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World Sneezes; U.S. Diners Get Sick

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  • Pamela Rice
    [ Fresh fruits and vegetables, bursting with nutrition, are the fastest-growing source of food-borne epidemics precisely because they lack the most reliable
    Message 1 of 1 , Nov 30, 2003
      ["Fresh fruits and vegetables, bursting with nutrition, are the
      fastest-growing source of food-borne epidemics precisely because they
      lack the most reliable kill step for viruses and bacteria: high-heat
      cooking." Full story below.]

      Copyright 2003 Los Angeles Times

      World Sneezes; U.S. Diners Get Sick
      By Madeline Drexler
      Madeline Drexler is a Boston-based journalist and author of "Secret
      Agents: The Menace of Emerging Infections."

      November 30, 2003

      BOSTON - If it's not the scallions, it's the raspberries,
      strawberries, cantaloupe, watermelon, alfalfa sprouts, lettuce,
      tomatoes, apple cider, orange juice, parsley, basil, cilantro or cole
      slaw. Or perhaps the hamburger, hot dogs, chicken, turkey, milk,
      eggnog, ice cream, cheese, oysters, clams, crab cakes, pastrami or
      macaroni salad.

      So goes a very partial tasting menu of foods that have spawned
      epidemics over the last few years. Put another way, the recent
      outbreak of hepatitis A, in which fecally contaminated green onions
      chopped into salsa killed three and sickened more than 600 customers
      of a Pennsylvania Chi-Chi's restaurant, was just the latest chapter
      in an endless saga of food-borne infections.

      This episode is also emblematic of how such epidemics have evolved in
      recent years. They're global: The offending scallions in Pennsylvania
      came from Mexico. They're diffuse: The same farm's widely distributed
      produce may have launched similar waves of disease in Georgia and
      Tennessee. They're insidious: Many victims didn't even realize they
      were infected, because of the monthlong incubation period of the
      virus. And they're a reminder that the United States desperately
      needs to fortify its border inspections, state health departments and
      assistance to nations that lack our public health resources.

      We often hear that the U.S. has the world's safest food supply. Yet
      according to the federal Centers for Disease Control and Prevention,
      each year 76 million Americans - nearly 1 in 4, and that's a low-ball
      estimate - become infected by their food. Most find themselves
      dolefully memorizing a pattern of bathroom floor tiles. Two million
      suffer drawn-out, sometimes lifelong medical complications. About
      325,000 land in the hospital. More than 5,000 - an average of 14 a
      day - die from eating contaminated food.

      Lately, we've been seeing new patterns of "food poisoning," a
      now-quaint term from the early 20th century, when dramatic illness
      was usually traced to toxins that had grown on spoiled foods such as
      a badly sealed jar of preserves or chicken salad left out too long in
      the summer heat. When local health officials worked up these classic
      "point source outbreaks," they would find that a knot of victims had
      all eaten a single dish.

      Today's epidemics are much more complex, because of profound shifts
      in what we eat, where our food comes from, how it's made and who
      makes it. Fifty years ago, grocery stores stocked about 200 items.
      Seventy percent of those were grown, produced or processed within a
      100-mile radius of the store. Today, the average supermarket carries
      50,000 food items or more. In the winter, as much as 75% of our fresh
      fruits and vegetables are harvested beyond U.S borders, where
      sanitary standards may be less stringent. More and more, an entrée
      may be made with ingredients from a dozen far-flung locales.

      As a result, in our miraculous food economy of scale, when things go
      wrong, they go wrong in a big way. One contaminated tidbit - a shred
      of meat from an infected steer mixed with hundreds of other carcasses
      for hamburger, melting ice from a box of tainted lettuce dripping
      down on the rest of an outbound lot, a soiled production line of
      cereal shipped coast to coast under 30 different brand names - can
      (and have) spread disease far and wide.

      Which means that many modern outbreaks are not so much "point source"
      as pointillist. Mass-distributed items with spotty or low-level
      contamination are consumed by people living far from the source.
      Often, this leads to a new, diffuse kind of epidemic: one with low
      attack rates (less than 5% of those who eat the contaminated food)
      but large numbers of dispersed victims, with the hardest hit being
      the elderly and immune-compromised, who can least afford it. In 1994,
      for example, a single salmonella-contaminated batch of ice cream
      infected an estimated 224,000 people across 48 states.

      So how can we make the world's safest food supply (a disputed claim)
      even safer? Some contend that the main responsibility for preventing
      food-borne illness rests on the individual. They say it's often
      carelessness close to home - either in your kitchen or a restaurant's
      - that inflicts the most damage. Admittedly, culinary negligence is
      rampant. The more we rely on packaged and microwaveable food, the
      faster we forget the temperature and hygiene precautions of 19th
      century home economics, and the more apt we are to mishandle raw
      ingredients. Moreover, changes in work and family life have led us to
      cook less and eat out more - Americans spend more than half of their
      food dollar away from home - exposing us to the ministrations of
      young, often-naive food handlers.

      Yet, pristine food preparation techniques would not have averted the
      Chi-Chi's disaster. The hepatitis A virus in those scallions could
      not have been easily rinsed off or neutralized with chlorine; through
      prolonged soaking in contaminated ice, the virus had probably seeped
      deep inside the onions, just as disease-causing organisms have been
      found in the tissue of alfalfa sprouts, parsley and other perishables.

      Much of today's raw produce is notoriously difficult to clean.
      Raspberries, for example - another recent source of repeat outbreaks
      - are deeply creviced and pitted, providing perfect hideaways for
      pathogens. Fresh fruits and vegetables, bursting with nutrition, are
      the fastest-growing source of food-borne epidemics precisely because
      they lack the most reliable kill step for viruses and bacteria:
      high-heat cooking.

      Clearly, the solution goes beyond individual initiative. Critics of
      American food safety have called for a single independent government
      agency to replace the current patchwork of bureaucracies and fiefdoms
      - the U.S. Department of Agriculture, the Food and Drug
      Administration, the CDC - which are all understaffed and often
      operate at cross-purposes.

      Short of that, the FDA's two new security-minded regulations, one
      requiring importers to specifically describe to the agency what food
      shipments will be arriving at U.S. ports, the other requiring
      registration of domestic and foreign food facilities, may also leave
      us feeling somewhat less queasy when they take effect Dec. 12.

      Another part of keeping the domestic food supply safe would be to
      improve living and working conditions abroad. The epidemic in
      Pennsylvania could have been caused by anything from sewage-laden
      irrigation water to handling by a sick fieldworker who couldn't
      afford to take a day off without pay.

      Note to Congress and the White House: Homeland security isn't just
      about terrorism. It's also about measures that protect us in our
      daily lives. What we call the world's safest food supply is actually
      the world's food supply. In an era of globalization, the tasting menu
      gets longer every day.
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