I had a good talk the R.J. Wilson of Healthway a few weeks ago – love the illustration.

Most of us live in relatively ignorant bliss when it comes to our food. We know that we shouldn’t eat from the salad bar of a seedy motel, for instance, and that we’re better off avoiding fast-food sushi.

Ultimately, however, we don’t really know what happens to our food before it’s presented to us.

Studies show that 76 million people are affected by food illness every year. Those illnesses can be caused by bacteria, viruses, molds, and even parasites—and in some cases, the symptoms are life-threatening.

Food poisoning attorney Bill Marler has seen just about everything. He has represented clients in some of the biggest food safety cases on record, and over time, his professional life has shaped his food preferences.

I have a different relationship with food because of my profession.

In early 2016, Marler compiled a list of six foods that he never eats (although, as we’ll explain shortly, he’s taken occasional liberties with one of those foods). The article quickly went viral, which didn’t surprise the attorney.

“I get asked a lot about what foods I stay away from,” Marler explains to HealthyWay. “It was one of those kind of things where I finally decided to just put them [together], and I came up with six.”

But while Marler thought that the piece would do well, he might not have anticipated its reach.

“My daughter called me and said, ‘Dad, you’re trending [online],’” he recalls. “It was the first time she actually thought I was interesting!”

We spoke with Marler to review the original list—and to find out whether he’s really serious about some of these.

1. The first item isn’t exactly a hard one to pass up…

What’s healthier than raw sprouts? They’re a great addition to any sandwich, right?

Not quite. In the past 20 years, over 30 reported illness outbreaks resulted from sprout consumption, including numerous cases of salmonella and E. coli.

In 2014, 19 people were hospitalized with salmonella poisoning from eating sprouts. Marler warns that there have been too many outbreaks to not pay attention to the risks.

The U.S. government’s consumer food safety website, Foodsafety.gov, includes this warning: “Children, the elderly, pregnant women, and persons with weakened immune systems should avoid eating raw sprouts of any kind (including alfalfa, clover, radish, and mung bean sprouts).”

Of course, the site also notes that cooking the sprouts kills the harmful bacteria, so if you prefer your bean sprouts cooked, you’ve got nothing to worry about.

Plus, sprouts are…well, kind of gross, so we don’t really mind avoiding them. Unfortunately, the list gets harder from here.

2. Marler admits to cheating on this one.

This one isn’t so much about the food as the way it’s prepared.

Pre-cut fruit seems like a great idea, in theory; you get delightfully sliced pieces of perfectly ripened fruit filled with vitamins, minerals, and antioxidants.

However, in his original article, Marler wrote that he avoids pre-cut fruit “like the plague.”

As Marler wrote, the extra handling and processing increases the chances that the fruit will be contaminated. According to the Australian Institute of Food Safety, pre-cut fruit is one of the most common foods associated with foodborne illnesses.

Still, Marler admits that he doesn’t exactly avoid cut fruits “like the plague.” He was using a bit of hyperbole to get his point across.

“If I’m traveling or looking for a quick lunch, sometimes it’s just too convenient,” he says.

He does recommend eating whole fruits instead; that should help people avoid listeria, a bacteria that can cause gastrointestinal and nervous system issues.

3. Ready for a healthy breakfast? Well…sorry in advance.

This one might be hard for some people to stomach; we can’t imagine asking for our eggs over-hard.

Even though much has changed in the way of the handling and processing of eggs nowadays, it wasn’t long ago that people were getting sick from raw eggs. In the early ’80s and ’90s, salmonella was an epidemic, but in 2010, the CDC reported around 2,000 cases of salmonella contamination involving eggs.

Salmonella can live both inside and outside the shells of eggs. Symptoms of salmonella poisoning can last for over a week and include cramps, diarrhea, and fever. Infectious disease experts recommend keeping eggs refrigerated until they’re ready to be prepared.

Marler admits that eggs are getting safer. “[Salmonella in eggs] is less of a problem than it was, say, 10 years ago,” he says. “But it’s still a risk that is, in my view, not worth taking.”

Not to disagree with our expert, but we’ll note that the risk is quite limited. Per Forbes, about one in 20,000 eggs is infected with salmonella. That’s a pretty small number, all things considered. Cooking your eggs (properly) limits the growth of bacteria and reduces the chance of salmonella poisoning.

Still, a representative of Foodsafety.gov tells HealthyWay that eggs still pose a pretty significant risk, particularly to immunocompromised people, and consumers need to understand that risk before partaking.

4. This food trend might seem healthy, but that’s not the case.

Pasteurization removes some of the nutrients in juice and milk and that doesn’t bode well with the super-health-conscious crowd. As a result, raw milk and juices have become more popular over the past few years, despite warnings from the FDA.

Marler argues that there’s no benefit compelling enough to minimize the risks involved with these drinks. Since pasteurization is an important safety procedure that eliminates harmful parasites, bacteria, and viruses from beverages, it would be irresponsible to risk possible infection for a couple of extra nutrients.

Of course, his opinion is informed by his case work. In 1996, Marler fought for several children against the popular beverage company Odwalla. One client developed a serious affliction called hemolytic uremic syndrome (HUS) from drinking unpasteurized apple juice. HUS is caused by E. coli and is linked to anemia and kidney failure.

Ultimately, Odwalla was held responsible and had to pay a $1.5 million fine and another $12 million to the victims.

5. We’ve got bad news for meat eaters.

Although something of a delicacy, rare steak (and other kinds of beef) carry with them a host of potential foodborne pathogens, including listeria, salmonella, and E. coli. Marler recommends steering clear of meat that is cooked rare.

He suggests that steak should only be consumed if it’s medium-well or well, which should kill the harmful bacteria.

It may not be the most delicious way to eat a steak, but Marler says the risks outweigh the rewards. The FDA cautions that red meat needs to be cooked to 145 degrees Fahrenheit (160 degrees for ground meats) in order to be safe.

Ground meat products (like hamburgers and meatloaf) need to be cooked even more thoroughly since bacteria that sits on the surface of the meat is often ground inside of it.

Still, we had to ask: Does he really order all of his steaks well done? Yes, although he recalled one meal in which a restaurant confused his order with his colleague’s.

“They switched the order, and I quickly looked at his steak and my steak and realized it,” Marler recalls. “We had to switch them back.”

6. But Marler received the most complaints for this final item.

Most people know that oysters are not the cleanest food available, but often people don’t realize why. Oysters filter feed, which means they eat (and hold on to) everything that’s in the water—and we mean everything.

When you eat raw oysters, you ingest their bacteria (somewhat obviously). Marler says that he has seen many more issues with the consumption of raw oysters over the last five years as compared to 20 years ago, and he believes that warmer water temperatures are to blame.

Why? Well, higher water temperatures mean more microbial growth, which means more cases of foodborne illness. In order for an oyster to be safe from bacteria and viruses, it must be cooked thoroughly. That reduces the risk of an illness, but doesn’t eliminate it altogether.

“We’re starting to see more cases [involving oysters],” Marler says, noting that, despite the pushback from his friends on the East Coast, he wouldn’t take the mollusks off of his list.

So, would Marler make any changes to this list?

Nope. He says that while he’s seen contamination with specific brands, he doesn’t think he’d make any additions.

“There’ve been lots of outbreaks linked to, for example, soy nut butter,” Marler says. “But [the list] includes things that, historically, in my experience, have been much more risky. They’re involve products that don’t have a ‘kill’ step—they’re not cooked.”

He also says that while he’s fairly strict about his own diet, he doesn’t ask his friends to order differently at restaurants.

“Most people know what I do, and they either don’t care or they change their order,” Marler says with a laugh. “I have a different relationship with food because of my profession.”

Perhaps I need to add in flour in cookie dough?

  1. Safely Thaw Your Turkey

Thaw turkeys in the refrigerator, in a sink of cold water that is changed every 30 minutes, or in the microwave. Never thaw your turkey by leaving it out on the counter. A frozen turkey is safe indefinitely, but a thawing turkey must defrost at a safe temperature. When the turkey is left out at room temperature for more than two hours, its temperature becomes unsafe as it moves into the danger zone between 40°F and 140°F, where bacteria can grow rapidly.

  1. Safely Handle Your Turkey

Raw poultry can contaminate anything it touches with harmful bacteria. Follow the four steps to food safety – cook, clean, chill, and separate – to prevent the spread of bacteria to your food and family.

  1. Safely Stuff Your Turkey

Cooking stuffing in a casserole dish makes it easy to make sure it is thoroughly cooked. If you put stuffing in the turkey, do so just before cooking. Use a food thermometer to make sure the stuffing’s center reaches 165°F. Bacteria can survive in stuffing that has not reached 165°F and may then cause food poisoning. Wait for 20 minutes after removing the bird from the oven before removing the stuffing from the turkey’s cavity; this allows it to cook a little more. Learn more about how to prepare stuffing safely.

  1. Safely Cook Your Turkey

Set the oven temperature to at least 325°F. Place the completely thawed turkey with the breast side up in a roasting pan that is 2 to 2-1/2 inches deep. Cooking times will vary depending on the weight of the turkey. To make sure the turkey has reached a safe internal temperature of 165°F, check by inserting a food thermometer into the center of the stuffing and the thickest portions of the breast, thigh, and wing joint. Let the turkey stand 20 minutes before removing all stuffing from the cavity and carving the meat. Learn more about safe minimum cooking temperatures and how to use a food thermometer for turkey and other foods.

  1. Take Care with Leftovers

Clostridium perfringens are bacteria that grows in cooked foods left at room temperature. It is the second most common bacterial cause of food poisoning. The major symptoms are vomiting and abdominal cramps within 6 to 24 hours after eating.

  • Clostridium perfringens outbreaks occur most often in November and December.2
  • Many of these outbreaks have been linked to foods commonly served during the holidays, such as turkey and roast beef.

Refrigerate leftovers at 40°F or colder as soon as possible and within two hours of preparation to prevent food poisoning.

Use a food thermometer to check for a safe internal temperature.

 Thanks to CDC

Homelessness in the greater Seattle/King County region seems to be rising as fast as High-Tech jobs and housing prices.  There are estimated to be 3,000 people in Seattle each night who are unsheltered and about 10,000 homeless people living on either the streets or in shelters. And, as the nights grow wetter and colder, the lives of our fellow citizens grow even more precarious.  Clearly, homelessness is a complex issue that combines various elements of poverty, substance abuse and mental health, however, now, enters yet another concern – public health – specifically, the growing risk of hepatitis A amongst the homeless, and the risk that it will spread.

It is what is happening in other regions and the risk that it could happen here is real.

In the Detroit, Michigan area there have been 486 cases of hepatitis A, including 19 fatalities, identified as related to an outbreak in Southeast Michigan, according to the Michigan Department of Health and Human Services. In October, health officials said they were investigating cases at Firewater Bar and Grill and a Little Caesars Pizza location in Detroit and a restaurant worker in Ann Arbor. Cases were also linked to Whole Foods in Detroit and Social Kitchen in Birmingham and recently at Champs Rotisserie and Spirits in Wayne County.

In San Diego, California, the county Health and Human Services Agency published new weekly totals, which add one to the number of deaths recorded since the health crisis started in November 2016. The running tally of confirmed cases also continues to increase, reaching 536 from a previous total of 516 – including 20 deaths. On September 15th, the county notified the public that a worker at World Famous restaurant in Pacific Beach had tested positive.

And, thanks to the Huffington Post, you can see the problem in the whole country:

Hepatitis A is preventable with a vaccine and/or good sanitation and/or handwashing. Hepatitis A is a communicable — or contagious — disease that often spreads from person to person. Person-to-person transmission occurs via the “fecal-oral route,” while all other exposure is generally attributable to contaminated food or water.

Hepatitis A is relatively stable and can survive for several hours on fingertips and hands. It can live up to two months on dry surfaces. The virus can be inactivated by heating to 185 degrees F (85°C) or higher for one minute, or disinfecting surfaces with a 1:100 dilution of sodium hypochlorite (household bleach) in tap water. Freezing does not kill the virus.

The vaccine is recommended by public health officials for the following people:

  • Travelers to areas with increased rates of hepatitis A;
  • Men who have sex with men;
  • Injecting and non-injecting drug users;
  • Persons with clotting factor disorders;
  • Persons with chronic liver disease;
  • Persons with occupational risk of infection;
  • Children living in regions of the U.S. with increased rates of hepatitis A; and
  • Household members and other close personal contacts.

So, what can we do to prevent the tragedies that have hit California and Michigan hard and appear to be spreading to other areas of the country?

  • Encourage and offer hepatitis A vaccines to the homeless and other at-risk members of the public;
  • Provide sanitary bathroom and handwashing facilities to the homeless; and
  • Provide assistance to our neighbors to deal with the underlying issues of poverty, substance abuse and mental health.

On March 7, 2017, The SoyNut Butter Company recalled all varieties of I.M. Healthy SoyNut Butters and all varieties of I.M. Healthy Granola products. On March 10, 2017, The SoyNut Butter Company expanded its recall to include Dixie Diner’s Club brand Carb Not Beanit Butter.  This after poisoning over 30 people – mostly kids – several that suffered from acute kidney failure.

The recall notice, drafted by I.M. Healthy, on the FDA website did not mention where the tainted product was sold.  Nearly six months later Food Safety News reported on September 5: “Earlier today, Amazon.com was still selling I.M. Healthy soy nut butter that was recalled in March when federal officials traced an E. coli outbreak to the product.”  Then on September 26 a friend of a client whose son nearly died from consuming the soy nut butter found the product on “Close Out” at Lucky’s Market on 200 Woodside Rd, Redwood City, CA 94061.

So, why does the FDA not release the names of retailers to retailers and consumers during a recall and/or an outbreak?

Caitlin Dewey of the Washington Post asked the same question in March of this year – “Why the FDA hides the names of grocery stores that sell contaminated food.”  I reread it today and it still makes my head hurt.

According to Caitlin: The FDA does not specify, however, which stores, centers or schools — because that would violate its interpretation of an obscure trade secret rule. 

This interpretation differs from that of other agencies in the federal food safety system, an overlapping and often illogical network of regulatory fiefdoms. The system, which is responsible for keeping food free of bacteria and other pathogens, frequently has to weigh the very real interests of private food companies against potential risks to the public. In the case of releasing retailer lists during major outbreaks, the FDA has historically sided with business, ruling that such lists constitute “confidential commercial information” and thus should not be available for public consumption. 

Critics say that the agency’s unwillingness to share this information poses a clear danger to public health, particularly in cases like the current E. coli outbreak, where parents may not know if their child consumed the recalled product.

 “Our mantra is that a more transparent food system is a safer food system,” said Thomas Gremillion, the director of food policy at the Consumer Federation of America. “And there are lots of instances where having that distribution list would help victims of food-borne illness.”

The FDA’s current recall process has been in effect for years, though the agency did gain more recall authority under the FDA Food Safety Modernization Act of 2011. It is, for the most part, a voluntary system — which means there’s some variance in how quickly recalls happen. While most companies are highly motivated to clean up any contamination, it takes time to evaluate and respond to possible threats. And that time can be multiplied several times over if a product has moved through the hands of several distributors, manufacturers or other middlemen, an issue that the FDA was faulted for in a June 2016 alert by the Inspector General’s Office.

When a company does issue a recall, it has wide latitude over the amount of information it shares; in some cases, a recall will never be made public. Recalls that are made public typically contain a description of the product and an explanation of the problem. But companies are not required to reveal where the product was sold — whether to a store, a school, a restaurant or another manufacturer that put it in other products.

The recall for SoyNut Butter, for instance, says that “products were distributed in multiple states and may have been purchased in stores or through mail order. They were also distributed to childcare centers and schools in multiple states.” Those states include Virginia and Maryland, where two people have fallen ill. I.M. Healthy did not respond to a phone call or email requesting comment, though a statement on its website called the contamination “deeply concerning” and said that the company had immediately issued a recall. A list compiled by the site eFoodAlert claims that the product was sold at a number of major grocery chains, including Kroger, Giant and Whole Foods.

“Industry argues that they don’t want to turn over who they sell to, because competition will know and try to undercut them,” said Bill Marler, a prominent food safety lawyer who is representing the parents of one of the children sickened in the SoyNut outbreak. “That’s all well and good under normal circumstances. But those rules should not and do not apply to a product that could cause people to become ill.”

In a statement to The Washington Post, the FDA affirmed that it believes its disclosure measures are sufficient and blamed the lack of downstream recall information on federal disclosure rules. Federal regulations do limit the sort of information that can be released to the public. Under the Freedom of Information Act and Title 21 of the Code of Regulations, government agencies — and specifically, the FDA — are told to exempt trade secrets and commercial information from any of their releases.

“Examples of [confidential consumer information] include raw material supplier lists, finished product customer lists, trace back information, etc.,” said Peter Cassell, a spokesman for the FDA. “CCI is exempt from Freedom of Information Act requests, but can be shared through certain information sharing agreements (including with other Federal agencies).”

“The FDA publicizes recall notices, including pictures of affected products, and uses social media accounts to reach consumers as swiftly as possible,” he later added. “In some cases, the FDA can release certain information that is otherwise exempt from disclosure if it is necessary to effectuate a recall. In many cases, it is most efficient for the company to directly notify its distributors so they can take appropriate action.”

Cassell declined to make an agency lawyer available for comment or explain how the FDA had arrived at its definitions. But it’s probably worth noting that when another agency considered similar precedents, it came to different conclusions.

In the early 2000s, the Food Safety and Inspection Service — the branch of the U.S. Department of Agriculture that regulates meat, poultry and egg products — decided to revisit its own interpretation of the trade secrets rule. During a lengthy comments period, industry groups concerned with protecting their distribution lists from competitors faced off against consumer advocates. In 2008, after several years of debate, FSIS’s final rule concluded that it would “not cause substantial harm to the competitive position of any business” to disclose retailer names.

“FSIS now routinely posts these lists,” said Deirdre Schlunegger, the chief executive of STOP Foodborne Illness, an advocacy group for patients that lobbied FSIS 10 years ago. “We obviously believe consumers should have as much information as possible to make safe food decisions.”

Today, when FSIS issues a Class I recall — those that seem “reasonably” likely to cause health problems — it also issues a list of all the retail locations that have, or have had, the product. During last month’s massive cheese recall, for instance, FSIS published a list of every Safeway, Albertsons and Pak ’n’ Save that sold Taylor Farms salads containing Sargento pepperjack. But because FDA regulates the cheese itself, there was no such list of stores that sold the cheese outside salads.

“It does makes me wonder why the FDA can’t do the same,” said Sandra Eskin, the director of the Safe Food Project at Pew Charitable Trusts. “The fundamental issue is — is this information important to consumers during a recall? I would argue yes.”

But the man who led the effort to reform FSIS’s traded secrets rule has his own suspicions as to why the FDA hasn’t followed his lead. Richard Raymond, who was the undersecretary of agriculture for food safety under President George W. Bush, says that the fiercest opposition to the change came from the food industry. Raymond, who had been the chief medical officer in his home state of Nebraska, came to Washington, D.C., determined to change the rules on confidential information. He found himself surprised by the level of resistance.

“They were scared to death it would hurt their business,” Raymond said. “The retail stores want to protect their brand. … When you ask why FDA hasn’t done it, I suspect they don’t want that fight themselves.”

The FDA did not respond to Raymond’s comment by press time. But Gremillion, of the Consumer Federation, would like to see the agency take action.

“Why do confidential business interests trump public health in some cases and not others?” he asked. “We need more transparency around this.

I think it is past time for the FDA and the industries it oversees to be transparent – willingly or not.

There are now 16 dead with 292 sickened with hepatitis A in San Diego – mostly in the ignored homeless population. And, the numbers of people with this preventable disease is spiking in Colorado (57 ill with 1 death), Michigan (319 ill with 14 deaths), New York (46 ill) and other states and cities (Los Angeles has at least 10 sick, Salt Lake City 21).  Lately, we have also seen the spread to food service workers, potentially exposing hundreds of unsuspecting consumers.

This is all preventable.

In 2006, health officials recommended routine hepatitis A vaccination for all children ages 12-23 months, that hepatitis A vaccination be integrated into the routine childhood vaccination schedule, and that children not vaccinated by two years of age be vaccinated subsequently. The vaccine is also recommended for the following persons:

  • Travelers to areas with increased rates of hepatitis A
  • Men who have sex with men
  • Injecting and non-injecting drug users
  • Persons with clotting factor disorders
  • Persons with chronic liver disease
  • Persons with occupational risk of infection
  • Children living in regions of the U.S. with increased rates of hepatitis A
  • Household members and other close personal contacts

The vaccine may also help protect household contacts of those persons infected with hepatitis A. Although generally not a legal requirement at this time, vaccination of food handlers would be expected to substantially diminish the incidence of hepatitis A outbreaks.

Although outbreaks continue to occur in the United States, no one should ever get infected if other preventive measures are taken. For example, food handlers must always wash their hands with soap and water after using the bathroom, changing a diaper, and certainly before preparing food. Food handlers should always wear gloves when handling or preparing ready-to-eat foods, although gloves are not a substitute for good hand washing. Ill food-handlers should be excluded from work.

Hepatitis A is a communicable (or contagious) disease that often spreads from person to person. Person-to-person transmission occurs via the “fecal-oral route,” while all other exposure is generally attributable to contaminated food or water. Food-related outbreaks are usually associated with contamination of food during preparation by a HAV-infected food handler. The food handler is generally not ill because the peak time of infectivity—that is, when the most virus is present in the stool of an infected individual—occurs two weeks before illness begins.

Fresh produce contaminated during cultivation, harvesting, processing, and distribution has also been a source of hepatitis A. In 1997, frozen strawberries were the source of a hepatitis A outbreak in five states. Six years later, in 2003, fresh green onions were identified as the source of a hepatitis A outbreak traced to consumption of food at a Pennsylvania restaurant. Other produce, such as blueberries and lettuce, has been associated with hepatitis A outbreaks in the U.S. as well as other developed countries.

HAV is relatively stable and can survive for several hours on fingertips and hands and up to two months on dry surfaces. The virus can be inactivated by heating to 185°F (85°C) or higher for one minute, or disinfecting surfaces with a 1:100 dilution of sodium hypochlorite (household bleach) in tap water. It must be noted, however, that HAV can still be spread from cooked food if it is contaminated after cooking.

So, for Goodness Sake, Vaccinate Against Hepatitis A

Islamic State leaders are reportedly asking its followers to carry out terror attacks by poisoning food in Western supermarkets.  It is not like poisoning our food has not happened before and we certainly have been warned.  In 2011 Secretary of State Hillary Clinton warned of infectious disease outbreaks caused by pathogens falling into the wrong hands and into our food. She said:

“Unfortunately the ability of terrorists and other non-state actors to develop and use these weapons is growing. Therefore this must be a renewed focus of our efforts.”

“Because there are warning signs and they are too serious to ignore.”

“Al Qaeda in the Arabian Peninsula had urged brothers with degrees in microbiology or chemistry to develop a weapon of mass destruction.”

Sound familiar? It should. In 2004 Health and Human Services Secretary Tommy Thompson warned of food-related terrorist attacks. He said:

“For the life of me, I cannot understand why the terrorists have not attacked our food supply because it is so easy to do.”

It reminded me of an Op-ed I did for Forbes a year or so ago:

Imagine this: At 10:00 PM, after yet another story about Donald Trump, a foreign TV network begins airing a video taken inside a facility showing someone treating wash water in a cucumber packing house with an unknown liquid. There is a claim that this was the terrorist act that has so far sickened 341 and killed 2 in 30 states with Salmonella.

In the next 15 minutes, every network news operation is playing the video. The broadcast networks break into regular programming to air it, and the cable news stations go nonstop with the video while talking heads dissect it. The Donald fades into the distance.

Coming on a Thursday evening on the East Coast, the food terrorism story catches the mainstream Media completely off guard. Other than to say the video is being analyzed by CIA experts, and is presumed to be authentic, there isn’t much coming out of the government.

Far-fetched? Don’t count on it. I have been saying for years that a foodborne illness outbreak will look just like the terrorist act described above, but without the video on FOX News.

Tell that to the 751 people in Wasco County, Oregon—including 45 who required hospital stays—who in 1984 ate at any one of ten salad bars in town and were poisoned with Salmonella by followers of Bhagwan Shree Rajneesh. The goal was to make people who were not followers of the cult too sick to vote in county elections.

Tell that to Chile, where in 1989, a shipment of grapes bound for the United States was found laced with cyanide, bringing trade suspension that cost the South American country $200 million. It was very much like a 1970s plot by Palestinian terrorists to inject Israel’s Jaffa oranges with mercury.

Tell that to the 111 people, including 40 children, sickened in May 2003 when a Michigan supermarket employee intentionally tainted 200 pounds of ground beef with an insecticide containing nicotine.

Tell that to Mr. Litvenenko, the Russian spy poisoned in the UK with polonium-laced food.

Tell that to Stanford University researchers who modeled a nightmare scenario where a mere 4 grams of botulinum toxin dropped into a milk production facility could cause serious illness and even death to 400,000 people in the United States.

The reason I bring this up is not to mark another anniversary of 9/11. I raise the issue not because I actually think that food terrorism is the cause of this week’s Salmonella cucumber outbreak. However, I wonder if it would have made any difference in our government’s ability to figure out there was an outbreak, to figure out the cause, and to stop it before it sickened so many.

After 9/11, Health & Human Services Secretary Tommy G. Thompson said: “Public health is a national security issue. It must be treated as such. Therefore, we must not only make sure we can respond to a crisis, but we must make sure that we are secure in defending our stockpiles, our institutions and our products.”

Before Thompson’s early exit from the Bush Administration, he did get published the “Risk Assessment for Food Terrorism and Other Food Safety Concerns.” That document, now 5-years old, let the American public know that there is a “high likelihood” of food terrorism. It said

the “possible agents for food terrorism” are:

  • Biological and chemical agents
  • Naturally occurring, antibiotic-resistant, and genetically engineered substances
  • Deadly agents and those tending to cause gastrointestinal discomfort
  • Highly infectious agents and those that are not communicable
  • Substances readily available to any individual and those more difficult to acquire, and
  • Agents that must be weaponized and those accessible in a use able form.

After 9/11, Secretary Thompson said more inspectors and more traceability are keys to our food defense and safety. To date, we’ve made some, but not enough movement to ensure this.

Would the fact of terrorists operating from inside a manufacturing facility somewhere inside the United States bring more or effective resources to the search for the source of the Salmonella? If credit-taking terrorists were putting poison on our cucumbers, could we be certain Uncle Sam’s response would have been more robust or effective then if it was just a “regular” foodborne illness outbreak?

Absolutely not! The CDC publicly admits that it manages to count and track only one of every forty foodborne illness victims, and that FDA inspectors miss key evidence as outbreaks begin. The FDA is on record as referring to themselves as overburdened, underfunded, understaffed, and in possession of no real power to make a difference during recalls. If you are a food manufacturer, packer, or distributor, you are more likely to be hit by lightning than be inspected by the FDA. You are perfectly free to continue to sell and distribute your poisoned product, whether it has been poisoned accidentally or intentionally.

The reality is that the cucumber Salmonella outbreak is a brutal object lesson in the significant gaps in our ability to track and protect our food supply. We are ill prepared for a crisis, regardless of who poisons us.

So, what can we do?  Since we inspect only about 1% of imported food that food could be tainted with biological or chemical agents before entering the United States. Given, also the lack of inspections domestically, toxins could easily be introduced in food at the farm, in transit, at processing plant or in restaurants.

More and better inspections by FDA and FSIA inspectors at various points in our food supply are absolutely necessary, as is good intelligence work by those at the CDC and FBI. However, when a terrorist uses a biological or chemical weapon against the civilian population – in food or otherwise, how quickly the outbreak is detected, analyzed, understood and addressed would be the responsibility of state and local public health offices and the CDC. Surveillance would be the key to limiting the damage and bringing the terrorists to justice.

We need to invest in the science of epidemiology and the surveillance of biological and chemical illnesses. We need to increase our laboratory capacity for biological and chemical agents, and our ability to quickly track patterns of potential illnesses. And, we need to strengthen the teamwork between state, local and federal health officials so outbreaks are caught early.

Perhaps a foodborne bio-terrorism event cannot be stopped, but with investments in surveillance, the event can be minimized.

I’m not sure I will get through what I plan on saying today at Dave’s Memorial, so I thought I would put it here:

Funerals are painful, and our hearts go out to Jill and the entire Theno clan. We all share just a small part of your grief.

Funerals are also uncomfortable, because they remind us all of life’s fragile nature and of all the things we should have said too so many.  Especially as we grow older, we think of all the deeds that we have not done, and the ever – decreasing time to do them.

However, we are here today to honor our friend Dave, who unlike most of us, left nothing undone and leaves this life a hero.  Dave was honored by so many.  Here are just a few:

  • NSF Lifetime achievement award
  • American Association of Food Hygiene Veterinarians
  • American Meat Science Association
  • International Association of Food Protection
  • International Meat & Poultry HACCP Alliance
  • Institute of Food Technologists
  • National Advisory Committee on Meat & Poultry Inspection
  • National Advisory Committee for Microbiological Criteria for Foods
  • National Cattlemen’s Beef Association’s Beef Industry Food Safety Council
  • National Meat Association
  • Black Pearl Award by the International Association of Food Protection
  • Innovator of the Year Award from Nation’s Restaurant News
  • California Environmental Health Association’s Mark Nottingham Award
  • Nation’s Restaurant News “Top 50 Players”
  • STOP’s Hero Award and Scholarship

And, this coming year Dave was due for even more deserved recognitions.

Of course, many in the food safety community’s most poignant visual, and most vivid memory, is of Dave asking a picture of Lauren what was the right thing to do.  However, Dave always knew what the right thing to do was, and Lauren was always beside him to confirm it.

In the end, Dave’s profile will not be etched into Mount Rushmore or on the Washington D.C. Mall – but it should be.  Why?  Because Dave’s life’s work saved countless lives and will continue to do so long after all of us have attended our own funerals.

Dave is and will be missed, but he will always be a hero remembered.

I dropped an Op-ed on the Hill this morning.  Here is an excerpt:

This week the CDC reported that at least 47 people were stricken with Salmonella, with one death, likely linked to papayas imported from Mexico. In the summer of 2016 came reports of hepatitis A tainted scallops sickening 292 in Hawaii. In that outbreak two died of liver failure complications. And, also in 2016, 143 people, mostly in Virginia, were also stricken with hepatitis A. This time the culprit was hepatitis A-tainted strawberries imported from Egypt.

While most food we consume is still produced in the United States, we rely on imports for some of our most nutritionally important but more risky commodities. And, imported food is increasingly taking a larger “bite” out of our food consumption. We now import over 90 percent of our seafood, 50 percent of our fresh fruit and 20 percent of our vegetables. Canada, Mexico, China and India are our top food trading partners. In 2014, we imported nearly $50 billion of food from just those four countries. Imports from all countries have increased, and that is especially true for China and India.

I am off to IAFP on Sunday.  I’m doing a “Point/Counterpoint” on what responsibility consumers have for food safety.

Who’s to Blame? Do Consumers own a Piece of Food Safety?

Lawyers Who Are Changing the World

By Jeff Tolman

I have great respect for people who take control of their lives and create a successful life and practice in the changing and evolving legal universe. That would be Bill Marler, Senior Partner at Marler Clark, The Food Safety Law Firm, in Seattle. Bill is considered the most prominent foodborne illness lawyer in America and a major force in food policy in the U.S. and around the world. Wondering if as a youngster he was innately interested in food and food poisoning – and, if not, how in the world he got into this niche practice – I gave Bill a call.

Bill grew up in Silverdale, WA, less than 10 miles from my office, the son of a Navy nurse and Marine Sergeant, both later teachers. After graduating from Olympic College in Bremerton, WA, Bill attended Washington State University. He graduated with three majors due to the fact he was elected to the Pullman City Council as a 19-year-old student and he was determined to fill out his term. After working as a paralegal in a Seattle law firm (Bog;e and Gates) for a year, Bill went to law school and received his J.D. from Seattle University School of Law in 1987. From 1987 to 1998 Bill worked in a variety of firms including Dick Krutch; McKay and Gaitan, Keller Rohrback; Perey Law Group; and Kargianis, Osborne, Watkins & Marler.

His first big civil case related to two children killed by Westley Allan Dodd. Bill decided to go right to the horse’s mouth and met with Dodd in the Washington State Penitentiary in Walla Walla, and for five hours heard about Dodd’s various contacts with the legal system. Determining the state of Washington had failed in its duty to monitor Dodd, resulting in the murders, a settlement was reached for the family of the victims.

Then came the 1993 E. coli outbreak at Jack-in-the-Box restaurants. Within a day Bill’s investigation led him to file a lawsuit and he became the face of that litigation. Sometime later, in two days of mediation, the plaintiffs received $23 million in settlements. Bill’s reputation as a foodborne illness go-to lawyer was cemented. Now, he said, there is not a significant outbreak of foodborne illness that isn’t touched by his firm.

In 1998 Marler Clark was formed, initially with four lawyers and four staff, now with six lawyers.

Bill is an enthusiastic, charming, ebullient, charismatic speaker. I wish we could have spoken for another hour or two. He was in Houston, speaking to a conference of food safety agencies. His schedule a week before and after our conversation took him all over America as a lawyer, speaker and advocate for food safety.  His next stop was Utah where he is representing a group of victims of food poisoning from a store’s chicken salad, including a 20-year-old woman who became brain injured, unable to work and unable to bear children as the result of the poisoning.

Bill indicated that the foodborne illness litigation is a small community of plaintiff and defense specialists where collegiality and professionalism still reign. He would recommend becoming a lawyer (he has a daughter who plans to take the LSAT) if you go in with your eyes open. Ask yourself: What do you want to do in your career? Can you afford to get a law degree?

Describing his life, he says, “I travel all over the world trying to convince companies that it’s a really bad idea to poison people.”

Not a bad goal to have. Not a bad way to spend a professional life.