As of July 29, 2013, CDC has been notified of 372 cases of Cyclospora infection from the following 16 health departments: Iowa, Texas, Nebraska, Florida, Wisconsin, Illinois, New York City, Georgia, Missouri, Arkansas, Connecticut, Kansas, Minnesota, New Jersey, New York, and Ohio.

Most of the illness onset dates have ranged from mid-June through early July.

At least 21 persons reportedly have been hospitalized in three states.

Nebraska and Iowa have performed investigations within their states and have shared the results of those investigations with CDC. Based on their analysis, Cyclospora infections in their states are linked to a salad mix.

As I said to the Des Moines Register today:

William Marler, a Seattle lawyer who often leads class-action lawsuits on behalf of people who suffered food-poisoning, said that in the age of the Internet, the public eventually will learn who manufactured and sold the tainted salad. “This information is going to come out. It’s just a question of when, not whether,” Marler said. He said consumers have a right to judge for themselves whether to continue shopping at a grocery store or eating at a restaurant that sold tainted produce, especially if the businesses have a history of problems. When public-health officials try to withhold such information, he said, “it makes it look like they care more about the industry than they do about the consumers, and that’s exactly the wrong message to be sending people.”

And, the Omaha World Herald:

Bill Marler, a Seattle attorney who specializes in food safety cases, said the names of the farm where the tainted vegetables originated and the grocery stores and restaurants that sold the salad mix eventually will come out.

Public health officials, he said, “do this so often where they hide the ball, they don’t tell the public, they’re not transparent, even after they know for sure what restaurant it was and who the manufacturer was. It really undercuts public confidence in our public health system.”

The public, he said, has the right to know who produced, distributed and sold the product.

Once again, as Dr. Doug Powell would say, the leafy green cone of silence descends.

As best as I can tell, here are public health’s arguments for disclosure and non-disclosure and my thoughts in italics:

A.  Although there is no written policy, it is the way we have done things for years.

Why do I hear my mom saying, “just because so and so does that does not mean you should too.” Like all government policies – change is good.

B.  Since the outbreak has concluded, there is not an immediate public health threat.

Frankly, that is true in most foodborne illness outbreaks.  In nearly every single outbreak investigated by the CDC the outbreak is figured out far after the peak of the illnesses happened.  However, disclosure gives the public information on which companies have a strong or weak food safety record.

C.  Disclosing the name of the company jeopardizes cooperation from the company in this and future outbreaks; and

If a company will only cooperate if they are placed in a witness protection program and with promises of non-disclosure, it does not say much for our government’s and the company’s commitment to safe food.

D.  Bad publicity may cause economic hardship on the restaurant.

True, but not poisoning your customers is a better business practice.

I would also add a couple more reasons that I have received via email (mostly anonymously):

1.  The source was an unknown supplier, so naming the restaurant might place unfair blame on the restaurant.

This one does make some sense.  However, is this the unnamed restaurants first problem with a faulty supplier, or is this a pattern?  And, even if it is the first time, perhaps some of the unnamed product is still in the market?

2.  Since the outbreak involves a perishable item, by the time the CDC announces the outbreak, the tainted product has long been consumed.

This one I have heard a “bunch” of times – especially in leafy green outbreaks.  However, why should the public be left in the dark about the type of product that sickens as well as the likely grower and shipper so they can make future decision who to buy from?

3.  Going public with the name of the restaurant compromises the epidemiologic investigation by suggesting the source of the outbreak before the investigation is complete.

I completely agree with this one.  This is a tough call, and one that must create the most angst for public health officials – they decide the balance between having enough data to go forward to protect the public health or wait for more data.  The point is do not go forward until the investigation is complete.

4.  Public health is concerned of making an investigation mistake like, it’s the tomatoes, err, I mean peppers.

See my answer to 3 above.  This is why under the law; public health officials are immune for liability for the decisions that they make in good faith to protect the public.

5.  Public health – especially surveillance – is under budgetary pressures and there are simply not the resources to complete investigations.

There is no question that this is true.  I have seen it in dropped investigations over the last few years.  Labs are not doing genetic fingerprinting to help reveal links between ill people.  And, many trace backs are stopped by the lack of people power to do the research necessary to find the “root cause” of an outbreak.

For me it is easy – the public has a right to know and to use the information as it sees fit, and people – especially government employees – have no right to decide what we should and should not know.  CDC, FDA and the state health departments of health should just do their jobs.