Epidemiologists from the Centers for Disease Control and Prevention (CDC), writing in the New England Journal of Medicine, said that better traceability, better understanding of how foods become contaminated on farms, and continued exploration of alternative hypotheses during an outbreak are necessary to reduce the impact of such occurrences in the future.
The 2008 Salmonella Saintpaul outbreak linked to jalapeño and Serrano peppers caused about 1,500 illnesses nationwide, and two deaths, according to CDC figures.
“Improvements in product-tracing systems and the ability of the systems to work together are needed for more rapid tracing of implicated products through the supply chain in order to maximize public health protection and minimize the economic burden to industry,” the authors wrote.
Due to early implication of raw tomatoes in the outbreak, the Food and Drug Administration (FDA) initially advised consumers not to eat tomatoes, with a devastating effect on the tomato industry. About a month after the erroneous warning about tomatoes was issued, the investigation led to the discovery of salmonella in Mexican peppers, but by that stage the tomato industry had lost an estimated $100m.
“This outbreak investigation highlights the recurring challenges of epidemiologic identification of ingredients in foods that are commonly consumed, rapid identification and investigation of local clusters, the need to continue exploring hypotheses during an ongoing outbreak, and produce tracing in the supply chain,” the authors wrote.
However, an accompanying editorial in the same issue noted that increasing the speed at which investigators can discover the source of a foodborne illness outbreak requires additional resources, and these cost money. It said that although the recently passed Food Safety Modernization Act provides for “long overdue modernization” of the FDA’s authorities, without the required additional resources, “requiring the FDA to carry out the law’s required activities will be like trying to get blood out of a rock”.
“Although all these new forms of authority will substantially enhance the FDA’s ability to prevent foodborne disease and respond more effectively when an outbreak occurs, the new law has a major shortcoming: dollars,” the editorial said. “There was no appropriation approved by the Congress for the act or authorization in the bill for the FDA to assess fees on the companies that it inspects.”
The CDC estimates that 48m Americans become ill as a result of foodborne pathogens each year, 128,000 are hospitalized, and 3,000 die.
Source: New England Journal of Medicine
Published online ahead of print. 10.1056/nejmoa1005741
“2008 Outbreak of Salmonella Saintpaul Infections Associated with Raw Produce”
Authors: Casey Barton Behravesh, Rajal K. Mody, Jessica Jungk, Linda Gaul, John T. Redd, Sanny Chen, Shaun Cosgrove, et al. for the Salmonella Saintpaul Outbreak Investigation Team.