Good news, but not excellent news, today from the US Department of Agriculture: It has agreed that, starting in March 2012, six more strains of E. coli will be considered “adulterants,” putting them in the same regulatory category as the much-feared E. coli O157:H7.
It is a big step, to do this. Those six bacterial bad actors — technically, E. coli O26, O45, O103, O111, O121, and O145 — are now responsible for the majority of foodborne illness caused by E.coli in the United States, causing almost twice as much illness each year as O157 does.
Declaring an substance to be an adulterant means that it cannot legally be distributed in food, and that therefore food processors can legally be held to account for products that contain it. O157 was declared an adulterant in 1994, one year after it killed four children and sickened hundreds more in an outbreak centered on Jack-in-the-Box hamburgers. Because of that ruling, meat processors were forced to detect the pathogen and work to suppress it. And they did: As you can see from the chart (cribbed from a CDC presentation archived here), there is less E. coli O157 than there was. There is not none, because O157 can reach people from other sources, including raw produce that has been exposed to manure in the field. But there is a lot less, and the adulterant declaration is responsible.
That’s a significant achievement not just because O157 still causes more than 90,000 cases per year, but also because they are such bad cases. O157 is what’s called an STEC — a Shiga toxin-producing E. coli — and the toxins it produced cause not only diarrhea, but red blood cell damage, kidney failure, and death.
However: All the other “non-O157s” are STECs also, and they also cause illness, hospitalization and death — about 112,000 cases per year, USDA Secretary Tom Vilsack said in a media briefing today. (There’s no transcript online that I can see. It was a frustrating briefing, because it was billed for 30 minutes but lasted only 15, leaving many reporters including me hanging in the phone queue waiting to ask our questions.)
The non-O157’s incidence has been rising, as captured by this chart (also cribbed from a CDC presentation, this one archived here). For more than a decade — as excellently summarized in June by Michele Simon at Food Safety News — the non-O157s have been causing significant outbreaks in the US, and the federal government has been dithering over what to do about it. Dithering, that is, despite assessments by its own experts that”Non-O157 Shiga toxin-producing E. coli have emerged as a significant public health issue” and “overall, the non-O157 STEC, in particular strains O26, O55, O103, O111, and O145, are just as prevalent and clinically significant as E. coli O157 in the US,” to quote an internal USDA report from 2007.
Under the measure announced today, the additional six STECS will be barred from commercial sale. That’s definitely progress. But here’s where the “buts” begin:
First, this rule applies only to raw ground beef and in the scraps or “trim” that are collected in processing plants to be made into ground beef. (And only trim will be tested initially, on the argument that it becomes ground beef. Choosing trim means the testing can be carried out at larger processors that may be better able to afford it.) It does not apply to any other meats, though STECs have been found in chicken and turkey.
It also will not apply to any other organism. So if this rule had been in effect this year, for instance, it still would not have prevented the contamination of ground turkey with antibiotic-resistant Salmonella Heidelberg that caused 36 million pounds to be recalled. For food-safety campaigners, this is probably the biggest disappointment: The Consumer Federation of America and the Center for Science in the Public Interest today both urged the USDA to enact a ban on resistant Salmonella. You can see in this chart (from this CDC paper) how many other problematic foodborne pathogens there are.
Finally, it doesn’t take care of all the STECs out there. This summer’s Europe-wide outbreak of thousands of cases of E. coli spread by fenugreek seeds was caused by a serotype dubbed O104 — which is not one of the six covered by today’s rule.
Still, it’s important to recognize that today’s action is a big step. You can tell that, in part, because the meat industry opposes it; in a statement emailed to reporters now online here, the American Meat Institute said, “USDA’s announcement today declaring six strains of naturally occurring nSTEC to be adulterants in ground beef is premised upon the notion that the government can make products safe simply by banning a pathogen. This new policy is not supported by science and likely will not benefit public health.” (The AMI sued the government in 1994 to prevent the O157 regulation from taking effect, and failed.)
It’s equally important though to look to the next steps, which would be to take the USDA’s Food Safety and Inspection Service to where its sister agency the Food and Drug Administration already is. At the FDA, any pathogen in food is an adulterant.
Food-safety attorney Bill Marler, who has been one of the chief campaigners for changing the regulations on STECs (and filed a petition to get the USDA to pay attention) thinks that’s the way to go. He told me in an email a few hours ago: “Hagen’s action today is a great first step in recognizing that pathogens have no place in our food supply. I look forward to the day when FSIS deems all pathogens in meat (beef, turkey, chicken and lamb) as adulterants just like FDA does for all other foods.”
Update: At Food Safety News, Helena Bottemiller has written an excellent lookback at the original decision to declare O157 an adulterant. Seventeen years later, we take this for granted, but it was game-changing at the time.
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