Marler Blog - Providing commentary on food poisoning outbreaks & litigation

Public Health’s job is the Public’s Health and that includes telling us the truth.

Last week I was perplexed when Director Catherine Templeton of the South Carolina Department of Health and Environmental Control (DHEC) announced that a “Spartanburg-area Mexican restaurant” was to blame for a recent E. coli O157:H7 outbreak where at least 10 have been sickened – two with hemolytic uremic syndrome (HUS).  According to Director Templeton:  “it is our policy not to release information during a pending investigation unless it affects the health of citizens of South Carolina.” 

In part I agree, if the investigation is in its infancy, and the agency does not know the source of the outbreak, by all means do not announce it.  Of course, by the time Director Templeton named a “Spartanburg-area Mexican restaurant” as the link to the outbreak that began in late April and ended in the first week of May the outbreak was over. 

A quick Google search revealed nearly a dozen Mexican-style restaurants in Spartanburg.  You have to wonder how angry all but one of those restaurants were?  So, you must give credit where credit is due to the owner of the El Mexicana for coming out from the kitchen to say:

“In the interest of all Mexican restaurant in Spartanburg, we felt like it was important to come forward and share what DHEC has determined so far in its investigation and our willingness to assist the agency any way that we can.”

However, I did not see a mention of concern over the customers – perhaps I missed it.

Director Templeton also maintained that it was unnecessary to publically name the restaurant because it no longer posed a health threat.  Why should consumers not be told which restaurants have poisoned customers – whether by bad habits or bad supplier decisions – so they can make choices where to take their families to dinner?  I think we have an absolute right to know.  What right does Director Templeton have to withhold that information?

Hiding the ball from the public as to the source of an outbreak when the outbreak and the investigation is in fact over – especially in the day of instant information via Facebook and Twitter – is not only a waste of time in the long run, but it is a disservice to the taxpaying consumers that Director Templeton is supposed to serve.  Not only is it unfair to the other “Spartanburg-area Mexican restaurants” that are not at fault, but history has shown that hiding public health information from the public can be incredibly detrimental to food safety.  Here are a few examples:

2011 Taco Bell Salmonella Outbreak - In January of 2012 the CDC announced that a Salmonella outbreak had sickened 68 people in 10 states.  While the CDC tracked the source of the outbreak, publically it has only named “a Mexican-style fast food chain restaurant – Restaurant Chain A”.  Reporters at Food Safety News ultimately learned from the Oklahoma State Department of Health that the chain in question was Taco Bell.

2011 Schnuck’s Romaine Lettuce E. coli O157:H7 Outbreak - In October of 2011, health officials in Missouri announced that they were investigating an E. coli O157:H7 outbreak. By October 31, county health officials named romaine lettuce from Schnuck’s salad bars as the likely source of the outbreak. On December 7, the CDC released a report linking the outbreak to “a single grocery store chain (Chain A).” In a December 8 news report, Schnuck’s confirmed that it was “Chain A,” though it refused to name its lettuce supplier.  In December of 2011, I filed two separate lawsuits against Schnuck’s on behalf of people who were hospitalized due to E. coli O157:H7 infections contracted in the outbreak.  Eventually I added Oklahoma-based Vaughan Foods to both lawsuits when I learned the company was the supplier of E. coli O157:H7-contaminated romaine lettuce to Schnuck’s stores.

2009 Caudill Seed and Jimmy John’s Salmonella Outbreak - Between February and March of 2009, 235 people in 14 states became ill with Salmonella.  The CDC conducted an investigation that uncovered alfalfa sprouts from a single unnamed grower to be the source of the outbreak. Many of those sickened ate at a restaurant dubbed “Chain A” by the CDC. While the CDC never did release the names of any of the companies involved, on March 15, 2009 the US Food and Drug Administration (FDA) issued an alert indicating the contaminated seeds came from Caudill Seed Company.  Later it was discovered that “Chain A” was Jimmy John’s. Jimmy John’s would go on to be involved in a total of 5 foodborne illness outbreaks tied to sprouts before finally pulling sprouts from it menus.

1993 Jack in the Box E. coli O157:H7 Outbreak - It has become common knowledge that a 1993 E. coli O157:H7 outbreak that sickened over 600, hospitalized 144, and killed four was linked to undercooked hamburgers from Jack in the Box. Nonetheless, to this day the CDC only refers to it as “chain A restaurant”. 

1982 McDonald’s E. coli Outbreak - While the Jack in the Box outbreak is commonly credited with introducing E. coli O157:H7 to the masses, a decade earlier at least 47 people became ill with severe symptoms of E. coli O157:H7 in Oregon and Michigan.  Almost all of those sickened had eaten undercooked hamburgers from McDonald’s – referred to only as “a fast food restaurant chain” in medical journals. 

Perhaps if researchers had made the 1982 McDonald’s outbreak more public, the Jack in the Box tragedy never would’ve happened.  Perhaps if Jimmy John’s had been publically identified as playing a role in the 2009 outbreak the company would have taken corrective food safety measures and stopped selling sprouts sooner.  And, in each of these cases, perhaps innocent people would not have been needlessly sickened, hospitalized or died.  Director Catherine Templeton and other health officials at local, state and federal agencies should learn from history and not blindly repeat it.

I have the honor to speak to the Colorado Department of Heath in Golden Tuesday.

For video for slide 7, see Death Toll Continues to Mount in Cantaloupe Listeria Outbreak.  And, on a slightly lighter note on slide 18, John Stewart on food safety.

Diamond Pet Foods still has some unanswered questions.

The CDC announced yesterday that a total of 14 individuals infected with the outbreak strain of Salmonella Infantis have been reported from 9 states. The number of ill persons identified in each state is as follows: Alabama (1), Connecticut (1), Michigan (1), Missouri (3), North Carolina (3), New Jersey (1), Ohio (2), Pennsylvania (1), and Virginia (1). The outbreak has been linked to multiple brands of dry pet food produced by Diamond Pet Foods at a single manufacturing facility in South Carolina.

What is remarkable is that the outbreak was not prompted by ill persons (or dogs) as is the usual case, but it was prompted by a sample collected by Michigan Department of Agriculture and Rural Development on March 14, 2012, during routine retail testing of dry pet food that tested positive for Salmonella Infantis.

Public health investigators used PulseNet to identify recent cases of human illness with a PFGE pattern indistinguishable from Salmonella Infantis, which was isolated from the unopened bag of dry dog food produced by Diamond Pet Foods.

Dog Food Illness and Recall Time Line

A.   On April 2, 2012, the Michigan Department of Agriculture and Rural Development detected Salmonella Infantis in an unopened bag of Diamond Naturals Lamb Meal & Rice dry dog food, which had been collected March 14, 2012, during routine retail testing of dry pet food.

B.   April 6, 2012 - Diamond Pet Foods is voluntarily recalling Diamond Naturals Lamb Meal & Rice. This is being done as a precautionary measure, as the product has the potential to be contaminated with Salmonella Infantis. No illnesses have been reported and no other Diamond manufactured products are affected. The product, Diamond Naturals Lamb Meal & Rice, was distributed to customers located in Alabama, Florida, Georgia, Kentucky, Maryland, Michigan, New York, North Carolina, Ohio, Pennsylvania, South Carolina and Virginia, who may have further distributed the product to other states, through pet food channels.

C.   April 30, 2012 - Diamond Pet Foods is expanding a voluntary recall to include Diamond Puppy Formula dry dog food. The company took this precautionary measure because sampling revealed Salmonella Infantis in the product. No dog illnesses have been reported. The recalled Diamond Puppy Formula dry dog food was manufactured by Diamond Pet Foods in Gaston, S.C., and distributed in the following 12 states: Alabama, Florida, Georgia, Kentucky, Maryland, Michigan, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia.

A few questions still unanswered are what prompted the April 6th recall by Diamond Pet Foods (I assume it was Michigan’s positive Salmonella Infantis test), and why on April 6 Diamond Pet Foods said that there were no illnesses reported (perhaps they did not know), and why on April 30th Diamond Pet Food said no dog illnesses have been reported, but did not mention people?

It does show the utility of PulseNet is helping track and stop pathogen outbreaks.

Below is the Rivera family.  An E. coli O157:H7 infection cost them over $6,000,000 in medical costs and kept Linda, still in a wheelchair, in the hosptial for over two years.

Food poisoning is not a new concern. The problem is, it’s not an old one either.  Consumers, Government and Industry have been working to eradicate foodborne illness in the United States since Upton Sinclair’s The Jungle revealed rampant contamination in the nation’s food supply and thrust food safety onto the national scene. And yet, pathogens continue to crop up in our food supply, sickening an estimated 48 million people per year, according to recently updated information from the Centers for Disease Control and Prevention (CDC). And these bugs don’t just land people on the toilet for a few days. Of those sickened, 128,000 are hospitalized each year and 3,000 don’t survive.

Not only are foodborne illnesses tragic; they are costly too. Illnesses from food poisoning pose a $77.7 billion economic burden in the United States annually.  (See, Economic Burden from Health Losses Due to Foodborne Illness in the United States, Author: Scharff, Robert L., Source: Journal of Food Protection®, Volume 75, Number 1, January 2012, pp. 123-131(9)).  That’s about the equivalent of what government spends on national intelligence each year. While agencies such as the CIA and FBI work to protect people from foreign and domestic threats, preventable foodborne diseases leak the same amount spent on these programs from the economy.

Please join us in pushing for a safer food supply so that the next time CDC updates its foodborne illness statistics, there will be fewer to report.

What you can do:

A.     Educate yourself on the topic:

• The Diseases - www.foodborneillness.com
• Current outbreaks – www.outbreakdatabase.com 

B.     Write or call your legislators to tell them why food safety deserves adequate funding and tight regulations, including increased testing and adherence to sanitation guidelines.

C.     Wear a t-shirt that spreads the message about the impact of food poisoning in the United States.  They are on sale at cost at www.occupyfoodsafety.com

I am giving a talk later this week to the Washington Restaurant Association.