Marler Blog - Providing commentary on food poisoning outbreaks & litigation

In February 2007, a case-control study with 65 patients and 124 controls was conducted to identify the food item associated with illness; the majority of interviews were completed by state and local health departments and were coordinated by CDC. For the study, a case was defined as infection with the outbreak strain of Salmonella Tennessee in a person aged >18 years with a history of diarrhea. Controls were well adults from the patient's community who were matched by geographic location. Controls were identified using a reverse online telephone directory that when given an address provided telephone numbers for residences in the same extended neighborhood as the patients. The median ages for the patients and controls were 53 and 58 years, respectively. Patients were more likely than controls to have eaten peanut butter (81% versus 65%, matched odds ratio [mOR] = 1.9, 95% confidence interval [CI] = 0.8--5.2), to have eaten peanut butter more than once a week (66% versus 40%, mOR = 3.5, CI = 1.4--9.9), and to have eaten either Peter Pan or Great Value peanut butter (67% versus 13%, mOR = 10.9, CI = 3.8--43.0). Neither the consumption of other peanut butter brands nor consumption of turkey products was associated with illness.

Epidemiologic data suggesting Peter Pan brands of peanut butter as the possible source of the outbreak were provided to FDA officials on February 13, 2007. The following day, FDA issued a health alert to consumers indicating that they should not eat Peter Pan or Great Value peanut butter with a product code beginning with 2111, both of which were manufactured in a single facility in Georgia operated by ConAgra Foods. ConAgra Foods voluntarily recalled the products, destroyed existing products in their possession, and temporarily halted production pending further investigation.

I have learned that the current Salmonella Tennessee case stool and urine positives (substantial numbers of ill people had urinary tract infections instead of stool cultures) have raised to 563 in 47 States. The first reported case is in August 2006 and remaining constant, but low, through September, spiking in October, November, December and then starting to trend down in January and February 2007. There does not appear to be a significant number of matched Salmonella Tennessee cases pre-August 2006 (ten in August and thirteen January to July 2006 and thirty cases in 2005) that are EPI-linked to Peanut Butter despite the recall date being extended to October 2004 (I am not aware of many matched Salmonella Tennessee cases in 2004, although there may well be a few).

The CDC reported in a statement March 7, 2007, that 425 people in 44 states had been infected with the strain of Salmonella Tennessee also found in Peter Pan and Great Value peanut butter products, and that 71 people had been hospitalized and no deaths. FDA investigators in the Con Agra plant also found that same Salmonella strain, but where it was located has not been announced. Two-thirds of the reported 425 cases began after December 1, 2006.

Putting this in context, the CDC estimates that 76 million foodborne illness, or food poisoning, cases occur in the United States every year (6.3 million per month), which means that one in four Americans contracts a foodborne illness annually after eating foods contaminated with such pathogens as E. coli O157:H7, Salmonella, Hepatitis A, Campylobacter, Shigella, Norovirus, and Listeria. Approximately 325,000 people are hospitalized with a diagnosis of food poisoning, and 5,000 die.

The CDC also reports that 40,000 cases of Salmonella are confirmed yearly in the U.S. As only about 3% of Salmonella cases are officially confirmed nationwide, and many milder cases are never diagnosed, the true incidence is undoubtedly much higher (approximately 1.4 million per year or 110,000 per month). It is estimated that 1,000 deaths are caused by Salmonella infections in the U.S. every year.

Last year's string of outbreaks of E. coli bacteria in the U.S. food supply have left many questions in the minds of Americans. But limited resources and other food contamination outbreaks left the Food and Drug Administration with no real answers.  In 2006, E. coli-contaminated lettuce served at a Taco John's restaurant sickened 81 people in Minnesota. Around that time, there were also outbreaks in spinach, then later peanut butter. The most recent outbreak was in a large portion of the nation's pet food supply.

In most cases, officials from the Food and Drug Administration and the Centers for Disease Control & Prevention have confirmed where the culprit food originated.  For instance, an investigation found that the tainted Taco John's lettuce most likely came from a farm in Central California. But the agencies have yet to unearth how these foods became contaminated and what can be done to prevent further contaminations.

Some have criticized the way these agencies handled the cases but officials said they are simply doing what they can with what they have.  One attorney, who has worked several contamination lawsuits involving the lettuce contamination, said investigations are typically slow. Bill Marler, a Seattle, Washington, attorney specializing in food-poisoning cases, said he has yet to get results from a 2005 Dole lettuce outbreak.

He told CNN, "You'd think that after so many outbreaks, the government and the leafy green industry would do something about this."

• California produce, it seems, has a problem with E. coli 0157:H7, which is most commonly found in cattle feces. Since 1995 there have been more than 20 outbreaks of E. coli in lettuce and leafy greens traced back to farms in that state.

• In 2001, the Centers for Disease Control and Prevention issued a “Compendium of Measures To Prevent Disease Associated with Animals in Public Settings” in an October Morbidity and Mortality Weekly Report.

• In 2003, authors of a study on the prevalence of E. coli O157:H7 in livestock at 29 county and 3 large state agricultural fairs in the United States found that E. coli O157:H7 could be isolated from 13.8% of beef cattle, 5.9% of dairy cattle, 3.6% of pigs, 5.2% of sheep, and 2.8% of goats. Over seven percent of pest fly pools also tested positive for E. coli O157:H7 (Keene et al, 2003).

• In 2004, Marler Clark launched www.fair-safety.com, a Web site designed to inform users of the risks related with human-animal contact in fair and petting zoo settings.

• Also in 2004, Marler presented on legal liability at the International Association of Fairs and Expositions’ 114th Annual Convention and Trade Show.

“You live in the United States of America and this isn’t supposed to happen. There is an assumption that everything is going to be O.K., that someone must have checked this out, but it is not the case.”

Attorney and food safety activist William Marler  [of Marler Clark in Seattle Washington] uses an alarming comparison when urging people not to eat bagged spinach. "Buying spinach is like being married to the same person for 30 years," Marler said. "But buying bagged spinach is like dating 30 people in a month."

At least 2.5 million broiler chickens from an Indiana producer were fed pet-food scraps contaminated with the chemical melamine and subsequently sold for human consumption, federal health officials reported Tuesday. Hundreds of other producers may have similarly sold an unknown number of contaminated poultry in recent months, they added, painting a picture of much broader consumption of contaminated feed and food than had previously been acknowledged in the widening pet-food scandal.

100,000 Indiana chickens that ate the melamine-laced food and are still alive have been quarantined and will be destroyed as a precautionary measure, as will any other animals that turn up as the investigation continues to expand.