Where is George Bush when you really need him?
I was pleasantly surprised this morning reading the 2009 CDC FoodNet data from MMWR (Yes, Morbidity, Mortality Weekly Review – Seriously) on the plane back from Washington D.C – perhaps.
Along with the FDA, FSIS, and 10 state health departments, the CDC has been tracking illnesses caused by nine food-borne pathogens since 1996 (three years post Jack-in-the-Box) through the FoodNet program. According to its 2009 report in MMWR, illnesses caused by E. coli O157:H7 have dropped by 25% over the past three years and are at their lowest levels since 2004. David Goldman, MD, MPH, administrator of FSIS, attributed much of the E. coli O157:H7 decline to meat processors (since last year) being required to test all components of meat used in ground beef. In addition, around the same time, inspectors received new guidelines for evaluating sanitation in meat processing plants. (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5914a2.htm).
David, that did not work out so well for young Abby Fenstermaker and her family in 2009 – did it?
Abby’s hemolytic uremic syndrome illness, and her Grandfather’s illness (note, he is presently on life support), were linked to a Class I Recall by FSIS in May 2009 – Illinois Firm Recalls Ground Beef Products Due To Possible E. coli O157:H7 Contamination.
However, perhaps the good work at FSIS is not the real reason for the drop in the number of ill? Perhaps we simply stopped counting the real number of E. coli O157:H7 cases?
According to the CDC itself, the number of state health department epidemiologists, and the tasks they can perform, have decreased since 2006, according to a study published by the CDC in MMWR on Dec. 18, 2009. (www.cdc.gov/mmwr/preview/mmwrhtml/mm5849a1.htm). The report indicated that the reduction in health departments’ epidemiology capacity was due in part to diminished federal public health preparedness funding, and states’ overall budget cuts. Annual grants to states through federal preparedness funding decreased from a high of $1 billion in 2002 to approximately $698 million in 2008. The reduction coincided with a decrease in bioterrorism/emergency epidemiology and surveillance capacity, the report states. For physicians, this means less guidance on how to treat public health emergencies, and more patients with illnesses that potentially could have been prevented had data been available, the report said. So, less funding, fewer epidemiologists means you count fewer E. coli O157:H7 cases? How convenient – the fewer you count, the better you look.
So, a 25% decrease in E. coli O157:H7 illnesses at the same time state health department epidemiologists are decreasing? Hmm, sounds like “fuzzy math” to me.