Earlier this week, something happened to me that happens to at least 48 million people in the United States every year: I got a foodborne illness. After a completely normal weekend and Monday, I woke in the middle of the night unusually thirsty; I glugged a big glass of water and stumbled back to bed. I got up Tuesday morning still thirsty, feeling kind of chilled and sluggish, and with no appetite. I skipped my usual fruit and yogurt, downed my usual two cups of coffee, skipped my usual hour-long walk and went to my desk.
About two hours later, my abdomen started to cramp.
About 30 minutes after that, I realized it would be a good idea if I went into the bathroom fairly soon.
I was there for a while.
Once the worst was over, I started making the kind of mental list that you make when something like this happens: What did I eat that got me into this state? In my head, I ran down the previous day, a work day that I’d spent mostly at home. Breakfast: an individual container of local nonfat yogurt and a chopped-up apple. (Yes, I’d washed it.) Lunch, light because I was going out for drinks later: commercial peanut butter that had been unsealed but in the fridge for a while, whole-grain crackers. Cocktail hour: a martini that a friend made, and some prosciutto and cheese from Whole Foods. Later on: some searingly hot Thai duck that my husband had brought home from a work lunch, but he that he had stashed for the interim hours in the office fridge.
Nothing seemed obvious. Internally, I shrugged, figuring I had something else in common with the annual millions of foodborne-disease victims: I’d never know where my illness came from. Most people don’t, and as a result, public health doesn’t either. For most foodborne infections, the lag between eating and suffering the after-effects is just long enough that people can’t pin down what might have caused the problem. Even if they do suspect a cause, proving the connection is no small task. Victims have to see a physician, get a sample taken, get the sample tested or forwarded to their state’s public health laboratory; and, ideally, retrieve the food if they can and get it tested, or at least retrieve some record of what they bought.
The necessity of fulfilling all those steps helps explain why so many foodborne cases are never brought to the attention of any health authority — and why, even when it seems likely that someone’s case is part of an outbreak, the illness is never added to the outbreak’s toll.
Mine might be a little different — maybe. Here’s what happened next.
I had a mild struggle over the next 48 hours, waiting for my intestines to get back to normal, feeling extraordinarily tired, fretting over my fingers being persistently cold and clumsy and waiting out cravings that were perplexing and a little abnormal for me. Still, I’ve written about the unpredictable aftermath of foodborne illness; I figured I was just providing myself with an after-the-fact example, one that was fortunately milder than what victims have shared with me.
That brings us to this morning. Like a lot of reporters, I get hundreds of work-related e-mails every day: tips on stories, product pitches, alerts from various disease-tracking systems, and regular updates from government health agencies around the planet, including the Centers for Disease Control. At about 11:30, a CDC bulletin landed in my inbox. It was an update to an investigation the agency has been pursuing for about two weeks, of a strain of Salmonella called Bredeney that has been linked to a brand of peanut butter sold at Trader Joe’s.
I’d been vaguely aware of the outbreak, but I’d noticed it was relatively small — 35 victims so far, in 19 states, with eight hospitalizations but no deaths — and I’ve been under the gun of deadlines, so I hadn’t paid professional attention. Nor personal attention, because I almost never shop at Trader Joe’s; there’s one just ’round the block from me, but it’s so popular that people come to blows over parking spaces, and it seldom feels worth the effort.
Today, though, I noticed that something had been added to the CDC’s Investigation Update, which focuses on the manufacturer of the Trader Joe’s peanut butter, Sunland Inc.:
- On October 4, 2012, Sunland Inc. expanded its ongoing recall to include all products made in the Sunland nut butter production facility between March 1, 2010 and September 24, 2012.
- On October 5, 2012, the FDA announced that environmental samples taken in the Sunland Inc. nut butter production facility show the presence of Salmonella.
- There have also been a number of recalls related to the expanded Sunland Inc. recall of products which include peanut butter and other products made with nuts and seeds.
Huh, I thought. Maybe it’s not just Trader Joe’s. I fished the peanut butter from my fridge: Naturally More, “What Peanut Butter Should Be.” I remembered buying it at Whole Foods. I checked the label for contact info: NaturallyMore.com. I looked them up, and at the bottom of the index page, underlined in red, I spotted this: Get Information About Naturally More Nut Butters Recall.
Here’s what it said, dated Sept. 24:
Naturally More Inc. today announced a voluntary recall of its Naturally More Butters products due to a potential contamination issue discovered in another brand’s product produced at the same manufacturing facility. All Naturally More products which contain a date on the lid of May 1, 2013 or later are affected by the recall. The butters are produced in a facility that may have been exposed to the Salmonella virus. There are currently no reported cases of any illnesses associated with Naturally More.
It gave a list of UPCs, the product number codes that float below bar codes on most labels. Here’s the list:
And here’s my label:
(In journalism, this is known as Becoming Part of the Story.)
To be clear, we still don’t know that this peanut butter made me sick. (To be sure of the steps, I called both the Georgia Division of Public Health, and a friend who works with the foodborne-illness section of the CDC.) The most important step isn’t actually checking the peanut butter, because the earlier steps in the investigation have proven that this product-coded batch is associated with Salmonella. The most important step is actually checking me, to see whether I was infected with the outbreak strain — and that requires visiting my physician, and collecting a sample for a test, and paying for the test and visit both. Which I might do — and as an inquisitive journalist, I should do — but doing that costs time and money, when this bout of illness has already cost me both.
Which is one of the lessons I want to underline here, for anyone who hasn’t thought about it before: how much the investigation of foodborne outbreaks relies on the goodwill of the victims. Some foodborne outbreaks ask much more of victims than this quick trip to my refrigerator and computer cost me; some require more invasive tests and much more lengthy look-backs, going back into grocery lists for a month or more.
The other point to underline — and we know this, but it’s worth emphasizing — is how complex and non-transparent our food system is. The peanut butter-Salmonella connection was first made via Trader Joe’s, then traced back to the peanut processor Sunland Inc., and then traced forward again. As of yesterday, the list of potentially affected peanut products is 240 items long. Most of them are rebranded by other companies with more recognizable names: Harry & David, Earth Balance, Arrowhead Mills, Kirkland (a Costco house brand), Archer Farms (from Target).
It takes an especially curious consumer to drill all the way through that chain of custody. Most won’t do it. Most, I suspect, won’t even know they need to.