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Importing health hazards

We now know that the recent deadly outbreak of hepatitis A was caused by contaminated green onions imported from Mexico. It took the Food and Drug Administration far too long to make that determination and to link the Pennsylvania outbreak to earlier outbreaks in Tennessee and Georgia.

The United States is vulnerable to disease crossing our borders. Every day, destructive organisms that threaten our health and our food supply cross into our country undetected. Gaps in border controls and inadequate inspections leave this country vulnerable to devastating viruses, bacteria, pests, and, in the potentially worst case, terrorism. More than two years after September 11, the FDA inspects less than 2 percent of the produce and goods that cross our borders. Yet imported produce is more than three times as likely as domestic produce to contain harmful bacteria. These figures are especially alarming because we now import nearly 25 percent of the produce that we consume.

Nobody's in charge. Marion Nestle, professor of nutrition, food studies, and public health at New York University, says that part of the problem with the food supply is that there is no agency responsible for looking at the big picture. "It's as if fruits and vegetables and meat and dairy products don't have anything to do with each other. The USDA does meat and the FDA does fruit and vegetables," Nestle says, adding that "If you look at the number of places that need to be inspected, the number of border crossings, the number of people who are crossing the border . . . it's just a huge problem. And the current method that we have for dealing with this is fragmented."

Most experts agree that simply ramping up inspections to appropriate levels here in the United States would be extremely difficult. Marjorie Hoy, professor of entomology at the University of Florida, told me, "Even if we increased [domestic inspections] 10-fold, 20 percent would still be a giant leaky border." A more viable solution would be to have more inspections overseas, particularly of food items.

Dangerous pests and illnesses that enter our country every year are also a threat to our crops. An estimated 50,000 nonnative invasive species cost this country $137 billion a year, affecting both our agriculture and our health. Nonindigenous species can be responsible for introducing new diseases, such as the West Nile virus. "The West Nile virus is an example where pests came in, spread through mosquitoes, and [now] we're going to have to live with it," Hoy says. "Animals will have to be vaccinated, wildlife are being affected, humans are being affected. So it's a long-term permanent cost to our society."

While screening at the border for disease has been effective in detecting cases like SARS and mad-cow disease, the illegal crossings of humans and animals still pose a threat. Smuggled animals and unchecked illegal immigration continue to be a disaster for disease control in this country. Just this year, exotic animals with monkeypox smuggled from Africa infected American prairie dogs, which then infected humans with the disease. Additionally, hundreds of thousands of illegal immigrants cross into the United States without health screening. Today more than 7,000 people in this country suffer from leprosy, once considered a rare disease here. Many of those infected immigrated from areas with leprosy problems, like Mexico and Brazil.

Last year, the Centers for Disease Control and Prevention found that foreign-born people accounted for more than half of all cases of tuberculosis in the United States. In fact, the rate of TB for nonnative-born people in the United States is eight times as high as for people born here. The CDC also found that the top five countries of origin of TB cases were Mexico, the Philippines, Vietnam, India, and China.

Rep. Tom Tancredo, a Colorado Republican, has introduced legislation to help protect our borders. Tancredo told me that the measure would require "a significant increase in the number of border patrol authorized, actually 20,000 authorized." And, "it encourages the president to use the military on the border," he says. Unfortunately, Tancredo has not yet gotten the support for the legislation that he hopes for.

Invasive species and disease from overseas present a largely overlooked risk to our welfare, one that we must vigorously attack on all fronts. At the very least, we need better inspection standards for goods entering this country and better controls on animals and people crossing our borders. Two years after 9/11, our borders are still wide open. That is simply unacceptable.

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