Maryn McKenna

Journalist and Author

CDC: Foodborne Illness in the U.S. Not Getting Better

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AnotherPintPlease (CC), Flickr

Image: AnotherPintPlease (CC), Flickr

The Centers for Disease Control and Prevention today released their annual survey of foodborne illnesses in the United States, and the news is, well, not great. In the words of the press announcement they sent out to announce the data release: “limited progress.”

The survey — technically the Foodborne Diseases Active Surveillance Network, but usually known as FoodNet — doesn’t cover the entire US; it’s a representative sample drawn from 10 sites in nine states where the CDC already has arrangements with epidemiologists and laboratory personnel. Those 10 sites, most of them at state health departments, cover 48 million people, or about 15 percent of the US population. So among that slice, in 2013, there were:

  • 19,056 lab-confirmed foodborne illnesses,
  • 4,200 of which were severe enough to cause the person to be hospitalized,
  • and 80 of which caused the person’s death.

(For context, the CDC’s extrapolation of foodborne illness nationwide, made in 2011, was 48 million illnesses, 128,000 hospitalizations and 3,000 deaths.)

The agency compared the 2013 numbers against two sets of data, one set taken covering 2010-12 and the other 2006-08. Its summation, from its report in its weekly publication MMWR:

Compared with 2010–2012, the estimated incidence of infection in 2013 was lower for Salmonella, higher for Vibrio, and unchanged overall. Since 2006–2008, the overall incidence has not changed significantly. More needs to be done.

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Shutdown Salmonella Outbreak Continues. CDC Food Safety Chief: 'We Have a Blind Spot.'

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Image: Ben Husmann, (CC), Flickr

We’re 11 days now into the federal shutdown and four days since the announcement of a major foodborne outbreak in chicken that is challenging the shutdown-limited abilities of the food-safety and disease-detective personnel at the Centers for Disease Control and Prevention, Food and Drug Administration and Department of Agriculture. Here’s an update.
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There's a Major Foodborne Illness Outbreak and the Government's Shut Down

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image: BokChoi-Snowpea (CC), Flickr

Late-breaking news, and I’ll update as I find out more: While the government is shut down, with food-safety personnel and disease detectives sent home and forbidden to work, a major foodborne-illness outbreak has begun. This evening, the Food Safety and Inspection Service of the US Department of Agriculture announced that “an estimated 278 illnesses … reported in 18 states” have been caused by chicken contaminated with Salmonella Heidelberg and possibly produced by the firm Foster Farms.

“FSIS is unable to link the illnesses to a specific product and a specific production period,” the agency said in an emailed alert. “The outbreak is continuing.”

(Updates to this post are at the bottom.)

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CDC Threat Report: Yes, Agricultural Antibiotics Play a Role in Drug Resistance

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Campylobacter bacteria. Image: CDC

The grave assessment on the advance of drug resistance, released Monday by the US Centers for Disease Control and Prevention, contained some important observations about the relationship between antibiotic use in agriculture and resistant infections in humans. Those observations, combined with remarks made yesterday by the director of the CDC and also with testimony given in the past by other CDC personnel, ought to put to rest what seems like a persistent meme: that the CDC has never said, or doesn’t believe, that agricultural antibiotic use plays a role in the advance of resistance.

This is important because it puts the CDC in line with a substantial body of research pointing to agricultural use playing a role in the emergence of resistance outside farm properties. With the CDC agreeing — plus, to some degree, the Food and Drug Administration — surely it’s time to move on to whether there are things that could be done to curb the risks posed by some ag practices, while respecting the role that livestock-raising in particular plays as a substantial economic sector, and as an engine in feeding the world.

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News Round-Up: Food, Foodborne Illness, And Antibiotic Resistance In Food

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OK, still catching up. Today: food, foodborne illness, and antibiotic use and resistance in food — lots of news in a multi-item rundown. (Under normal circumstances, I’d give each of these items a post of its own; but since they all happened in the past few weeks, it seems better to note them and move on.)

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"Sh*t, Just Ship It": Felony Prosecution for Salmonella-Peanut Executives

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A pretty extraordinary thing happened Thursday, here in Georgia: A district court in the middle part of the state unsealed a 76-count, 52-page indictment of former officials of the Peanut Corporation of America (PCA), charging them with fraud and conspiracy for knowingly distributing peanut products contaminated with Salmonella.

The 2009 outbreak caused by the contaminated peanuts reached, literally, nationwide. Hundreds of products were recalled; 714 people were known to have been made sick by it in 46 states, one-fourth of them were hospitalized, and nine died, according to the Centers for Disease Control and Prevention. (As with other foodborne outbreaks, in which only a fraction of cases are confirmed by lab analysis, the actual number of victims may be much larger.) While that is not the largest outbreak recorded in the United States — the Salmonella in eggs scandal of 2010 sickened almost 2,000 people — it is definitely large: Most of the multi-state foodborne outbreaks analyzed by the CDC involve fewer than 100 known victims.

The PCA outbreak’s size makes it unusual, but so does the decision to press for prosecution: That happens in very few foodborne-illness cases. But if you read the indictment (which I extracted from the federal PACER system and put up at my Scribd account), you’ll see why the Department of Justice decided to prosecute this time. It alleges a trail of not only negligence — unrepaired roof leaks, ignored rodent infestations — but also deliberate deception which ranged from faked origin labeling to falsified lab results.

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Becoming Part of the Story (Maybe): The Peanut Butter Recall

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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. [Read more…]

Drug Resistance in Food: Chicken, Shrimp, Even Lettuce (ICAAC 4)

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A final post from the ICAAC meeting, which concluded at one end of the Moscone Center in San Francisco Wednesday just as the Apple iPhone 5 launch was beginning at the building’s other end. (Definitely a crossing of geek streams.)

There’s far too much going on at a meeting like this to cover everything. So what emerges, as journalists move around the session rooms and exhibit floors, are stories regarding whatever caught a reporter’s eye based on his or her existing interests and news sense.

What caught my eye was a lot of research into foodborne illness, and particularly into the possibility of food being a reservoir for antibiotic resistance (which, constant readers will know, is something I’m interested in). [Read more…]

Bats, Booze, Bugs, Birds, Blood and Bushmeat (ICEID 4)

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Since I started electing to do blog coverage of scientific meetings, I’ve run into an unfortunate reality. On any meeting day, there are one or two presentations that either are strikingly newsworthy or fit into an ongoing topic that I’m already interested in, and that therefore I feel obliged to write about. That means I’m unable to cover dozens, sometimes hundreds, of other interesting papers and posters.

I feel bad about this, especially when authors stop what they are doing to talk to me. So here’s my admittedly insufficient remedy: a quick round-up of a few of the hundreds of intriguing presentations this past week at the biennial International Conference on Emerging Infectious Diseases. (Program here; it’s a pdf, abstracts not individually searchable.) Apologies to everyone whom I didn’t get to.

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More News: FDA Curbs One Class of Farm Drugs

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Here’s a bookend to the Food and Drug Administration’s disappointing Christmas Eve notice that it will cease trying to regulate the largest classes of growth-promoter antibiotics. Today, the agency announced that it is forbidding certain uses of a different class of drugs, cephalosporins.

To those who are concerned about antibiotic overuse in agriculture, though, this is good news — though it may be more good news-bad news-bad news-good news.

The dialectic looks like this:

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Big News But: USDA Bans "Other" E. coli Strains

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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.

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Drug Resistance in Food — Coming From Aquaculture?

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In the midst of the giant Salmonella Heidelberg outbreak last week — now up to 107 cases in 31 states, and triggering a recall of 36 million pounds of ground turkey — it was easy to miss that a second and even more troubling strain of resistant Salmonella is on the move. As I wrote last week, that strain is called Salmonella Kentucky ST198, it is much more drug-resistant than the U.S. Heidelberg outbreak, and it has been spreading since 2002 from Egypt and north Africa through Europe, and has now been identified in the United States. Its primary vector appears to be chicken meat.

There is an interesting and troubling aspect to the spreading Kentucky strain that there wasn’t time to talk about last week, in the midst of the Heidelberg news. It’s this: The authors suspect that this enhanced resistance — to Cipro, and thus the class called fluoroquinolones that are very important in treating Salmonella — may have come into African chickens via drug use in aquaculture.

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Resistant Salmonella: Deadly Yet Somehow Not Illegal

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As the scale of the nationwide outbreak of Salmonella Heidelberg started to sink in Thursday — along with the stunningly large recall of 36 million pounds of ground turkey, much of it probably already eaten — there were a number of moments that made a careful listener need to stop and just think.

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Highly Resistant Salmonella: Poultry, Antibiotics, Borders, Risk

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If you’re a strain of Salmonella, it’s a very good week. If you’re a human, not so much.

There are two stories occurring simultaneously that underline the rising danger of drug-resistant organisms in the food supply, and the porousness of networks for detecting the dangerous bugs in time.

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Goodbye, Team D? When One State's Cuts Hurt Everyone

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Here’s a little tip that will make you feel like a public-health insider. The next time you read any news related to foodborne illness in the United States, look for this word:

Minnesota.

The chances are good that you’ll find it, probably buried deep in the footnotes. That’s not because Minnesota has particularly unhealthy food. (Disregard those 47 things on a stick served at the State Fair.) Instead, it’s because Minnesota has excellent food detectives.

Largely thanks to its Scandinavian sense of social responsibility — Minneapolis is still Scandinavian enough that the cashiers in my downtown grocery store spoke Swedish to the older customers — Minnesota has always been willing to support a crack state department of public health.

E. coli in hazelnuts packaged in California? Salmonella-bearing red pepper in salami made in Rhode Island? More Salmonella in peanut butter from Georgia? Even more Salmonella in peppers from Mexico? Anthrax from downed cattle? Crypto from chicken salad? Solved by MNDoH, every one.

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The biggest foodborne-disease threat may not be addressed by the new food-safety law

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So if we wanted to reduce the danger of pathogens passing to people via food — not just drug-resistant bacteria, which are an increasingly significant problem, but all disease-causing ones — where to start?

Formulating a strategy is more difficult than it seems. In the US, policing food safety is divided among several federal agencies: the FDA, USDA and CDC. The FDA has responsibility for most of the food supply, including seafood, produce, processed food and fresh eggs. The USDA’s Food Safety and Inspection Service (FSIS) regulates fresh meat and poultry and egg products. The CDC surveys the illnesses that result from any of them, estimating most recently that one in six US residents, or about 48 million people, get sick each year, 128,000 are hospitalized and 3,000 die.

But most of those illnesses are never investigated, because a substantial portion of them occur individually or in small clusters, not in major outbreaks. Many of them have long-term consequences that are never recorded by any federal counting mechanism. And there’s currently no surveillance system that links pathogens and food — which means there’s no way to target which foods, or food-raising practices, pose the greatest risks.

The new food-safety bill, signed in January, addresses at least some of those barriers, by requiring a risk-based approach to foodborne illness — meaning, you look at what is causing the greatest problem, and aim your efforts and funding in that direction. But the bill — which certain Congressmen have threatened to starve of funding — covers primarily the FDA. And a new analysis suggests that’s not where the greatest problems lie. [Read more…]

Food safety: Needs speed, technology — and funds

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Perhaps you remember the Great Tomato Scare of 2008.

It started in mid-May, when the New Mexico Department of Health told the Centers for Disease Control and Prevention that it had identified a  Salmonella cluster: four people who were infected with an identical, uncommon strain called Salmonella Saintpaul, and another 15 who seemed to be part of the same outbreak but whose infections hadn’t been characterized enough for authorities to be certain. Then there were cases in Texas, and then more cases in the Navaho Nation. By June 9, 2008, there were at least 150 cases nationwide; by July 1, the count was 869. By the time the outbreak ended in late August, there would be 1,499 victims — almost certainly an undercount — in 43 states. Two people died.

The outbreak was chaotic. On June 3, based on some early studies, the Food and Drug Administration warned people in New Mexico and Texas against eating certain types of raw tomatoes; on June 7, the FDA expanded the warning to nationwide. Investigators were puzzled by tomatoes causing an outbreak so early in the season, and hypothesized that they must have been grown in a warm climate area — maybe California, Florida or Mexico. Then they were troubled by how widely the outbreak spread. Because tomatoes can come from so many different places, they wondered whether the source of the contamination wasn’t the growing fields, but rather a packing house or a wholesaler where fruit from many different farms came together.

Consumers were just as confused. The FDA said raw red plum, red Roma and red round tomatoes were no-gos, but cherry tomatoes, grape tomatoes and tomatoes sold on the vine were OK. People were unsure what was safe to eat and from where it was safe to buy. The entire enormous tomato industry — 8 billion pounds per year in the US — ground to a halt.

There was just one problem: The cause of the outbreak wasn’t tomatoes at all. [Read more…]