The Top 10 Foodborne Illness Outbreaks in the US

The recent E. coli 0104:H4 outbreak of gastroenteritis in Europe that sickened thousands and killed over 20 people was one of the largest foodborne disease outbreaks in the world (for the latest updates check out this article). This prompted my colleagues over at Onlinecertificateprograms.org to post an article entitled “10 Worst Food Contamination Outbreaks” that outlines the most serious foodborne illness to afflict the US.

Some of you may remember some of the more highly publicized ones including the “Jack in the Box” and “Sizzler” E. coli outbreaks in 1993 and 2000 respectively. While E. coli is still on everyone’s mind, the other usual suspects including Salmonella, Listeria and botulism are also featured!

 Here is the list! 

  1. Washington Packing Corporation, Botulism (1963): After two women died from botulism due to eating a bad can of A&P tuna packed by the Washington Packing Corporation, health authorities began investigating the company's foods, eventually discovering that the bad tuna had been shipped and stocked in major population centers throughout the Midwest. Wary consumers immediately stopped purchasing tuna, causing the then $277 million industry to suffer a 35% decrease in sales. The families of the two women were paid $226,500 by Washington, which was shut down after the incident.
  2. Skewer Inn Restaurant, Botulism (1983): Botulism struck again 20 years after Washington, resulting in one death. The oversight occurred at Peoria, Illinois' Skewer Inn, a popular restaurant located in the constantly-busy Northwoods Mall. Each victim ate beef patty-melts containing contaminated onions, later experiencing symptoms such as blurred vision, slurred speech, trouble breathing and paralysis. Overall, 28 people were hospitalized, 12 of whom required ventilatory support for varying periods of time.
  3. Jalisco Cheese, Listeria (1985): The deadliest food contamination outbreak in US history was caused by listeria, a bacteria found in sewage, soil, stream water and plants that manifests through fever, aches and diarrhea. Many of the 142 Southern Californians who fell ill from Jalisco's Mexican-style soft cheese suffered dire consequences — 48 died including 19 stillbirths and 10 infants. When an investigation was completed, the bacteria were traced back to poorly pasteurized milk used to make the cheese at an Artesia plant.
  4. Hillfarm Dairy, Salmonella (1985): Consumers would've been best-advised to avoid dairy products altogether in 1985. The Hillfarm Dairy debacle wasn't as severe as the Jalisco debacle, but it was far more widespread, as 16,284 cases of food poisoning due to salmonella were confirmed and possibly 200,000 cases altogether existed in the Midwest. Two deaths resulted, and as many as 12 may have occurred due to two batches of tainted milk produced in Melrose Park, Ill.
  5. Jack in the Box, E. coli (1993): Highly publicized and nearly catastrophic for Jack in the Box, the 1993 E. coli outbreak in the Pacific Northwest could've been prevented if the fast food chain had selected better meat, or at least cooked the contaminated meat at the right temperature. According to reports at the time, the patties eaten by the victims contained fecal matter and weren't cooked at 155 degrees Fahrenheit as mandated by Washington state law. Four children died and more than 700 others became sick, prompting the USDA to enforce stricter regulations, and Jack in the Box to overhaul its food safety procedures.
  6. Sizzler, E. coli (2000): One of the nation's largest steakhouse franchises experienced a crisis in 2000 when an E. coli O157:H7 outbreak in Milwaukee, Wis., originating from two restaurants in the area, sickened 65 people and killed a three-year-old girl. Health officials discovered that raw meat shipped from the Excel meat packing facility in Colorado came into contact with food eaten by the victims. According to Sizzler, it required all of its restaurants to cook beef entrees at the 160-degree temperature recommended by the US Food and Drug Administration.
  7. Pilgrim's Pride, Listeria (2002): At the time, it spurred the largest meat recall in US history. The listeria outbreak of fall 2002 ended with 46 illnesses, three miscarriages and the deaths of seven people, causing Pilgrim's Pride, then the second-largest poultry company in the US, to suspend operations at its Franconia, Pa. plant. From there, products were shipped to grocery stores, food service institutions and restaurants around the country, specifically affecting Connecticut, Delaware, Maryland, Michigan, New Jersey, New York, Ohio and Pennsylvania.
  8. Chi-Chi's restaurant, Hepatitis A (2003): Typically a problem suffered by residents of developing countries where personal hygiene standards are poor, a hepatitis A outbreak is a problem most Americans don't worry about facing. Thanks to a batch of green onions used in food at Chi-Chi's Mexican restaurant in Beaver, Pa., more than 660 people fell ill and four people died in the nation's worst outbreak of the infectious disease. Almost all of the victims contracted it by eating mild salsa and cheese dip, which contained raw onions that were traced to Mexico.
  9. Natural Selection Foods, E. coli (2006): Veggie eaters across America halted their consumption of spinach in late 2006, as reports surfaced that certain helpings were contaminated with E. coli O157:H7. In early fall, 199 people were infected in 26 states — 31 of whom suffered kidney failure — and three people died. At fault was a farm in San Benito County, Calif., where CDC investigators suspected irrigation that was possibly contaminated from cattle feces, originating from nearby Paicines Ranch, came into contact with spinach fields.
  10. Peppers and Tomatoes, Salmonellosis (2008): Jalapeno peppers, serrano peppers and tomatoes contributed to the 2008 United States salmonellosis outbreak, which proved difficult for the CDC to trace. Ultimately, investigators discovered the strain in irrigation water and serrano peppers originating from a packing facility in Nuevo Leon, Mexico and grower in Tamaulipas, Mexico. It infected 1,442 people in 42 states, with the most incidences occurring in Texas (384). At least one death was attributed to the outbreak.

Until next time...

 Good Luck and Good Eating!!!!!!!!

 

A Massive Enterohemorrhagic Escherichia coli Outbreak is Ravaging Northern Europe

A massive foodborne outbreak of enterohemorrhagic E. coli (EHEC; typically E. coli 0157:H7) has caused16 deaths and sickened over 470 persons in Northern Europe. The source of the outbreak is thought to be fecally-contaminated raw vegetables including cucumbers, tomatoes and leaf lettuce. The source of the outbreak is still uncertain. German public health officials initially pointed to several cucumbers from Spain as the culprits. But, while these products were contaminated with EHEC, it appears that a different EHEC is responsible for the German outbreak.

Most of the sickened individuals are in Northern Germany although public health officials fear that the outbreak may spread. To that end, the outbreak appears to have worsened over the last 24 hours, with nearly 100 more people suffering from severe and potentially fatal symptoms. Typically, there are only 50 to 60 cases of EHEC infections per year in Germany.

Fecal contamination of the raw vegetables is the likely cause of this massive outbreak because E. coli is found in large quantities in the digestive systems of humans, cows and other mammals. Enteropathogenic strains of E. coli have been responsible for a large number of food contamination outbreaks in a wide range of countries. In most cases, the disease caused by these organisms is characterized by severe abdominal pains, diarrhea and generalized malaise. However, EHEC can cause more severe symptoms, ranging from bloody diarrhea to the rare hemolytic uremic syndrome which can lead to kidney failure, seizures, strokes, comas and death. The uremic syndrome is caused by secretion of a potent and sometime lethal enterotoxin manufactured by EHEC.

Unlike Salmonella gastroenteritis, where large number of organisms must be ingested to cause disease, EHEC infections can be caused by far fewer bacteria following ingestion of contaminated foodstuffs. In this regard, infections caused by EHEC are similar to those caused by Shigella spp which can be caused by between 1 to 10 ingested bacteria.

Let’s hope that the source of the outbreak is quickly identified before more people get sick or die.

Until next time...

Good Luck and Wash All Raw Vegetables Before Eating!!!!!!

 

Common Causes of Food borne Illnesses

The Centers for Disease Control (CDC) in Atlanta, GA estimates that there are about 48 million illnesses caused by food borne bacteria each year. As many of you know, the incidence of outbreaks of Salmonella gastroenteritis is growing steadily and it seems that a week can’t go by without a report of a new outbreak. For those of you who are so inclined, the CDC publishes a weekly report entitled Morbidity and Mortality which tracks and reports the incidence of infectious diseases in the US. 

Interestingly, most food borne disease outbreaks primarily result from improperly handling, storing, transporting or preparing of raw food stuffs and consequently are easily preventable. To that end, the folks at Nursing Schools.net sent me a link to a post on their website that describes ways in which to better manage raw foods that can help to prevent or minimize the incidence of food borne illnesses in the US. An excerpt of the post is shown below.

The 12 Most Common Causes of Food Poisoning

**It is important to point out that the term “food poisoning” is anachronistic because in the past, it was not clear what was responsible for the illnesses caused by tainted food. While not currently used much in food microbiology circles, food poisoning (or intoxication) was historically used to describe ingestion of food that contained bacterial toxins but no living bacteria and caused disease. Staphylococcal “food poisoning” is the most common type of food intoxication that causes disease. In contrast, food borne illness is used to describe disease caused by ingestion of contaminated food containing live bacteria which subsequently colonize the lower gastrointestinal tract, invade the intestinal mucosa and thereby cause disease.**

Raw or undercooked food. Whether you're cooking at home or going out, eating food that hasn't been cooked thoroughly or brought to the appropriate temperature can put you at high risk of developing food poisoning. While you might enjoy rare steak, runny eggs or certain raw veggies, these foods can all carry bacteria when they are not cooked long enough or hot enough to kill off the offending particles. Common bacteria found in undercooked food include Escherichia coli, Salmonella and Campylobacter. Be safe instead of sorry and ask that your food be cooked through or use this chart when at home.

Food that is not stored at the proper temperature. While simple common sense would tell you that leaving foods like meat and dairy products out of refrigeration makes them unfit to eat, temperature regulation can be a bit more complicated. Refrigerators can malfunction, foods can be forgotten on the counter and instructions on labels can be misread. To keep yourself safe, always check the temperature on your fridge and freezer. They should be at 40 degrees F and zero (0) degrees F respectively. Always read the label to see what foods will need be refrigerated immediately and which have to be cooled after opening. If you plan to freeze foods, do it within 2 days of purchase. This can help prevent some very serious bacteria from growing and making you sick.

Letting food sit out. Most of us are smart enough to not let refrigerated foods sit out, but sometimes we can forget to put away the leftovers or want it on hand at a party. In order to keep these foods safe to eat and avoid some common bacteria taking hold, you should always put leftovers away as soon as you can. If you're serving food at a party, keep hot food at 140 degrees F or warmer, cold foods at 40 degrees F. Never leave perishable food out for more than two hours, especially if the weather is warm. This will help ensure that neither you nor your guests end up sick.

Not washing hands before eating or preparing food. Contamination of foods from dirty hands is a big cause of many cases of food poisoning. Always wash your hands thoroughly before and after handling foods at home (for at least 20 seconds) and only eat at restaurants with strong showings in health department assessments. Additionally, always make sure your hands are clean before eating food as well, especially if you will be touching them. Without these precautions, you could put yourself at risk of coming in contact with bacteria like staphylococcus-aureus and Clostridium perfringens.

Contamination of other foods by raw meat. Cross-contamination of foods is a major health issue and one that many out there should be highly conscious of avoiding at home. When juices from contaminated meat get onto cutting boards, hands and into the refrigerator, contamination can spread to other foods, some of which you might not plan to cook at all. It is essential to keep raw meat, poultry and fish separate from other foods. Always wash any utensils, countertops and cutting boards that have come in contact with them immediately, sanitizing them with bleach and water, or even having separate tools for handling meat can be a big help.

Eating raw shellfish. Raw oysters may be a delicacy, but ingesting them doesn't come without some serious risks. Oysters from the Gulf of Mexico are commonly contaminated with Vibrio vulnificus bacteria which can cause mild to serious food poisoning. Additionally, even oysters that do not come from this region are often left un-refrigerated for several hours while being brought to shore. While you may be fine after eating raw oysters, be aware that ingestion of these shellfish uncooked is a big risk and could lead to serious health issues.

Improper canning. Canning foods at home has been a common practice for several decades, but it's one that needs to be carefully monitored in order to ensure that the food being preserved won't carry contaminates along with it. Botulism is perhaps the most common bacteria contaminant in improperly canned food, and is one of the most serious and potentially deadly forms of food poisoning out there. Always boil jars and lids to be used in canning to kill off any lingering bacteria and make sure that all cans are properly sealed. Improper canning can also happen with foods you get off grocery store shelves so look out for bulges, discolored food, or seepage.

Ingesting expired food. We've all done it at one point or another, but eating expired food comes with a big risk for food poisoning attached. Always check expiration dates before ingesting any food in your home or purchased at the store. If there is no date on the package, no packaging or only a sell by date, use the government guidelines for cold storage to help you determine if a food is safe to eat or not.

Not heating or reheating thoroughly. You might think that you only have to worry about food poisoning in foods that haven't already been cooked, but that's not entirely the case. You should also be careful with foods that you're reheating, especially if they've been hanging out in your fridge for more than a couple of days. When reheating foods, make sure that meats reach a temp of at least 160-170 degrees F and that other foods come to around 165 degrees F. This will ensure that any bacteria that might have made its way into the food will be killed off and that you'll be able to avoid a common cause of food poisoning.

Not washing produce thoroughly before preparation. Even those seemingly innocuous veggies can be the source of food poisoning if not washed and prepared properly. Prior to reaching your table, there's no telling how many things they may have come in contact with, so always clean any fruit or vegetables with a soft kitchen brush and water (or a pre-prepared veggie wash) to ensure that any bacteria it contains will be largely washed away. This is especially important with foods that you do not plan to cook. While foodborne illness is more commonly caused by meats, recent outbreaks of Salmonella and E. coli have originated in spinach and tomatoes.

Unclean cooking utensils and surfaces. When it comes to food safety, cleanliness matters. Dirty kitchens attract mice and rats that can spread disease and also create ideal places for bacteria to grow and thrive and access your food. It's essential to keep any space you plan to cook in and any tools you plan to use highly sanitized. The USDA advises putting a tablespoon of bleach into one gallon of water to create a sanitizing liquid. This can help prevent any bacteria hanging out in your kitchen from getting on food and will ensure that none are able to cross contaminate one another.

Unpasteurized foods. For the most part, people are fine after eating foods that are unpasteurized, provided they have been stored and served in a safe manner. Yet for those with compromised immune systems, who are pregnant and the very young and very old could be at risk for food poisoning from these. Commonly pasteurized foods include milk, cheeses, yogurt, ice cream, ciders and juices. Unpasteurized versions of these foods can carry Salmonella, E coli, and Listeria monocytogenes, which can make individuals very sick

While these precautionary and preventative tactics will help to reduce food borne illnesses, it will not eliminate them completely. But, it is a good place to start to improve food safety and public health!

Until next time...

Good Luck and Good Job Hunting!!!!!!

 

TWiM Episode 4: Cantaloupes and Salmonella Gastroenteritis

On episode #4 of the podcast This Week in Microbiology, Vincent, Cliff, Margaret, and Michael review foodborne bacterial illness in the context of outbreaks associated with cantaloupes and Lebanon bologna.

Right click to download TWiM #4 (51 MB .mp3, 75 minutes).

 

Links for this episode:

Subscribe to TWiM (free) on iTunesZune Marketplace, via RSS feed, by email or listen on your mobile device with the Microbeworld app.

 

 

In the News Again: Salmonella!

As many of you know, I am a big Salmonella fan (not really that strange for a microbiologist who did his PhD thesis on Salmonella gastroenteritis). However, this notorious food-borne pathogen has once again made its way into the US food supply chain. 

This time, an Iowa-based egg producer, Wright County Egg, is at fault. This outbreak which began in May and sickened hundreds of American has resulted in the recall of over 380 million eggs! Ironically, the outbreak started just weeks before new government safety rule went into effect to reduce the risk of Salmonella infection of eggs. Public health officials believe that this is the largest outbreak of salmonellosis of poultry-related products in recent years.

Like most other nationwide Salmonella outbreaks, this one is a result of poor sanitary conditions and inadequate quality control at the production facility. Wright County Egg had repeatedly been cited for violating US Food and Drug Administration regulations. Yet, the company was allowed to continue operations without fixing the problems identified by FDA inspectors and regulators.

For those of you who may not know, chickens are frequently infected by Salmonella spp and can be found in the feces from infected animals. Chickens are not the cleanest of animals and fecal contamination is expected and common at most egg laying and processing facilities. If adequate health, sanitary and quality control procedures are assiduously adhered to at these production facilities, the likelihood of Salmonella infection of poultry products is very low. Conversely, the incidence of infections is sure to increase if these rules and regulations are not adhered to.

Once again we are in the midst of another major “food poisoning” outbreak, because a company cut corners to reduce costs and failed to adhere to federally mandated Good Manufacturing Practices for foods and related products.

As Woody Allen quipped in the closing moments of his film “Annie Hall”....”Most of us need the eggs.” Truer words were never spoken!

Until next time....

Good Luck and Good Job Hunting (try microbiology)

 

Salmonella, Turtles and Frogs...Oh My!

As many BioJobBlog readers may know by now, my PhD thesis focused on elucidating the underlying pathogenic mechanisms that contributed to the pathogenesis of Salmonella gastroenteritis. Salmonella gastroenteritis, which is primarily a food-borne illness, occurs in approximately 1.4 million Americans each year. Most people who develop Salmonella gastroenteritis recover without treatment within four to seven days. However, some people develop diarrhea so severe they are hospitalized and can become critically ill. According to a former lab mate, who accidentally infected himself, Salmonella gastroenteritis is much worse than the mild form of the disease described in many microbiology textbooks!

While I haven’t performed any research in this field for about 30 years, I still consider myself to be a Salmonella expert (go figure). Therefore, it should come as no surprise that a newspaper article entitled “Salmonella outbreak linked to pet frogs”— that appeared in the Salt Lake Tribune several weeks ago—caught my eye.

According to the article, a 31-state Salmonella outbreak (which was first detected in Utah was linked to pet frogs. The U.S. Centers for Disease Control and Prevention (CDC) in Atlanta started a national investigation to find the source of the outbreak this past summer, after five Utahans were infected by the strain of S. typhimurium a common cause of gastroenteritis (I knew getting a PhD would useful one day). In all, 85 people across several states developed gastroenteritis and nearly two-thirds had had some contact with frogs. Most of the patients were children and among those whose outcomes are known, almost a third required hospitalization. None died.

The source of the outbreak was eventually linked back to a single frog breeder in California that distributed the African dwarf frogs thought to be responsible for the multi-state outbreak. According to CDC officials, the bacteria were likely spread through contact with the tanks' water, not the frogs themselves. Of those who supplied information to the CDC, 30 percent said they cleaned the frog's aquarium in the kitchen sink and 35 percent used the bathroom basin.

While this last bit of information wasn’t remarkable, I finally—after almost 30 years as card carrying microbiologist—realized how the urban legend about Salmonella and turtles got started! Like many kids, I had a pet turtle. I remember my parents cautioning me about handling the turtle because I would get sick (of course I handled the turtle and never got sick). Later on, as a microbiology undergraduate student, I learned about the relationship between Salmonella and turtles and that turtle had been associated with Salmonella gastroenteritis outbreaks in the past. An interesting but inconsequential fact because I no longer owned a pet turtle.

Early on as a graduate student, I learned that it takes a minimum of about 108 salmonellae to cause gastroenteritis. At the time, I wasn’t thinking much about turtles and failed to realize that the large dose required for infection pretty much ruled out the likelihood that picking up a turtle would almost certainly result in Salmonella gastroenteritis. Although reptiles and amphibians harbor Salmonella in their gastrointestinal tracts, a child would have to suck on an infected turtle (or eat its poop) to get a large enough inoculum to initiate an infection—now this is where the PhD training become evident. However, if parents clean their children’s infected tanks in kitchen or bathroom sinks and then fail to wash their hands or the sinks with disinfectant, the number of salmonellae present in these environments would be sufficient to cause disease if infected food or water was ingested. And, this is what likely happened in the frog outbreak; based on the epidemiological data presented by CDC investigators

So, what is the lesson of this story? While it is true that turtles and frogs may carry Salmonella (in a separate study 21 percent of frogs from 16 retailers tested positive) the likelihood of developing gastroenteritis after touching or briefly handling frogs or turtles is extremely low. However, it is not a good idea to handle them for long periods of time without washing your hands before your next meal or cleaning their tanks in areas where food is prepared or people brush their teeth! Food borne illnesses are easy to prevent if appropriate personal hygiene is practiced and foods are prepared and cooked according to recommended standards. 

Finally, it took a long time, but I can now feel comfortable around turtles. This is probably a good thing—my friend Pete is a turtle fanatic and he constantly wants me to pick up his pets!

Until next time...

Good Luck and Good Job Hunting!!!!!!!!!!

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The Importance of Digital Communications During Infectious Diseases Oubreaks

As we all know, the H1NI pandemic has been raging on for close too 10 ten days now. Curiously, “Fear & The Flu: The New Age of Pandemics” is the title this week’s cover story in Newsweek magazine. From an informational standpoint point, “this may be too little, too late”—as the old saying goes. While the Internet has been around for over twenty years now, government agencies, most notably the US Food and Drug Administration (FDA) and the Centers for Disease Control (CDC) continue to rely almost exclusively on old media to communicate with the American public during infectious disease outbreaks. Apparently, the administrators who run these government agencies haven’t been listening closely enough to President Obama’s assertion that “we live in the digital age.”

Communications between the public and government health officials is vital when trying to manage and control infectious disease outbreaks. “Every single government agency as well as companies and non-profits need to be digitally literate and competent in a time of pandemic” asserts Eye on FDA blogger Mark Senak. For their performances in recent infectious disease outbreaks, Mark gives CDC an “A” for effort—although there is substantial room for improvement. FDA on the other hand didn’t fair as well. “The FDA is not nearly as sophisticated in terms of digital. Their only Twitter account is for food recalls.  And their YouTube channels are all confusing and unorganized. They have a long way to go.”

The Internet was originally designed as a digital tool to transmit and move large amounts of information from one place to another. That said, it is also a powerful communication vehicle that can be used to broadcast valuable, scientifically-accurate information during infectious disease outbreaks by leveraging social media tools like Twitter, Facebook and instant messaging. To that end, it’s time for public health agencies to recognize the power of digital media and craft communication plans that can be implemented in the next infectious disease outbreak.

Until next time...

Good Luck and Good Job Hunting!!!!!!

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Another Day--Another Salmonella Outbreak

Tainted pistachio nuts are the culprit for this week’s Salmonella outbreak.  Fortunately, Kraft Foods’ quality unit was doing its job and was able to alert consumers about the problem before the outbreak reached epidemic proportions. At present, there are only two suspected cases of Salmonella gastroenteritis that may be linked to tainted pistachios. The contamination has been traced back to a California company which, according to reports, is the second leading producer of pistachios in the US.

As I have mentioned several times before, Salmonella outbreaks are nothing new and not out of the ordinary in the food industry. However, what is new is the growing lack of regulatory compliance that seems to be pervasive at American food manufactures. Many blame declining food safety on the US FDA’s lack of trained inspectors. While this may play a role, I believe that the real problem lies with the failure of many food industry executives to make a commitment to quality outlined in FDA’s Current Good Manufacturing Practices (cGMPs). 

I have been teaching cGMP to biotechnology students for the past six years or so.  I always tell them that the regulations are meaningless unless management makes a commitment to quality. And, the only way to accomplish this is by insisting that all manufacturing taking place at a company stringently adheres to all GMP regulations and guidelines. For those you who may not be familiar with cGMPs, they are the minimum regulatory standards that must be met to insure US product (food, drugs and cosmetics) quality and safety.

Over the past decade or so, Americans have grown accustomed to a wide variety of choices when it comes to raw and processed foods. To meet demand, US food manufacturers must source and import fruits, vegetables, spices and other foodstuffs from all over the world. Regardless of the origin of a food source, cGMPs clearly state the onus is on the manufacturer (not the supplier) to perform the necessary tests to insure food safety and quality. The recent spate of Salmonella outbreaks suggests that some food manufacturers are either cutting corners or don’t fully understand what testing is necessary to guarantee food safety. Unless something changes, Americans confidence in the safety of US food supply will continue to wane.

Until next time...

Good Luck and Good Easting (avoid pistachios)

 

Breaking Up Is Hard To Do: Should FDA Be Split Into Two Independent Agencies?

I just returned from a weekend of teaching regulatory affairs to biotechnology students at Georgetown University where I tried to convince them that the US Food and Drug Administration (FDA) is fundamentally sound despite its near demise during the Bush administration. Even before the Bush-induced wreckage, the agency was chronically understaffed, under funded and had serious leadership and morale problems. This, coupled with two nationwide Salmonella outbreaks in the past year, several highly publicized drug recalls, and steadily declining drug approval rates has prompted its critics to propose that FDA be split into two separate agencies—one that oversees the drug industry and another that would have responsibility for cosmetic and food safety. For those of you who may not know, FDA became responsible for oversight and regulation of the food and drug industries, in addition to the drugs, after passage of the Food, Drug and Cosmetic Act in 1938.

Drug industry advocates and longtime FDA critics contend that the agency as it exists today can no longer effectively oversee and insure the safety of American food and drug supplies. Critics argue that the history of FDA suggests that the agency focuses on medical products and only focuses on food safety when a crisis comes up. And when they occur, FDA is so distracted that it interferes with the drug review/approval process. While this is what FDA critics want you to believe, it is simply not the case. Despite its recent problems, the FDA has historically done an outstanding job when it comes to drug and food safety—when it is funded and staffed to appropriate levels.

Unbeknownst to the American public, food borne illnesses are very common and Americans are only alerted when the outbreaks reach a certain size. While the recent Salmonella outbreaks were larger in scope and breadth than past outbreaks, they were not extraordinary. However, they were extremely media worthy at the time that they were reported on. You may recall that at the time of the outbreaks, the American economy was beginning to fail and there was an inordinate amount of China, Mexico and free trade bashing going on in the US. Unfortunately, the news media decided to exploit the outbreaks to make a case that Americans ought to reduce their reliance on imported foods—a practice that was beginning to cut into the revenues of the US agriculture and food industries. Ironically, the Salmonella outbreaks might have been prevented if the production facilities (owned by American companies) were compliant with FDA mandated quality control and assurance regulations which were designed to insure food safety.

Drug industry advocates who argue that FDA ought to be split into two separate agencies have financial interests rather than safety concerns in mind.  As an investment banker or VC will tell you, slow, new drug approval rates can have serious financial consequences for the companies that are developing them—it can literally cost a company millions of dollars a day for every day the drug is kept off the market.  Interestingly, when FDA increased its drug approval rates in the late 1990s and early 2000s, there weren’t many industry insiders advocating a break up of the agency. Only recently, as FDA has become more risk adverse which in turn, has caused the new drug approval rates to slow again have critics begun to call for massive organizational changes at FDA.

Like I told my biotech students over the weekend, the only mechanism by which FDA can insure food and drug safety is by conducting regular inspections of drug and food manufacturing facilities. Unfortunately, FDA hasn’t been able to keep up with its mandatory inspections schedule because the agency has been under funded and poorly staffed for over a decade. Several FDA inspectors, who I talked with suggested that routine inspections of manufacturing facilities takes place every three to five years rather than every two years as required by FDA regulations. While in theory this shouldn’t affect a company’s ability to remain compliant with FDA regulations, in reality it does. Put simply, pharmaceutical and food companies, like most other for profit industries are incapable of policing themselves in the absence of regulatory oversight.

I ‘m not certain that the agency needs to be split into two separate agencies to continue to insure the safety of the American drug and food supplies. What I know is the agency needs more funding and much larger numbers of trained inspectors to be successful. In my opinion, the safety of the American food and drug supplies can only be guaranteed if the companies regulated by FDA make a commitment to quality manufacturing and play by the rules.

Until next time...

Good Luck and Good Job Hunting!!!!!!!!!

 

A New Year and Another Salmonella Food Poisoning Outbreak

Salmonella enteriditis, an organism dear to my heart (luckily not my posterior small intestine) is a common cause of food poisoning. As some of you may know, I did my PhD thesis work on Salmonella gastroenteritis (aka food poisoning) and I like to think that I am something of an expert on the topic. 

Typically, Salmonella food poisoning outbreaks are localized and rarely reach epidemic proportions. However, there have recently been two major nationwide Salmonella outbreaks in the US —one in 2007 and now in early 2009.

The current outbreak has afflicted 388 people in 42 states and may be caused by the same strain (Saint Paul) that was responsible for the 2007 outbreak. Ultimately, the 2007 outbreak was linked to contaminated tomatoes. The jury is still out on the cause of the most recent outbreak. Needless to say, CDC scientists are scurrying to quickly identify the source of the current outbreak because it took the agency over 5 months to conclusively identify the culprit in the 2007 epidemic. Not surprisingly, many grocery stores and restaurants suffered financially because of the outbreak.

Many of you may be wondering why Salmonella food poisoning is becoming such a problem in the US. I don’t believe that the strains responsible for the most recent outbreaks are more virulent than the ones that have traditionally caused more localized outbreaks. Instead, the reliance of food manufacturers and grocery store chains on one or two major food distributors (rather than multiple suppliers) is likely responsible for the severity and breadth of these nationwide outbreaks. This suggests that regulatory agencies ought to more closely scrutinize the microbiological quality of the operations of the major distributors. I believe that those efforts would greatly reduce the likelihood of future major outbreaks of food poisoning.

Until next time.


Good Luck and Good Job Hunting (avoid raw vegetables, undercooked poultry and raw eggs)
 

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Salmonella in the News Again

This may be one of the more notable years for Salmonella food poisoning. First, there was a modest outbreak in the eating clubs at Princeton University and now a larger outbreak in Texas and New Mexico. This is the first time that I can recall in my almost 30 years as a card-carrying food microbiologist that there has been this many highly-publicized cases of Salmonella food poisoning in one year. Although I don’t wish Salmonella gastroenteritis on anybody, it is kind of rewarding that an organism that led to my PhD is making headlines once again. Typically, Salmonella outbreaks are not noteworthy and rarely receive much notice— usually taking a backseat to potentially life-threatening outbreaks of enteropathogenic Escherichia coli.

Like the Princeton outbreak, the exact source of the Salmonella infection is unclear. That said, public health and CDC officials are leaning towards large, raw tomatoes. In 2006, the Food and Drug Administration discovered that consumption of tomatoes in restaurants had caused a salmonella outbreak that affected 21 states. , “until the source of the outbreak is identified federal and local health officials in both states have recommended that infants, the elderly and anyone with an impaired immune system avoid eating Roma and red round tomatoes that are not grown at home or sold attached to the vine.” So far, 40 confirmed cases, with patients ranging in age from 3 to 82, have been reported in New Mexico and Texas since April. To date, 17 people have been hospitalized, but no deaths have been reported.

Molecular analyses indicated that all of the cases in New Mexico and Texas were caused by the same strain, a relatively rare serovar called Saint Paul (6th most common serovar infecting humans). Federal health officials at the Centers for Disease Control in Atlanta, GA fear that this may be the beginning of a large national outbreak of Salmonella gastroenteritis. This is because about 30 cases caused by the Saint Paul strain, have also been reported this year in Arizona, Colorado, Idaho, Illinois, Indiana, Kansas and Utah. Like the New Jersey, Texas and New Mexico outbreaks, the cause of those other outbreaks is under investigation.

Salmonella gastroenteritis generally last between four and seven days, and most people are able to recover without medical (antibiotic) treatment. But, it can sometimes lead to death in immunocompromised adults or young children. Symptoms include headache, nausea, abdominal pain, diarrhea and sometimes vomiting.  Although textbook descriptions of the pathogenesis of Salmonella gastroenteritis generally portray it as a mild illness, I can tell you that people I know (lab mates of mine) who came down with the disease (gee, how did that happen?) suggest otherwise!

I suspect that fecally-contaminated water may be source of the infection. But, then again, it has been almost 30 years since I thought about Salmonella gastroenteritis. That said, I don’t think that you ever forget the essence or minutiae of your thesis work!

For those of you who are interested, the electron micrograph of Salmonella typhimurium shown with this post is from my PhD dissertation. As I recall, the electron micrograph was taken in 1980 and the bacterium shown in the micrograph was grown for 48 hours on nutrient agar . Althought I would like to take credit for the shot (nice pose eh?),  it was taken by Phil Hegge in the Department of Bacteriology at the University of Wisconsin-Madison, my alma mater. if you look closely you may be able to see fimbriae along with the flagella.

Until next time

Good Luck and Good Job Hunting (and remember to wash your tomatoes)!!!!!

Princeton U Salmonella Outbreak Revisited

I apparently made a few errors in the post about the recent Salmonella food poisoning outbreak at PU (pun intended). I want to thank the anonymous member of the Princeton Graduating Class of ’09 for pointing out the inconsistencies and errors in the post.  First, the so-called “dining clubs” are actually called eating clubs. Second, fraternities and sororities are allowed at PU and I hear that they are alive and well. Finally, I inadvertently noted that the University has severed contracts with several of its produce suppliers which may have been the putative source(s) of the outbreak. In fact, the University didn’t cancel contracts but only temporarily closed a few of the eating stations at the Frist Campus Center. My local newspaper reported that contracts where severed–I guess you truly can’t believe everything that you read!

I was duly chastised for not adequately verifying my information before I hastily crafted the post. I stand corrected and will attempt to be more vigilant in the future. That said, I think that my lack of understanding of the practices and customs at Princeton University is directly related to the fact that I attended Cornell as an undergraduate. Mea Culpa!

Until next time…

Good Luck and Good Job Hunting!!!!!

Salmonella Outbreak at Princeton University--Oh My!!!

Yes, even the Ivy League isn’t immune to food poisoning outbreaks from time-to-time. There are currently 10 confirmed cases of Salmonella food poisoning at Princeton U. Another 50 people or so have also fallen ill with gastrointestinal symptoms consistent with Salmonella food poisoning.  As a precaution, university officials have temporarily discontinued doing business with their produce suppliers. For those of you who don’t know, Princeton is famous (infamous?) for its so-called dining clubs. These clubs take the place of sororities and fraternities which are not allowed at this august institution of higher education. Obviously, there is more than eating that goes on at these “dining clubs.”

The reason I am blogging about the outbreak is two-fold. First, I live about seven miles from Princeton and it has been all over the local news. Second, I did my PhD work on the pathogenesis of Salmonella gastroenteritis. So, Salmonella food poisoning is dear to my heart (thankfully, not my gastrointestinal tract). Many infectious disease experts tend to dismiss the seriousness of Salmonella gastroenteritis. This is likely because it is usually not as devastating as shigellosis or infections caused by enteroinvasive strains of Escherichia coli (which is actually Shigella masquerading as E. coli). As my major professor once put it “You know when you have Salmonella gastroenteritis—if you can’t decide than it is not salmonellosis.”

I am happy to report that I never came down with gastroenteritis while working for over three years with enteroinvasive Salmonella strains (even though I was routinely mouth pipetting and eating lunch in the lab; practices which aren’t acceptable by today’s standards). I like to think that “the bugs” were afraid of me. Alternatively I had either a great immune system or extremely good aseptic techniques. Whatever the reason, it is always embarrassing when card-carrying microbiologists come down with the disease(s) that they are studying. Luckily, I never came down with the disease caused by the bacterium that I was studying during my first postdoctoral fellowship—Neisseria gonorrhoeae. That would have been extremely difficult to explain!

Until next time…

Good Luck and Good Job Hunting (remember to wash your hands)!!!!!!!!