By Annys Shin
Washington Post Staff Writer
Friday, September 22, 2006
It took exactly 14 days from the time state health officials in Wisconsin noticed five cases of E. coli O157:H7 in the same county until investigators arrived Wednesday at a field in California's Salinas Valley in search of the bacteria that ended up in bagged spinach and sickened 157 people in 23 states.
The outbreak -- the largest, in terms of victims, caused by fresh produce -- has exposed strengths and weaknesses in the highly fragmented U.S. food safety system. And the extent of it has federal officials talking about imposing tougher regulation.
"There are good agricultural practices out there. . . . The question that will be addressed is: Are they adequate? Are they being followed? Does the industry need to be further regulated to be safe?" said David W. Acheson, a top Food and Drug Administration food safety official.
Even as public health officials have gotten better at identifying the onset of illness borne by raw fruits and vegetables, the rules and procedures to prevent those outbreaks remain weaker than those for meat and poultry, consumer advocates and food safety experts said. And their enforcement relies on the voluntary efforts of growers and processors, and on the FDA, which has responsibility for much of the food supply but nowhere near the authority or resources devoted to the monitoring of meat and poultry.
"The FDA is acting like the fire department after the fire has already started," said Caroline Smith DeWaal, director of food safety for the Center for Science in the Public Interest.
Public health officials have sought to contain E. coli O157:H7, which over the past 20 years has turned up in hamburgers, alfalfa sprouts, apple juice, cheese and lettuce. Escherichia Coli is normally found in the digestive tracts of humans and warm-blooded animals, but the rare and particularly toxic strain, E. coli O157:H7, damages the intestinal lining, leading to internal bleeding and organ failure. It can be fatal, especially for the very young and old. The latest outbreak killed a 77-year-old woman in Wisconsin.
Wisconsin public health officials were the first to sound the alarm on the current outbreak and call in the federal government, after receiving a report on Sept. 5 of five E. coli cases in Manitowoc County, located between Green Bay and Milwaukee. It later turned out that only one of those cases was linked to the tainted spinach; the others were traced to a local fair. But the initial cluster helped put state epidemiologists on high alert two days later when they learned of five more cases in the southeastern part of the state.
In those five, all of the victims had come down with Hemolytic Uremic Syndrome, a condition caused by E. coli that leads to kidney failure. On Sept. 8, Wisconsin officials notified the Centers for Disease Control and Prevention in Altanta and shared the DNA fingerprint of the E. coli strain with PulseNet, an 11-year-old network of public health labs operated by the CDC that has become instrumental in uncovering outbreaks of food-borne illness.
By Sept. 13, detailed interviews with seven of the victims led Wisconsin officials to believe there was a link with spinach, Department of Health and Family Services spokesman Jason Helgerson said. Through the CDC, they learned Oregon officials had reached the same conclusion. With spinach suspected as the culprit, the CDC called in the FDA.
On Sept. 14, the CDC held a conference call with several states reporting cases of E. Coli O157:H7. That evening, the FDA issued its initial warning to consumers not to eat bagged fresh spinach.
The next day, last Friday, the FDA, based on information gathered from victims, narrowed down the search to Natural Selection Foods, which processes spinach used by 30 different brands, and broadened its warning to include all fresh spinach, loose and bagged.
Using supplier and distribution records at Natural Selection, the FDA confirmed California as the source of the contamination on Tuesday. The next day, about a dozen FDA and California state investigators descended on a farm in the Salinas Valley, the first of nine farms they had singled out through records.
On Wednesday, New Mexico officials said they found the strain of E. coli involved in the outbreak in an opened bag of spinach from which a victim had eaten; that helped investigators with further details such as what fields the tainted crop may have come from. Yesterday, FDA officials sent six more investigators into the fields, bringing the total to 19.
Over the past decade, outbreaks of E. coli caused by fresh produce have become more frequent, while the number caused by meat and poultry has declined. Consumer advocates and some food safety experts believe the disparity reflects differences in the regulation of fresh produce and of meat and poultry.
The bifurcated system, which puts the U.S. Department of Agriculture in charge of meat and poultry and gives the FDA oversight of the rest of the food supply, has changed little since its creation a century ago following publication of "The Jungle," Upton Sinclair's expose of Chicago slaughterhouses.
Last year, the FDA's approximately 800 inspectors conducted about 20,000 food safety inspections of all non-meat products, allowing them to visit a processing plant on average once every few years. By contrast, the USDA, which has an inspector daily in more than 6,000 processing plants nationwide, performs the same number of inspections in a matter of days, said Tony Corbo, a lobbyist with Food and Water Watch.
"I liken this to Jack in the Box all over again," said Michael Doyle, director of the University of Georgia's Center for Food Safety. He was referring to a 1993 outbreak of E. coli in Jack in the Box hamburgers that sickened hundreds and killed three.
After that episode, the USDA mandated tougher processing standards, which food safety experts credit with lowering the frequency of meat- and poultry-related E. coli and salmonella outbreaks.
"Until the government comes in and says we're going to have a law here . . . I don't think we're going to make any monumental change in improving the safety of bagged salads in general," Doyle said.
Food safety in the fresh produce industry is largely a matter of self-regulation. Typically, the FDA and state health department officials can inspect only processing plants and don't venture onto farms unless there's an outbreak. The FDA doesn't have the power to order recalls, though it can seize food before it has gone to retailers if a producer doesn't agree to one. The federal government has more powers when it comes to produce that has a plant disease that threatens other crops, DeWaal said.
Growers and processors say they have an added layer of scrutiny from third-party auditors they hire "to avoid the situation we're seeing now," said Bob Perkins, executive director of the Monterey County Farm Bureau.
The FDA was more assertive after the 19th episode of E. coli-tainted greens last October, sending a warning letter to the industry, which in the following months worked out a set of voluntary best practices for farmers and processors.
Yesterday, industry leaders were talking again about more voluntary guidelines.
Earlier this month, the FDA and California state officials, with the cooperation of the industry, began visiting fields and processing plants to get a better grasp of possible sources of contamination.
Industry leaders and some food safety experts contend there is no point to further regulation until scientists can figure out how produce becomes contaminated with E. coli.
"If you don't know what the problem is how is that inspector going to help you?" said Jerry Welcome, spokesman for the United Fresh Fruit & Vegetable Association. "Is the answer throwing inspectors in and putting more regulations in, or do we need to spend more time and effort to figure out how does it happen?"