Where is John Snow when you really need him?

According to the CDC, as of Wednesday, January 7, 2009, 388 persons infected with the outbreak strains of Salmonella Typhimurium have been reported from 42 states. Among the 372 persons with dates available, illnesses began between September 3 and December 29, 2008, with most illnesses beginning after October 1, 2008. Patients range in age from <1 to 103 years; 48% are female. Among persons with available information, 18% were hospitalized.

So, we have a shelf- stable product (like cereal or peanut butter) or a frozen product (chicken nuggets) or refrigerated product (eggs or cheese) that are all kept for an extended period and shipped all over the United States. It is also a product that is consumed by infants and people over twice my age. Oh yes, and the 388 people thus far counted share the same genetic finger-print of Salmonella Typhimurium in their stools.

Yet, local and state health departments, and the CDC, have made no announcement “publically” what product has sickened nearly 400, put 75 in the hospital and killed a woman in Minnesota. Do they really not know what the product is? Are they worried that the product identification needs to be perfect so there is no comparison to last year’s tomato/pepper Salmonella outbreak? Is public safety in the balance? Or, do we simply need better, more timely information so an outbreak can be determined early, the correct product identified and pulled from our shelves.

As I have said too many times, we need to improve surveillance of bacterial and viral diseases. First responders – ER physicians and local doctors – need to be encouraged to test for pathogens and report findings directly to local and state health departments and the CDC promptly. Right now, for every person counted in an outbreak there are some 20 to 40 times those that are sick but never tested. The more we test, the quicker we know we have an outbreak and the quicker it can be stopped.

These same governmental departments, whether local, state or federal, need to learn to “play well together.” Turf battles need to take a back seat to stopping an outbreak and tracking it to its source. That means resources need to be provided and coordination encouraged so illnesses can be promptly stopped and the offending producer – not an entire industry – are brought to heal.

“Change is coming” – right?