Journalist and Author
Resistance factors — the mutations that allow bacteria to defend themselves against the attack of antibiotics — spread around the world in unpredictable patterns with remarkable speed. How do they do that?
A team of researchers suggested Saturday that seagulls might be to blame.
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.
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.
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.
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.
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.
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…]
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…]
