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Foodborne Outbreaks: More Complex, Deadlier, Harder To Stop

The complex paths that ingredients take to become the foods we eat, and that foods follow to reach our plates, are creating foodborne disease outbreaks that occur in many places at once and are more common and more deadly than ever before.

That’s the conclusion of a new report from the Centers for Disease Control and Prevention, released Tuesday at the same time that fast-casual chain Chipotle Mexican Grill is struggling with an outbreak of E. coli that has sickened 37 of it customers in several states. More than half of the deaths due to food that occurred in the United States between 2010 and 2014 came from multi-state food-related outbreaks, the CDC said. Overall, outbreaks that crossed state lines accounted for only 3 percent of the 4,163 food-related outbreaks the agency analyzed—but those outbreaks accounted for much more illness and death than usual, including 11 percent of the 71,747 food-related illnesses, 34 percent of the 4,247 hospitalizations, and 56 percent of the 118 deaths attributed to food.

Produce is the leading cause of outbreaks, the CDC said.
Produce is the leading cause of outbreaks, the CDC said.

Such outbreaks are becoming more virulent: The multi-state outbreaks were more likely to be caused by Salmonella, Listeria or toxin-producing strains of E. coli, while outbreaks that were confined to individual states tended to be caused by the vomiting disease norovirus. They are also becoming more common: There were fewer than three per year between 1973 and 1980. The CDC said Tuesday that there are an average of 24 per year now.

“On average, there are about two (outbreaks) per month, and they can be big and they can be lethal,” Dr. Thomas R. Frieden, the CDC’s director, said in a briefing for reporters.

Frieden said the disease-detective agency hopes the food industry will work with federal officials to take more responsibility for delineating the complex processes that both assemble ingredients into finished foods and also distribute them through nationwide—sometimes worldwide—networks.

The Chipotle outbreak of pathogenic E. coli, which has affected customers in two states, sending 12 of them to hospitals, has led the chain to close 43 of its West Coast restaurants. The company is meeting with federal officials, according to Dr. Kathleen Gensheimer of the Food and Drug Administration, who shared the media briefing with Frieden.

Even the simplest foods can have astoundingly complex “supply chains.” In the graphic below, the European nonprofit Forest 500 traces the components of a burger, fries and packaging from a typical fast-food meal served in Europe, and identifies 75 different supply chains that escort the various ingredients through more than a dozen countries, sometimes traveling halfway around the world.

The nonprofit organization Forest 500 estimates that the ingredients and packaging for a typical burger (served in Europe) come from 75 supply chains.
The nonprofit organization Forest 500 estimates that the ingredients and packaging for a typical burger (served in Europe) come from 75 supply chains.
Graphic by Forest 500, original here.

And at the 2013 Digital Disease Detection conference in San Francisco, former military epidemiologist Amy Kircher, DrPH, director of the University of Minnesota’s Food Protection and Defense Institute, said the average American burger contains the products of 82 supply chains—and that importing those components opens a portal not just for naturally occurring diseases but for deliberate contamination as well.

The CDC sad Tuesday that 15 percent of complicated outbreaks over the past five years originated in imported food, mostly from Mexico and secondarily from Turkey. Fruit, nuts and seeds, fish and vegetables, and bagged salad mix were the main foreign culprits.

Frieden said the CDC is relying on the reorganization of federal food safety created by the Food Safety Modernization Act (FSMA for short), which gave the FDA new tracking and enforcement powers, and aims to push the responsibility for detecting contaminated imports from the very limited federal workforce to foreign governments cooperating with the US.

But, as Helena B. Evich of Politico reported in an investigation published last July, the 2010 FSMA is effectively an unfunded mandate, all but abandoned by the administration that pushed so hard for its passage. The FDA, she said, is $276 million short of what it needs to implement the law’s sweeping changes and has not been able to implement any of the tough new rules it created.

Funding is the critical component that would allow federal food safety to peer into supply chains and keep such large outbreaks from occurring again, agreed Sandra Eskin, director of food safety at The Pew Charitable Trusts. She points out that, according to the CDC’s report,  fresh produce causes an ever-larger proportion of complex outbreaks, and that the unpredictable contamination that occurs in fields demands sophisticated, predictive responses that agencies can’t now afford.

“These outbreaks underscore the need for FDA’s new prevention-based safety standards for fruits and vegetables,” she said. “However, If FDA does not receive the funding necessary to effectively implement these standards, then consumers will continue to be sickened with foodborne illnesses that are largely preventable.”


5 thoughts on “Foodborne Outbreaks: More Complex, Deadlier, Harder To Stop

  1. Sorry to sound so vulgar to a respected publication, but I think a huge factor is smartphone use by employees at delivery and service points. It’s very common to poop while playing on your phone. While washing your hands has been pounded into our minds, cleaning your cell phone screen has not. Also factor in an employee preparing raw chicken, checks their text or face book. Then they wash their hands, prepare ready to eat salad and play with their phone again during the prep. I also think a huge factor is a false sense of safety with gloves. Take the same service scenario above- preparing raw chicken, then ready to eat salad without changing gloves. Now the 15% in out of country produce, I can’t speak on that.

    1. As valid as your argument is, I think the main issue is the workers out in the fields. Honestly, these people rarely have facilities to clean themselves properly. It’s mostly just port-o-potty and bucket of water if they’re lucky. Their facilities are often acres away from their work location and they are paid based upon the amount they pick. This bolsters the idea to relieve yourself where you’re working while no one is looking so that you don’t waste time walking back and forth from the toilet.

  2. The Politico article unfairly assigns blame to the Obama administration and ignores the fact that the budget the Constitutional duty of Congress, which has been controlled by the Republican party since the 2010 elections. Just keeping the “lights on” in the US government has been one series of “fiscal cliffs” after another, with only one political party willing to send the US over the edge into default and/or shutdown. Only one party is knee-jerk anti-regulation (and anti-funding for existing regulations that get in the way of profit).
    I’m not claiming that Democrats are perfect on these issues, but laying a big chunk of the blame on the Obama administration is another example of the false dichotomy of “both sides do it,” when only one side does most of the harmful things (not adequately funding the new regulations in this case).
    We’ll see how much of the Obama administration’s new request gets funded. My guess it will be significantly less than the already-too-low amount the Obama administration requested. The the lion’s share of votes against the administration’s already-too-low request won’t come primarily from Democrats, I can almost guarantee.
    Please don’t pass along warped reporting like this. Put the blame where it really lies, and be specific, so the public can consider that information the next time they go to the voting booth (or maybe motivate people to go to the voting booth who might not otherwise go).
    This may seem like a harsh attack out of nowhere, but this “both sides do it” garbage has been effectively used for a long time to obscure the root causes of our horrible food (industrial, chemical, take your pick) inspections process, leading to a lot of needless morbidity and mortality (on-the-job accidents, chemical spills/plant explosions, etc.).
    Wading into a true apportioning of blame is wading into a political minefield and fraught with danger, but the past and current methods for effecting change (more effective food inspections, in this case) has NOT worked.

  3. probably the healthiest food we find on a desert island in the Pacific that is not polluted.
    I do not think that there is something healthy, it’s just an equation about how to eat less polluting

  4. I don’t think the graphic supports your arguments. It doesn’t show actual supply chains, but hypothetical ones. From the upper-right corner of the image:
    “This graphic indicates the complexity of hypothetical global supply chains that could lead from tropical forests to a food product purchased in Austria.”

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