Early Report - Insider Medicine

Gorny: More public health resources needed

In this email I received today, Jim Gorny - former United Fresh senior vice president of food safety and technology and now at UC Davis - shares his valuable perspective on the current tomato/salmonella illness outbreak. His analysis reviews the differences between the industry conception of traceability and what public health authorities seek in a traceback investigation. Finally, he makes a strong case for more investment in public health resources as one part of the remedy to avoid future outbreaks and industry wide damage in their wake. Thanks for passing your thoughts on to the industry, Jim.

Tom,

With great sadness I've been following the recent Salmonellosis foodborne illness outbreak associated with tomatoes. From a regulatory perspective this current scenario is unfolding in manner so ominously reminiscent of the incident in September 2006 that is sends a chill up my spine. Having been very involved in September 2006 issue I wanted to share my perspective about making sure that this never happens again, as right now we are at a critical teachable moment and it would be shame to waste this opportunity.

James R. Gorny, Ph.D.
Executive Director
Postharvest Technology Research & Information Center
University of California, Davis
Department of Plant Sciences/MS2
3045 Wickson Hall
One Shields Avenue Davis, CA 95616
Tel: 530.754.9270
Email: jrgorny@ucdavis.edu
http://postharvest.ucdavis.edu/


From Jim:

Epidemiology versus Traceback
Twenty months after watershed events in the lettuce and leafy greens industry, the current tomato foodborne illness outbreak scenario is ominously reminiscent of the September 2006, with epidemiological data (to determine the most likely food and source of that food) lagging far behind reported/confirmed illnesses cases. The produce supply chain has been again stopped in mid-motion due to a foodborne illness outbreak and there is deep and pervasive uncertainty in the marketplace. Everyone in the tomato industry is now suffering from being labeled with a broad brush as the potentially responsible party and it affects those responsible for these illnesses as well as the vast majority of completely innocent parties.

Since September 2006 many persons have advocated for expenditure of more resources to enhance produce traceability, as they believe that enhanced traceability is the most effective means of avoiding the complete shut down of a produce industry sector. Well it has happened again and traceability was never the cause of these industry wide shut downs and it is unlikely that enhanced traceability will ever prevent a future industry wide shut down.

First and foremost continued foodborne illness outbreaks being associated with consumption of certain produce items is the real issue here. Continued focus on preventing produce contamination in the first place throughout the supply chain is the most effective means of preventing any and all future produce industry wide supply chain shut downs.

Secondly, painstakingly slow epidemiological investigations carried out by local, state and federal public health officials are the real cause of these industry wide shut downs. Epidemiological investigations aim at identifying the most likely root cause of a foodborne illnesses outbreak. This occurs by first identifying clusters of illnesses, making sure the disease causing agent is exactly the same among ill individuals, determining what common food ill individuals ate and where that food came from. Determining in the epidemiological investigation where the tainted food came from (which store, then which distributor, then which grower/shipper/packer) by identifying commonalities among where ill individuals purchased their food, is critical to ultimately identifying the most likely root cause of contamination.

Importantly, epidemiologist’s investigating the foodborne illness outbreak must be EXTREMELY careful in assuring that the link between what ill persons ate and where they purchased that food item from is factually correct. If a false assumption is made early in the investigative process (i.e. wrong food product or wrong point of purchase) it leads the epidemiological investigation down the wrong distribution chain, thus wasting time, resources and ultimately delaying the identification of the true cause of the illnesses.

The real issue regarding industry wide shut downs is not about produce traceability (although good traceability does help) but it is about epidemiological investigations that are slow, laborious, time consuming and resource intensive affairs. Because multiple federal, state and local public health authorities must collaborate in these investigations it increases the complexity of the task. This is not a criticism of public health officials trying to protect public health but merely a statement of facts regarding these investigations.

Public health agencies are currently fragmented and under-resourced to effectively monitor and respond rapidly to developing public health issues. Why did it take upwards of 6 weeks for public health officials to identify this cluster of illnesses? and then only due to the diligence of state public health officials in New Mexico? Food industry, government and the public should be concerned about this lagging response time and its subsequent effects on public health and commerce. Since September 2006, each and every foodborne illness outbreak investigation should have been viewed as an opportunity to enhance investigation team response times to assure that public health and well being. Simply put more public health resources are needed to adequately protect public health and commerce in a timely manner or we will continue to see industry wide shut downs in the produce industry.

GMA: Cut the ethanol tariff

The spike in corn prices is keeping the heat on biofuels as the whole supply chain deals with higher food costs. One issue is the tariff on imported ethanol. Here the GMA stakes out a position that the tariff should decline in concert the 45-cent credit to blenders mandated in the new farm bill. From GMA:


(Washington, DC) - The Grocery Manufacturers Association today issued the following statement by Vice President for Federal Affairs Scott Faber in regard to Senator Dianne Feinstein’s (D-CA) and Senator Judd Gregg’s (R-NH) introduction of legislation intended to reduce the tariff on imported ethanol. Co-sponsored by Senators Maria Cantwell (D-WA), Wayne Allard (R-CO), and Susan Collins (R-ME) the bill would reduce the 54-cent ethanol tariff on imported sugar-based ethanol from Brazil to 45 cents, matching the 45-cent tax credit to blenders as mandated by the new Farm Bill.

“This week in Rome, there was broad agreement that U.S. food-to-fuel mandates and subsidies have greatly contributed to distortions in the world grain market and have led to skyrocketing food prices here and around the globe. We applaud Senators Feinstein, Gregg, Cantwell, Allard and Collins for taking another step in the right direction by proposing the reconsideration of the tariff on imported ethanol. However, the current food crisis will not be solved by incremental change alone; urgent Congressional action is needed to examine the full economic and environmental impacts of these food-to-fuel taxes and subsidies immediately.”

DeLauro: Heed the call

One of the consequences of the tomato-salmonella outbreak - not contemplated so far in the rush of news - is the impact on proposed food/produce safety legislation. In the "you knew this was coming" department, a statement from a prominent lawmaker very attuned to food safety issues:

From Spinach to Tomatoes, Little Progress in 2 Years Preventing Food Borne Illness Outbreaks Tied to Produce

Washington, D.C. – Congresswoman Rosa L. DeLauro (CT-3) issued the following statement on the continued investigation into the salmonella poisoning linked to uncooked tomatoes. Over 85 people in eleven states have been sickened, including approximately 57 cases of illness caused by a rare type of Salmonella bacteria called SaintPaul.

“After the E. coli outbreak involving spinach in 2006, which sickened nearly 200 people and caused three deaths, the total market value for spinach has yet to recover from its pre-outbreak levels. We are in danger of seeing a repeat of this situation with the recent salmonella outbreak involving tomatoes, which thus far could be linked to over 85 cases in as many as nine states.
“What is very disappointing about this most recent outbreak is that steps could have already been taken to avoid these problems. The fresh produce industry demonstrated initiative last year in requesting strong federal safety standards. The FDA also proposed safety standards for produce last year that were rejected by the Bush Administration.
“When even industry acknowledges that self-regulation and voluntary guidance is not working, it is long past time for the federal government to act. Congress should heed this call and move forward with reforming the food safety system that includes controls linked to preventing contaminations, science-based performance standards, frequent inspections, and accountability for imported foods.”

Tomato confusion

Above: States with persons with the outbreak strain of Salmonella Saintpaul, by state of residence, April 15 to June 4, 2008.

I was in the supermarket that we often shop at last night and stopped to talk with a teenager working in the produce department stocking and building a display.
I noted the red roma tomatoes on a nearby stand and I asked if the store was getting very many inquiries from people concerned about tomatoes and salmonella.
Not really answering my question, he said something like, “We don’t do business with those people that had that problem.”
"Good," I said without much conviction, not bothering to correct him (he told me it was his first month on the job) that the U.S. Food and Drug Administration had not yet identified “those people” responsible for salmonella-tainted tomatoes, not to mention they had not definitely narrowed what country or region the tomatoes come from.

It goes without saying that this is not a fun time to be a produce industry decision maker who has anything to do with plum, roma or large tomatoes.



Here is coverage from the Denton Record-Chronicle that tells of more cases related to the outbreak.