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Outbreaks Put Worry on the Table

Every few weeks, it seems, deadly germs turn up in the food supply.

Heather Whybrew, a college student in Washington State, became gravely ill after eating a salad in her school cafeteria. Carl Ours, of Ohio, was temporarily paralyzed after eating chili dogs and drinking beer. Mari Tardiff, of California, spent three months on life support after she drank unpasteurized milk.

Is it becoming more dangerous to eat?

Public health experts cannot give a definitive answer, largely because the historical figures on food-borne illness are spotty. But most of them believe the nation’s food supply is markedly safer now than it was 100 years ago, and probably safer than a decade ago.

Yet, even if fewer people over all are getting sick, the big recalls and outbreaks of recent years, like the discoveries of the industrial chemical melamine in infant formula and salmonella in peanut butter, are still worrisome to many health experts and safety advocates.

(Swine flu, despite its name, is not contracted from food.)

While there are more recalls and known outbreaks as a result of more sophisticated techniques for tracking illness to its source, some incidents have revealed new problems developing in the food supply.

New products like bagged salads require extra handling, increasing the risk of contamination. Foods once considered safe, like spinach and peanuts, are now seen as risky. And more food is coming from abroad, posing unique problems.

Many safety advocates say the recent problems highlight the inadequacy of government oversight, particularly at the Food and Drug Administration. The agency regulates 80 percent of the food supply, but to safety advocates the agency lacks adequate money or authority.

“Those are warning signs that we need to get a better system in place rapidly,” said Caroline Smith DeWaal, director of food safety at the Center for Science in the Public Interest, an advocacy group. “The trends clearly show that consumers should be more worried about the food supply because the hazards are becoming more pronounced.”

The Obama administration has promised an intensive focus on food safety. On Capitol Hill, crackdowns are under consideration. And the food industry, reeling from costly recalls, is more open to change.

Robert E. Brackett, senior vice president for the Grocery Manufacturers Association, said major food companies have made strides. But the recent outbreaks have shown that a single sloppy ingredient supplier can damage large segments of the food industry.

“I think we’ve come to realize that until you raise the bar for everyone, we are not going to make much progress,” he said.

Food has always contained germs, and it has always posed a risk of illness. An estimated 76 million Americans, a quarter of the population, contract food-borne illness each year, but the vast majority of the cases are so mild that victims do not realize where the germs came from.

Starting in 1996, the government started collecting better figures on these illnesses. Figures before that are incomplete. But Dr. Robert Tauxe, deputy director of food-borne diseases at the Centers for Disease Control and Prevention, said there was no doubt the food supply is safer now than in the days before municipal sewer systems, refrigeration and milk pasteurization.

A century ago, it was common for food to come into contact with human sewage, picking up germs. For instance, in 1900, typhoid fever killed 31 people out of 100,000. As sanitation improved and such diseases largely disappeared, new ailments, many associated with animal waste, took their place.

Salmonella infections increased steadily in the United States from 1942 through 1990 before beginning a gradual decline, the C.D.C. reported. Another 13 pathogens, including a toxic strain of the intestinal bacterium Escherichia coli, have been identified since 1976.

Since the C.D.C. began its improved tracking in 1996, cases tied to some major germs have decreased significantly. Authorities cite better oversight of the meat and poultry industry.

Ailments caused by the toxic strain of Escherichia coli have dropped 25 percent. Campylobacter cases are down 32 percent and listeria cases, down 36 percent. A few relatively rare diseases have increased, and rates of salmonella, a common food-borne illness, are largely unchanged. (Most salmonella cases are mild.)

The paradox is that even as food has grown safer, contamination scares and recalls keep coming to light. William Marler, a lawyer in Seattle who specializes in representing victims of food-borne illness, said that every time his business appeared to slow from a dropoff in cases, some new type of contamination would crop up.

“It’s like the Dutch boy putting his finger in the dike,” Mr. Marler said. “When you put your finger in one hole, another emerges.”

Part of the explanation, public health experts say, is that the technology for identifying multistate outbreaks has improved greatly.

Decades ago, the burden of illness was probably higher, but foods were not recalled as often, simply because investigators could not implicate them in a given outbreak. Now, modern genetic techniques can often link cases of food-borne illness, even in different parts of the country, allowing investigators to pinpoint the tainted food.

He cited the recent salmonella outbreak in peanut products. Authorities tracked the salmonella to an open jar of peanut butter in Minnesota, identified victims in 46 states and determined that it came from a plant in Georgia with poor maintenance and hygiene.

The peanut case also reflected the growing complexity of the food supply: a small Georgia plant sold peanuts or peanut paste to several hundred customers who used them to manufacture thousands of products. To date, 3,913 distinct types of products related to this incident have been recalled.

Food manufacturing is also growing more complicated. Bagged salads, developed in the 1980s, provide a convenient solution for eating leafy greens. But where a contaminated head of lettuce might have made one family ill, bagged salads, which combine leaves from dozens of heads, have the potential to spread the germs.

Ms. Whybrew, the college student, ate a salad last May in the cafeteria at Pacific Lutheran University in Tacoma, Wash. It was tainted with E. coli. She spent a month in the hospital with severe diarrhea and pneumonia.

“It was weird for me to get that sick from eating vegetables, which is something you are supposed to eat,” Ms. Whybrew said.

Public health experts say the complexity of the food supply illustrates the need for tougher government oversight, including more field inspectors.

Mr. Ours, for instance, ate a hot dog topped with chili made at a factory in Georgia where the equipment was malfunctioning. The chili had not been cooked well enough to kill a germ called botulinum.

Mr. Ours, a 40-year-old furniture mover, woke up the next morning with double vision and went downhill from there. “It nearly killed me, I know that,” said Mr. Ours, who now has little faith in the safety of the food supply. “I was a prisoner in my own body for a month. The only thing I could do is lay and blink.”

Some people are tempted to opt out of the modern industrial food system altogether. But doing so can put them at risk of the very diseases that were banished from the food supply decades ago.

Concerned about health, Ms. Tardiff, the California nurse, bought organic and less processed foods whenever possible. She decided to try raw milk, believing the unpasteurized product would supply helpful organisms.

Instead, she got a dose of an unhelpful germ: campylobacter, easily killed by pasteurization. The ensuing intestinal illness caused a debilitating nerve disease. Ms. Tardiff communicated by blinking for months, and still cannot stand or use her hands.

“This has been life-altering,” she said. “All I want to say is, ‘Be careful.’ ”


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