People, not Statistics, became Sick and Died in the Listeria Cantaloupe Outbreak

According to the CDC’s final report, a total of 146 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes were reported to CDC from 28 states. The number of infected persons identified in each state was as follows: Alabama (1), Arkansas (1), California (4), Colorado (40), Idaho (2), Illinois (4), Indiana (3), Iowa (1), Kansas (11), Louisiana (2), Maryland (1), Missouri (7), Montana (1), Nebraska (6), Nevada (1), New Mexico (15), New York (2), North Dakota (2), Oklahoma (12), Oregon (1), Pennsylvania (1), South Dakota (1), Texas (18), Utah (1), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (4).

Among persons for whom information was available, reported illness onset ranged from July 31, 2011 through October 27, 2011. Ages ranged from <1 to 96 years, with a median age of 77 years. Most ill persons were over 60 years old. Fifty-eight percent of ill persons were female. Among the 144 ill persons with available information on whether they were hospitalized, 142 (99%) were hospitalized.

Thirty deaths were reported: Colorado (8), Indiana (1), Kansas (3), Louisiana (2), Maryland (1), Missouri (3), Nebraska (1), New Mexico (5), New York (2), Oklahoma (1), Texas (2), and Wyoming (1). Among persons who died, ages ranged from 48 to 96 years, with a median age of 82.5 years. In addition, one woman pregnant at the time of illness had a miscarriage.

Two more have died since the CDC’s report became final. It is likely that the CDC will never count them, but they should.

Lest we forget, this outbreak was much more than statistics.

Listeria Cantaloupe from Marlerclark on Vimeo.

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Vitor Belfort with Hepatitis A - "in two weeks I am back in the gym." Not So for Everyone

vitor-belfort1.jpgAccording to press report, in a series of Twitter messages issued today, former UFC champion and recent contender Vitor Belfort (19-9 MMA, 8-4 UFC) revealed that he has contracted hepatitis A – a “moderately” serious infection caused by contaminated food or water that's often mistaken for the flu.

The illness will keep Belfort from cornering Randy Couture in Toronto this Saturday at UFC 129, though it won't endanger his fight with Yoshihiro Akiyama (13-3 MMA, 1-2 UFC) at UFC 133, which takes place Aug. 6 at Wells Fargo Center in Philadelphia.

In fact, Belfort wrote today that the illness is a minor bump in the road.

"Guys I just want to let u know that ... hepatitis A is easy to treat so don't worry, in two weeks I am back in the gym," he stated.

Not so for everyone.  In late October 2003, Beaver County ER doctors reported an alarming number of Hepatitis A cases. Investigators from the Pennsylvania Department of Health initiated an investigation immediately and discovered that many, if not all, cases had eaten at Chi Chi’s restaurant in Monaca, Pennsylvania’s Beaver Valley Mall. Along with the health department, the federal Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) conducted further studies of the outbreak. Preliminary analysis of a case-control study suggested that green onions were the probable source of the outbreak. The onions had been shipped to the restaurant in boxes and were stored and refrigerated in buckets of ice. They were eventually chopped up and served in various dishes at the restaurant, often uncooked, as in the preparation of mild salsa. “Preliminary trace-back information indicated that the green onions supplied to Chi Chi’s had been grown in Mexico.” Ultimately, over 650 people were sickened in the outbreak. The victims included at least thirteen Chi Chi’s employees and numerous residents of six other states. Four people died from their injuries, and more than 9,000 people obtained immune globulin shots as protection against the virus. This is the story of one of those cases.

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Food Safety - "Where's the Cash?"

The Food Safety Act of 2010 (an amalgam of S. 510, with Tester/Hagen Amendment, and H.B. 2749) was quietly signed into law by President Obama, along with a few dozen other bills, upon his return from Christmas and New Years in Hawaii. The quiet signing ceremony of legislation that passed overwhelmingly in both Houses, albeit, not without several times seeming to be D.O.A., was in stark contrast to the rants of the “King of Crazies,” Glenn Beck, who, according to Huffington Post:

“"Beck recently called the law "the Death Star", adding, "this is what Stalin did," and claiming that America has the safest food supply in the world."

Beck is now being joined by a chorus of Republican’s claiming that the legislation needs no funding because as former ranking Republican Jack Kingston claims “the U.S. food supply 99.99 percent safe.”

In essence the argument is that we can not afford the $1.4 billion (over five years) price tag to implement the legislation which in large part if the cost of hiring more inspectors at FDA to allow inspections of food manufacturing facilities more frequently than the five to seven years that occurs now. Or as Fred Love, a spokesman for Rep. Tom Latham, who sits on the appropriations subcommittee that deals with the FDA, said in an e-mail:

"When one considers the record deficits our country faces and the renewed focus on fiscal restraint in the U.S. House of Representatives, it's going to be very difficult to find the money to pay for implementation of the bill."

Several Republicans point to the “new CDC numbers” as evidence that the Government’s work on food safety is done. Since 1999, the CDC has estimated the number of cases of foodborne illnesses in the USA each year as 76 million, with 325,000 hospitalizations and 5,000 deaths. Now, after almost a decade of work, the CDC released new numbers - 47.8 million cases of foodborne illness, 127,000 hospitalizations and 3,030 deaths.

However, before the Republican’s once again claim “Mission Accomplished,” the CDC says the drop is likely caused by improved surveillance of illnesses, better criteria for determining an actual food-related illness, and exclusion of international travel-related illnesses. Yet, even if the new numbers from the CDC also show improvement, should we really be satisfied that ONLY 48 million of us yearly are sickened by the food we eat?

Setting aside the personal, human, toll for a moment to look at the numbers; In a 2010 report by Robert L. Scharff for the Pew Memorial Trust, medical and other costs to victims amounted to $152 billion a year. This Pew Study (based upon the 1999 CDC estimates), presumably with a 37% reduction in counted illnesses, the costs to victims yearly ONLY are a few billion over $100 billion.

In addition, the Pew Study did not account for recall costs, lost sales, loss of reputation, loss of exports, etc., to the businesses that caused or businesses that were in the chain of distribution of the offending product. However, one only has to remember the Spinach, Tomato, Peanut Butter and Egg outbreaks in the last few years to see $100’s of millions in business losses – independent of the $10’s millions paid in personal injury settlements and verdicts.

So, really, is our food supply “99.99 percent safe?” So, really, is Beck correct that implementing this bill would be akin to Stalin’s food policies or the Star War’s “Death Star?” Is $1.2 billion over five years too much to invest in providing more resources to the FDA, the CDC and State and Local Health Departments to do more inspections and more accurate surveillance of foodborne disease?

Glenn and his Republican minions should ask Linda Rivera and her family:

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Elizabeth and Michael Armstrong were extremely health-conscious when it came to feeding their two children—Ashley, 2, and Isabella, 4. There was, as a result, nothing unusual about their feeding them a salad made with Dole-brand baby spinach in August, 2006. Unfortunately, the spinach proved to be contaminated with E. coli O157:H7, and Ashley and Isabella became two of the many victims of a nationwide outbreak of infections linked to Dole’s bagged spinach products. Although Isabella recovered relatively quickly from her infection, Ashley developed a rare and extremely dangerous complication—hemolytic uremic syndrome, or HUS.

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