.