My daughter never met a chicken tender she didn't like. But during a recent family vacation in Florida, 9-year-old Anna was struck with a bad case of salmonellosis -- disease caused by salmonella. And while we'll never know for sure, we strongly suspect it was caused by contaminated, undercooked poultry at one of her daily restaurant chicken meals.
There is more than a little irony in this tale of excruciating stomach pains, bathroom vigils and hospital emergency rooms.
As a food writer for 25 years, I've interviewed numerous victims of food-borne diseases and parents of children who've died from them. I've attended scores of conferences and hearings where food safety issues are debated among government officials, industry and activist groups.
But this was the first time I got to see firsthand how devastating full-blown food-borne illness can be. Believe me, we're not talking about a bad tummy ache.
And while the experience illuminated many of the food safety issues that I have long covered, I was still surprised and overwhelmed by Anna's illness. Surprised at the nonchalant attitude of doctors toward food-borne disease and the uneven follow-through of the public health system. Surprised at the gap between the bureaucratic rhetoric and the reality of the problem. And overwhelmed by a very sick daughter, whose condition she accurately described as "having my butt on full blast."
The Centers for Disease Control and Prevention (CDC) estimates that there are 76 million cases of food-borne illness a year in the United States. (We're dealing here only with sickness caused by a bacteria or virus in a contaminated food. The CDC estimate does not include the untold millions of upset stomachs caused by overeating, rich foods and such that many people mistake for food-borne illness.) The problem sends nearly 325,000 people a year to the hospital; 5,000 a year die from it. The young, the old and the immune-compromised are hit hardest.
Some progress is being made, however. In April, when Anna was home sick, the CDC announced its latest food-borne diseases surveillance figures -- a story I (ironically) had to cover.
The good news: Infections caused by five hard-to-spell bacteria -- E. coli O157:H7, campylobacter, cryptosporidium, listeria and yersinia -- underwent significant declines in 2004, compared with 1996-1998. The bad news: Salmonella infections showed the smallest decline. Of 15,806 laboratory-diagnosed cases of food-borne infections from the 10 states under CDC surveillance, more cases -- 6,464 -- were from salmonella than any other bug.
In what may be the most surreal exchange of my career, I asked Agriculture Secretary Mike Johanns during a telephone press conference why there hadn't been more progress made in combating salmonellosis -- and what the U.S. Department of Agriculture (USDA) planned to do about it. Johanns passed the question to another USDA official, who said that the agency was committed to developing policies to address the problem. Somehow, with my salmonella-infected daughter groaning in the next room, I didn't find this answer adequate.
Even CDC surveillance data don't get at the real scope of the problem. Most food-borne infections go undiagnosed and unreported because many sick people don't seek attention. Of those who do, many are not tested. In the case of salmonellosis, the CDC estimates that 38 cases occur for every one that's actually reported.
I can certainly see why.
Finding the Culprit
When we brought Anna to the hospital with severe stomach pains, diarrhea and dehydration, the doctor -- who seemed intent on diagnosing appendicitis -- ordered a sonogram, an X-ray and finally a CT (computed tomography) scan, which shows the most detailed images. But a stool culture -- the standard diagnostic test for food-borne illness and a cinch to collect while your child is perennially on the pot -- was not even mentioned, even though frequent diarrhea and stomach pains are hallmarks of the illness.
