Newark Star-Ledger (NJ)
Carol Ann Campbell
Cheese. Lettuce. Chopped meat. Cilantro. Tomatoes.
Think of all that goes into a taco and you have an idea of the many theories behind the source of the E. coli outbreak linked to Taco Bell restaurants in New Jersey and New York.
To unravel the mystery and prevent future outbreaks, state health officials yesterday began a "trace-back," or a reverse trip through the food chain. Along with investigators from the U.S. Food and Drug Administration, they visited a Taco Bell food distributor in New Jersey.
They are searching for the paper trails to find the source of the bacteria that has sickened at least 42 people in New Jersey and New York and one in Pennsylvania. Several Taco Bell restaurants, including the one in South Plainfield, remained closed yesterday.
Meanwhile, the state Public Health and Environmental Laboratories in Trenton continued testing Taco Bell foods.
So far, 17 types of food taken from the Taco Bell on Stelton Road in South Plainfield last week have been tested -- everything including meat, cheese, lettuce, salsa and vegetables used to make the company's Mexican-style dishes.
All the samples tested negative, said Marilyn Riley, a spokeswoman for the state Department of Health and Senior Services. Additional samples arrived yesterday for testing, she said.
Experts said investigations into Escherichia coli O157:H7, the dangerous strain of the bacteria, have widened far beyond the usual culprit -- ground beef, which has become safer in recent years. At the same time, experts have found an increase in contaminated fruits and vegetables.
"There have been major changes in how meat is produced, and we can point to documented decreases in E. coli in hamburger," said Linda Harris, a food safety expert at the University of California at Davis.
Fast-food restaurants also have improved handling practices and standardized cooking to kill any bacteria still present, she said.
"The hamburger at fast-food places now is probably better than the hamburger you buy at the grocery store," said Caroline Smith DeWaal, director of food safety for the Center for Science in the Public Interest, an advocacy group.
Meanwhile, E. coli has increasingly turned up in lettuce, spinach, salsa and other types of produce.
"You have to look at every ingredient going into the tacos," DeWaal said. "You literally go into the cooler and start pulling out food items to be tested."
The public was alerted to the widening E. coli threat by a multistate E. coli outbreak -- traced to contaminated spinach -- that sickened 200 people in September and October.
William Marler, a Seattle lawyer whose firm focuses on cases of food-borne illnesses, said a 1993 E. coli outbreak at Jack in the Box restaurants that killed four children and sickened 600 other people shook the fast-food and meat industries.
"They realized they could not count on a 16-year-old burger flipper to be the stopgap," he said. "The industry has done an amazing job."
Now, Marler said, nearly all of his firm's E. coli cases are related to fresh produce, not hamburger.
"Now when you have an outbreak, you have to look at what product does not have a 'kill step,'" or pasteurization step to kill bacteria, Marler said. Some outbreaks have been linked to fresh salsa made from cilantro, green onion and tomatoes, he said.
E. coli can contaminate produce in several ways, experts said. Water contaminated by cows can be sprayed on crops. Manure used as fertilizer can be spread on fields. Poor hygiene of workers in the processing plant can cause problems.
"Food can be contaminated all through the food chain," said Harris of UC Davis.
Some explain the rising number of reports by pointing to the increasing industrialization of produce, the greater use of marginalized land for crops, and greater awareness of the link between produce and E. coli.
THE SPINACH CONNECTION
New technology can now link disparate cases. This fall's spinach outbreak was linked by PulseNet, a public health network operated by the U.S. Centers for Disease Control and Prevention that collects genetic fingerprints of bacteria. Once the illnesses were linked, investigators began questioning as many of the sick people as they could.
"Eighty percent of the people had eaten spinach," said David Acheson, a food safety official at the Food and Drug Administration. "That's way higher than we normally would expect to see."
Investigators then scooped bags of spinach from refrigerators for testing.
In New Jersey, samples taken from patients in the recent outbreak are being sent to PulseNet.
Finding the source of E. coli remains difficult, even with high-tech tools. The contaminated food can be long gone when investigators start poking around. Often, experts said, the source is never identified.