With four dead and nearly 200 injured, many seriously, many still hospitalized, last week’s bombing in Boston has been yet another horrific reminder of how vulnerable we can be.

I must admit as I recoiled from those numbers, I also thought of a spinach E. coli O157:H7 outbreak that killed five and sickened over 200 in 2006, and a 2011 cantaloupe Listeria outbreak that killed at least 33 and sickened at over 145.  It made me wonder how we would be reacting to a different Boston act of terror.  Let’s suppose:

Last Friday, April 19th, on the same day Massachusetts Department of Health asked for help from the Centers for Disease Control and Prevention (CDC) and the U.S. Food & Drug Administration (FDA) with a growing outbreak of human Salmonella illnesses linked to marathon runners who ate orange slices along the route, a foreign TV Network begins airing a video taken inside a fresh produce distribution center somewhere showing workers treating oranges with an unknown liquid. There is a claim that the growing illnesses are a terrorist act.

In the next 15 minutes, every network news operation is playing the video. The broadcast networks break into regular programming to air it, cable news stations go nonstop with the video while talking heads dissect it, and social media – twitter and Facebook are overwhelmed.

Coming on a Friday afternoon 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 any foodborne illness outbreak looks just like the terrorist act described above, but without the video on FOX News. Far-fetched?

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.

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.

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 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 little real movement to ensure this.

So would the fact of a terrorist group operating from a produce distribution center inside the United States or Mexico have brought more or effective resources to the search for the source of Salmonella? If credit-taking terrorists were putting poison on our oranges, could we be certain that Uncle Sam’s response would be more robust, more effective than if it was just a “regular” food 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 its inspectors miss key evidence as outbreaks begin. The FDA is on record as referring to themselves as overburdened, underfunded and understaffed.  If you are a food manufacturer, packer, or distributor, you are more likely to be hit by lightening 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 my hypothetical Salmonella outbreak is a brutal object lesson in the significant gaps in our ability to track and protect our food supply. We are still ill prepared for a crisis, regardless of who poisons us.