December 2008

Eating fresh cheese at a fair in Kansas was the only recent exposure associated with illness. Of 101 persons who ate the cheese, 66 percent became ill, the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report said.  On October 26, 2007, a family health clinic nurse informed the Kansas Department of Health and Environment that Campylobacter jejuni had been isolated from two ill persons from different families who were members of a closed community in a rural Kansas county.  By Oct. 29, 17 additional members of the community had reported gastrointestinal illness. All 19 persons reported consuming fresh cheese on Oct. 20 that was made the same day at a community fair from unpasteurized milk obtained from a local dairy, the report said.

An investigation by the Kansas Department of Health and Environment and the local health department determined the source and extent of the outbreak. Eating fresh cheese at the fair was the only exposure associated with illness.  Although all samples of cheese tested negative for Campylobacter, results of the epidemiologic investigation found an association between illness and consumption of fresh cheese made from unpasteurized milk, the report added.

Unpasteurized milk and milk products should not be consumed, especially among populations at high risk of infection complications — the young, pregnant, elderly and immunocompromised.

"According to the latest news reports, the 22 companies implicated in the Chinese powdered milk crisis are likely to pay 1.1 billion yuan ($160 million) in compensation to the families of the over 294,000 children sickened by tainted milk products. The reports indicate that the compensation will range from 2,000 yuan ($290) for children who suffered kidney stones to 200,000 yuan ($29,000) for the families of the children who died as a result of consuming tainted powder milk. To put these figures into perspective, if a similar number of children became sickened by tainted food products in the United States, the payout would rival the current automotive industry bailout. Nevertheless, one might assume that $160 million in compensation to the victims of this pervasive failure of Chinese dairy safety is a good thing, right? The answer is both "yes" and "no."

The fact that the Chinese companies implicated in the crisis have offered to "shoulder the compensation liability" shows at least some recognition of companies’ responsibility to the purchasers of their products. Furthermore, any compensation the victims receive cannot come soon enough, as many of the families have incurred significant medical bills from their children’s hospitalizations. Still, the victims of the crisis will be left to ponder the $160 million question: Will this voluntary form of compensation, meant to ensure customer goodwill, result in safer food products in China?

Chinese courts have yet to accept any of the civil cases filed on behalf of victims of the powdered milk crisis. The cases have sat in limbo for months, and with the prospect of a voluntary corporate payout, the chances of these cases ever seeing the light of day are slim to nil. The fact remains that, in the kind of rampant business-economy that China seeks to create, civil cases create a liability threshold for corporations. If a company chooses to ignore safety standards, a well-functioning civil court system will (in theory) ensure that the company faces a significant financial risk in doing so. Unfortunately, the precedent China has set in the powdered milk crisis, by refusing to hear civil cases and encouraging a corporate payout, creates a system in which corporate liability is a voluntary option. This, in turn, leads to businesses that do not see manufacturing safe products as a mandatory legal requirement, but as public relations consideration that can be remedied by simply choosing to "shoulder the compensation liability."

Only time will tell whether the voluntary payout will encourage Chinese companies to manufacture safer products; let’s hope, for the sake of the 294,000 sickened children, that the biggest lesson Chinese companies take from the crisis is that selling contaminated products is not a profitable business."

Our food supply seems so challenged, that it was hard to narrow it down to only 10.

1. Globalization: More international recalls and outbreaks due to expanding globalalization of the food supply and the challenges of oversight/infrastructure in developing countries. International challenges probably deserve a list of their own, but in the mean time, this wide umbrella includes the possibility of bioterrorism and/or “economic/chemical terrorism” (intentional adulterations with a profit motive, like melamine).

2. Local Food: Outbreaks linked to local food and/or farmer’s markets. Community Supported Agriculture (CSA) groups and food co-ops need to demonstrate knowledge and practice of food safety, and be inspected. In addition to produce and meats/fish, prepared items are currently unsupervised in some, but not all locations.

3. Non-O157 STEC (Shiga Toxic producing E. coli) illnesses and outbreaks (both beef and produce): E. coli O157:H7 is listed as an adulterant, is tested for, and is still a terrible problem. E. coli strains that are non-O157 (but are equally as deadly) have not been evaluated or listed, and are not regularly tested for.

4. Animal to Human contamination: More contamination events involving the whole food chain (from animal feed to animals to humans). Whether it’s dioxin in Irish hogs or melamine in Chinese egg-laying hens, it’s clear that what goes into animals eventually goes into us. As the market for animals-as-food grows, so does the price to feed those animals and then the impetus to cut corners.

5. Having to do more with less: Public funding for food safety research, surveillance, and education is down, but the work load (and its importance) continues to grow.

6. 21st Century communication: In addition to improving communication between each other, food safety agencies need to improve communication with consumers. Outbreaks will move through the population with increasing speed, and agencies need to streamline their processes (and embrace social media like twitter and Facebook) in order to keep up.

7. Balancing food protection and environmental health: How to balance on-farm food safety practices with the protection of water quality, the prevention of soil erosion & dust, and the protection of wildlife and their habitats.

8. Zoonotic diseases: The rise of grain prices and starvation in other parts of the world will have many consequences, including the possibility that as people hunt wild animals for food, they may become exposed to new diseases, triggering a zoonotic virus jumping into humans. (A zoonotic virus is one that originates in animals and crosses to humans, like avian influenza.)

9. Consumers and food safety: How do consumers sort through the cacophony of information on food? What’s “safe”? What does “organic” mean anymore? How is it that “USDA inspected and passed” doesn’t guarantee pathogen-free meat? Who does the consumer believe/trust? Included in this category are the raw milk controversy, food irradiation, and even the new labeling laws like COOL (Country Of Origin Label). Will we get closer to farm to fork tracking of all fruits and vegetables this year?

10. Pet food ills: Pet food testing is increasing, so the level of contamination will become more apparent, and we should expect more recalls. Supervision of the pet food industry as a whole needs improvement, with clarity in ingredients and calorie counts.

AP and the Haphazard Gourmet Girls report that the companies whose tainted milk products sickened nearly 300,000 children and were blamed in the deaths of six will likely pay 1.1 billion yuan ($160 million) in compensation to victims’ families.  Details of the compensation plan came shortly after trials began for 15 people on charges related to the production and sale of melamine, an industrial chemical added to milk to falsely boost protein readings in quality tests.  The 22 companies blamed in the scandal will make a one-time 900 million yuan ($131 million) cash payment to victims.  The remaining 200 million yuan ($29 million) would cover bills for lingering health problems, the paper said, citing an unnamed source from the China Insurance Regulatory Commission.

Details in the report roughly correspond to figures provided this month by lawyers seeking to sue the companies involved, who said that most children who suffered kidney stones would get 2,000 yuan ($290), while sicker children would be paid 30,000 yuan ($4,380).  Families of children who died will each get 200,000 yuan ($29,000).

If this had happened in the United States – 300,000 children poisoned – the payout would have rivaled the auto bailout.

Parts I, II, and III of this series provided a literature review and commentary on the history, technology, food safety, and food quality aspects relating to the use of ionizing radiation in fresh iceberg lettuce and spinach processing. To finish the analysis, a review of the literature on potential consumer and industry acceptance of food irradiation relative to its costs and benefits is presented. Two major and intertwined challenges might limit or delay the application of this processing method in the market place for fresh iceberg lettuce and spinach despite FDA’s approval: 1) consumer acceptance of the technology and 2) costs to the leafy green industry to implement the process. Given the gravity of the situation with outbreaks from fresh iceberg lettuce and spinach in recent years, it is imperative to examine carefully these challenges, and potential solutions including food irradiation.

Consumer Confidence and Acceptance

Consumer confidence in the lettuce and spinach industry

Fresh-cut (minimally processed) produce has grown to a $15 billion dollar per year industry in North America, and salad greens comprise a significant portion of that market, including iceberg lettuce and spinach (Palumbo et al, 2006). Likewise, a disproportionate number of the produce-related foodborne disease outbreaks have been linked to contaminated fresh-cut lettuce and spinach (Table, Part II). As a result, consumer confidence in this market has been shaken, which severely hurts the US economy, as well as the consumers who enjoy these products as fresh, healthy, and nutritious food sources.

For example, a survey conducted by the Food Marketing Institute of the US Grocery Shopper trends (2007) found that “safety concerns prompted 38 percent of consumers to stop purchasing certain foods in the past 12 months — up from 9 percent in 2006. Among those who stopped buying products, the items most often mentioned were spinach (71 percent), lettuce (16 percent), bagged salad (9 percent) and beef (8 percent). The survey was conducted in January 2007, when the outbreak linked to spinach was still in the news and illnesses associated with other foods were starting to make headlines.”

Based on these finding, one may ask: does food irradiation represent an opportunity to improve consumer confidence in the safety of fresh iceberg lettuce and spinach?

The answer would appear to be a resounding, “yes,” given the strong scientific evidence that irradiation is an effective and safe approach to reduce the levels of the most important foodborne pathogens in combination with other approaches such as GAPs and HACCP, as discussed in the earlier parts of this series. NASA has been irradiating astronauts’ food successfully since the 1970s, but acceptance and availability of the technology for approved foods such as ground beef and poultry in the civilian market place has been limited despite the benefits recognized by the scientific and medical communities. A review of consumer surveys provides insight into some of the complex reasons that this technology has not been widely adapted in the US and other parts of the world.

Historical perspective on consumer acceptance of food irradiation

Prior to FDA’s new rule for fresh iceberg lettuce and spinach, food irradiation at similar medium-level doses was approved in the US for numerous applications including control of foodborne pathogens in other fresh and processed foods. A large body of literature exists on the issue of consumer acceptance of food irradiation, especially for beef and poultry products. Notably, many of these consumer surveys took place 10-20 years ago, and similar studies on perceptions relating to the use of ionizing irradiation in fresh lettuce and spinach processing have not appeared in the literature as of the time of writing this review.

Dr. Christine Bruhn at the University of California, Davis published many of the pioneering studies on consumer acceptance, and recently made this comment about consumer acceptance of food irradiation in a series on the new FDA rule published by Jim Prevor’s Perishable Pundit (2008):

“My work and that of other researchers over the last 20 years has found some people are ready to buy irradiated product right now….This group of consumers represents maybe 10 percent of the population. At the other side of the spectrum, 10 percent of consumers are appalled by irradiation. They believe it makes the product less safe and less nutritious and wouldn’t touch it with a 10-foot pole. The majority of the population is in the middle. They don’t know very much about irradiation, or how it would benefit them.”

Clearly, the target audience for education (pros and cons) about food irradiation and FDA’s new rule concerning fresh iceberg lettuce and spinach, should be the 80 percent “in the middle.”

DeRuiter and Dwyer (2002) published a review article on consumer acceptance of irradiated food. Although slightly older, Sapp (1995) also provides an excellent review of the literature on consumer acceptance in the book, “Food Irradiation: A Sourcebook.” Some research highlights and selected original papers from these reviews and other sources are summarized below.

• Most consumers know little about food irradiation (American Meat Institute, 1993; Bruhn, 2001)
• A survey conducted at FoodNet sites in 1998-1999, indicated that the primary reason consumers would not buy irradiated foods (meat, poultry) was due to insufficient information about the risks and benefits; the survey also showed 50% of those asked were willing to buy irradiated meat and poultry and among those, 25% were willing to pay a premium price (Frenzen et al, 2000)
• Numerous studies have shown that consumer acceptance increases after they are given educational information about food irradiation, and many consumers have reported that they would prefer irradiated over non-irradiated meats after given science-based information (Bord and O’Connor 1989; Bruhn and Schutz, 1989; Fox et al, 1998; Resurreccion et al, 1995 )
• The use of audio and/or visual materials on food irradiation such pamphlets, slide shows and videos shifts consumers toward a positive attitude on food irradiation (Bruhn et al, 1986b; Hashim et al, 1995; Pohlman et al, 1994)
• Labeling is important to consumers, and strongly influences their acceptance of food irradiation; in one survey, 80% of US consumers indicated they would buy products with the approved Radura label and a statement: “irradiated to destroy harmful bacteria (Bruhn 2001)
• Consumers have expressed more concern about foodborne illness than irradiation “safety” (Bruhn et al, 1986)
• In a survey of 250 dieticians employed in health care facilities, the responses were surprisingly receptive to irradiation (Giamalva et al, 1998)
• Surveys indicate that military consumers, in particular, may be amendable to irradiated food (DeRuiter and Dwyer, 2002; Pohlman et al, 1994)
• Consumer confidence depends on making food clean first, and then using irradiation to make it even safer (DeRuiter and Dwyer, 2002)
• Consumers indicate they trust information most from health professionals (Bruhn 2001; American Meat Institute 1998); but, also trust in government and industry are the important factors affecting acceptance of irradiation (Bord and O’Connor, 1990)
• An interesting and innovative educational campaign was launched in Florida to promote food irradiation (Bruhn 2001; Hunter 2001), that engaged the state and local county health department and multiple media outlets. They used billboards with pictures of mothers and children to draw a comparison between pasteurized milk and irradiation. The billboard read:

Pasteurization, Safer Milk.
Irradiation, Safer Meat.

Additionally, the state health officer (a physician) made a statement directed at consumers and retailers (restaurants, grocery stores): “I hope you will purchase irradiated chicken and ground beef as they become available. This combination will afford your family maximum protection against foodborne illness.”

The role of the Internet in acceptance of food irradiation

It is worth noting, that since many of these studies were conducted more than a decade ago, the potential influence of the Internet, including anti-irradiation activist websites, has not been factored into the consumer acceptance equation. An informal survey on the web during this review showed a preponderance of mostly non-science groups against food irradiation, and a relative paucity of recent web-based information from scientists, industry, and government about the potential benefits. It is also difficult to predict how increased consumer demand for “organic” and “natural” foods will affect acceptance of food irradiation of fresh produce such as lettuce and spinach. Irradiation of organic food is currently prohibited. There is an urgent need to conduct new studies in today’s marketplace including assessments of consumer attitudes toward irradiation of leafy greens and other produce. Additionally, it would be useful to examine consumer demand in different types of markets (e.g., chain restaurants, institutional settings such hospitals, long-term care facilities, and prisons).

Economic Costs and Commercial Viability

Similar to the literature review on consumer acceptance, most of the papers that address economic costs and potential benefits (from reduced outbreaks and recalls) relating to food irradiation are outdated, and not specific for fresh lettuce, spinach or other leafy greens. Nevertheless, there are common themes that can be applied today when weighing the costs and benefits of radiation to control foodborne pathogens and spoilage organisms in fresh iceberg lettuce and spinach.

The human costs

The type of costs that accrue for individuals and society due to foodborne diseases and recalls include but are not limited to:

• Physician and emergency department visits
• Hospitalization
• Outpatient medication
• Productivity loss
• Long-term complications (e.g., HUS)
• Premature death
• Loss to industry from recalls and highly publicized outbreaks
• Loss of consumer confidence and market share
• Liability (lawsuits) and increased insurance premiums

As previously discussed in Part II, Tauxe (2001) analyzed the potential benefit of irradiated meat and poultry and estimated that 900,000 cases of infection, 8,500 hospitalizations, over 6,000 catastrophic illnesses, and 350 deaths could have been prevented each year. Similarly, Morrison et al (1992) conducted a cost:benefit analysis for irradiation of poultry products, and concluded that the savings from decreased foodborne illness would be greater than the small increase in cost passed on to consumers. Although similar studies have not been conducted for lettuce and spinach-related illnesses, it is reasonable to assume that irradiation would also result in reduced human illnesses and associated costs.

The facility costs

There is no debate concerning whether or not irradiation is technically feasible for fresh iceberg lettuce and spinach. The technology has been shown to be safe and effective (see Parts I, II, and III). The major disincentive for implementing food irradiation processing in the leafy greens industry relates to economic feasibility.

The fresh iceberg lettuce and spinach industry faces unique challenges with this technology. First, there is a geographic challenge. The majority of fresh iceberg lettuce and spinach is grown and shipped from the west coast (mostly the Salinas Valley, California). This region does not currently have a facility to accommodate radiation of fresh produce at the dose approved by the FDA for foodborne pathogen control; therefore, it is necessary to either 1) build stand-alone or in-line unit(s) in the major lettuce/spinach production region or 2) ship the packaged products to irradiation facilities in other distant parts of the country. There is potentially less financial risk in utilizing an offsite location given the uncertainty of consumer demand (see below); however, shipping to an out-of-state irradiation facility increases costs, and adds another layer in the distribution system where contamination could be introduced, especially if there is an accidental failure in temperature (refrigeration) control.

Second, it may be necessary still to optimize the conditions for ionizing radiation processing for specific facilities and product types/sizes (including packaging) to maximize the food safety benefits and minimize the potential negative effects on food quality such as off odors; this is a relatively simple problem to address once a facility is in place.

Several excellent reviews of the costs associated with irradiation facilities are available, but they are outdated (Cleland et al, 2001; Frenzen et al, 2001; Hayes, 1995; Kunstadt, 2001a; Kunstad, 2001b; Morrison et al, 1992; Morrison, 1989).

There are three major components that factor into costs for industry (and that may be passed on to consumers):

• Capitol costs (hardware and land/property)
• Annual operating costs (type of product and radiation source/dose, personnel maintenance, tax/insurance, regulatory requirements)
• Annual throughputs

Cleland et al (2001) summarize the critical importance of annual throughput: “total cost per unit of product decreases as the throughput rate increases because the fixed costs (e.g., capitol amortization, utilities, maintenance) are then spread over a larger market of units.” In other words, the financial success (economic feasibility) of building an irradiation facility is closely associated with the demand for the product.

Thus, the uncertainty of the market place with regard to the number of consumers (including retailers) that will purchase fresh iceberg lettuce and spinach treated with radiation for food safety and quality is perhaps the greatest challenge in implementing FDA’s new rule.

Consumer Willingness to Pay

Although the actual number of potential customers remains unclear for irradiated fresh iceberg lettuce and spinach, numerous surveys have indicated that once consumers are educated about the food safety benefits of the process, most are willing to pay an increased price (Bruhn 2001; Frenzen et al, 2001; Hayes, 1995; Sapp 1995). Furthermore, published studies indicate that the increased cost per pound for meat and poultry products amounts to only a few cents. Although current numbers are not available in the literature for lettuce/spinach, Sadex Corporation estimated the increased cost for food irradiation at the medium dose level would be approximately 10 to 20 cents per pound using e-beam technology (personal communication). This seems like a small price to pay for increasing food safety, but as reviewed exhaustively in this series, many complex scientific, social, economic, and policy factors influence the decisions surrounding acceptance and use of food irradiation.

In the final part of this series (Part V), the pros and cons of FDA’s new rule will be summarized, and the potential “next steps for action” presented.


Continue Reading Pros and Cons of Commercial Irradiation of Fresh Iceberg Lettuce and Fresh Spinach: A Literature Review – Part IV. Consumers and Costs.

Lovely, something else to worry about.  What would Pooh do? According to Andrew Schneider of the Seattle Post-Intelligencer, the United States imports most of its honey and for years China was the biggest supplier.

But in 1997, a contagious bacterial epidemic raced through hundreds of thousands of Chinese hives, infecting bee larvae and slashing the country’s honey production by two-thirds. Chinese beekeepers had two choices: They could destroy infected hives or apply antibiotics. They chose to do the latter. That was a mistake, said Michael Burkett, a professor emeritus at Oregon State University and an internationally known authority on bees and honey.

"You hear about people shooting themselves in the foot? Well, the Chinese honey-sellers shot themselves in the head," he said.

The Chinese opted to use chloramphenicol, an inexpensive, broad-spectrum antibiotic that’s so toxic it’s used to treat only life-threatening infections in humans–and then only when other alternatives have been exhausted.

Now, 11 years later, some the honey buyers who take the trouble to test for it, still find the banned antibiotic in some of their imported honey. The U.S. Food and Drug Administration says tainted honey from China is on top of its watch list and has been for six years–since the agency released the first of three "import alerts" targeted at banned substances in honey. FDA considers a food adulterated if, among other reasons, it contains an animal drug deemed unsafe for unapproved uses.  Chloramphenicol certainly meets that definition.

Anyone reading the back of his or her honey jar?

Last week I warned, “A safer food supply cannot wait.”   Here is yet another reason, according to news reports this morning, Mexico has now suspended meat imports from 30 processing plants in 14 states, including some of the nation’s largest (and ones I have sued), on Wednesday and Friday, according to a list posted on the U.S. Department of Agriculture Web site.  USDA spokeswoman Amanda Eamich said in an e-mail that Mexico had discussions over the course of the last five business days with the agency regarding concerns about the general condition of meat products, sanitation issues and "possible pathogen findings."

Published reports, however, raised the possibility the move could reflect Mexico’s objection to a recently enacted law that requires meat products to bear country-of-origin labels.   The country-of-origin labeling law (COOL) mandates the separation of foreign cattle and pigs in U.S. feedlots and packing plants. Foreign animals are also required to have more documentation about where they come from and, in the case of cattle, must have tags that indicate they are free of mad cow disease.

If our focus was in fact on food safety, domestically or with imports, COOL would be unnecessary and trade would not be interrupted.

Well the reported 294,000 Chinese children (number from government sources – likely a gross under-count) poisoned by Sanlu woke up this morning with a lump of coal as their gift from Sanlu and the Chinese government – Sanlu has filed for bankruptcy protection. Now the chance that these victims would ever have received compensation has disappeared.

Interestingly in the recent New England Journal of Medicine, Julie R. Ingelfinger, M.D., a superb physician who has reviewed Hemolytic Uremic Syndrome cases for me in the past, authored and interesting look at Melamine and the Global Supply of food. The introduction is below:

Food contamination, whether accidental or intentional, has been a sad, recurrent theme throughout recorded history, going back some 8000 years and described in the Old Testament. However, a new dimension has been added in this new millennium: globalization and international agribusiness allow problems with the food supply to spread around the planet all too quickly. The most recent, and still evolving, example is the epidemic of melamine poisoning stemming from tainted infant formula in China. More than 294,000 children in China have reportedly been affected by adulterated formula. Over 50,000 were hospitalized, and at least 6 died. Some are said to remain in the hospital. There are also reports that children in other parts of Asia — such as Taiwan, Singapore, and Vietnam — were also affected. Those who became ill had ingested melamine-contaminated powdered infant formula; some 22 brands were implicated. In the wake of this stunning discovery, the contaminated formula was taken off the market, but the story of melamine contamination is far from over.

In addition to its catastrophic health effects, the contamination has had major economic effects, with the United States and other countries banning the importation of milk and other food products from China. Recent news reports note that China has asked the United States to lift its ban on milk products and that the U.S. Food and Drug Administration (FDA) has opened an office in Beijing (and will open others in Shanghai and Guangzhou and in other countries) that will examine food exports destined for the United States.

BBC reported this morning that  – "China firms ‘to pay milk victims"

The firms also agreed to create a fund to cover victims’ medical bills Chinese dairy firms involved in the tainted milk scandal are to compensate the families of the nearly 300,000 affected children, state media said.  Twenty-two companies will make an undisclosed one-off cash payment to the families, Xinhua reported quoting the China Dairy Industry Association.

The Kerman-based dairy that has been linked to bacterial illnesses and recalls, on Monday agreed to plead guilty to shipping misbranded food — in this case, raw milk labeled for pet use that instead was consumed by people — across state lines. According to the Fresno Bee – In a plea agreement filed Monday in U.S. District Court in Fresno, Organic Pastures agreed to, among other things:

1) Organic Pastures Dairy in Kerman is one of only two raw-milk producers in California, 2) Stop shipping unpasteurized raw milk across state lines, 3) Put a notice on its Web site within two weeks that it no longer will sell raw-milk products outside of California, 4) Notify, in writing, any out-of-state customers from the past year that the dairy no longer will offer raw milk or raw-milk products, and 5) Allow the federal Food and Drug Administration to, without prior notice, make inspections of the dairy.

Perhaps more disturbing are these comments by Mr. McAfee on the Complete Patient:

Let me be very clear….

I am not a pacifist and there is a tipping point at which activism and defense of the rights of my home, my food, my freedom and my family takes precidence over peaceful politically appropriate action with cameras and playing along while you get raped. . . .

Another Wounded Knee, Ruby Ridge or Waco could easily happen in America because of police abuse, massive unemployment, corruption, Wallstreet rip offs, denial of the right to food etc. . . .

I also believe that each and every mentally and emotionally stable free American should know how to shoot and shoot well and that those Americans that choose to do so should own a gun and appreciate its place in history and freedom. On of my fondest memories was visiting Switzerland in 1983 and seeing a youth with a machine gun on his back going to the shooting range on a moped. I thought to myself….no body will ever mess with his rights. Homes in Switzerland have huge machine SIG guns and everyone knows how to use them. There is little violence in that land and the crime rate is nill. Cops thoughtfully enter homes after asking politely and do not brandish weapons like Miami Vice. . . .

I shoot and own guns….but you will never see them displayed or used against cops or any person. Until the tipping point. At that point my life is then the value which must be laid down in the balance and it is worth giving in trade. . . . Remember, those that live by the sward can also die by it. If you raise a gun in anger expect to pay a dear price at some point.

Mark McAfee

The Tampa Bay Tribune ran Annys Shin’s (Washington Post) article on the long-term health consequences of foodborne illnesses. Given my post last night, it is timely. Increasing the safety of our food supply makes [cents]. As I said to her:

These people face a lifetime of medical treatment. "Anyone with HUS will be monitored for the rest of their lives. If the acute course was severe enough, the risk of long-term kidney complications, including end-stage renal disease and kidney transplant, is quite high. The future medical cost alone can then be in the millions," said William Marler, a Seattle lawyer who sues retailers and food companies on behalf of food poisoning victims.

That is the scenario Elizabeth Armstrong faces. Her two daughters got sick after eating bagged baby spinach in 2006. Her older daughter, Isabella, who was 4 at the time, survived with no apparent health problems. But her younger daughter, Ashley, who was 2 at the time, developed HUS. She has only 10 percent kidney function and will likely need more than one kidney transplant in her lifetime, including one before she is an adult.

So, let’s focus on food safety in 2009.