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Q&A: Former WHO Food Safety Head on the Outbreak

As part of our ongoing expert Q&A series, a conversation with Jorgen Schlundt, former head of Food Safety, Zoonoses, and Foodborne Diseases at the World Health Organization, now the deputy director of the National Food Institute in Denmark, on the unfolding E. coli catastrophe centered in Germany and what it means for EU food safety coordination.

Q: I can imagine you are very busy right now. What’s the latest on the outbreak?

A: We’re following this from the side, the main event is really in Germany. It seems to be clear that it is cucumbers and/or tomato salad … we have 14 Danes [sickened in the outbreak.] We’re trying to manage this in Germany and in Denmark.

Q: Do you think the outbreak will continue to grow, or have we seen the worst?

A: We really cannot know. I personally don’t think it will get that much bigger, but it has grown pretty fast. It might be that we haven’t reached the peak yet, but the numbers seem to be stabilizing.

Q: How does this outbreak compare with others you’ve seen in the EU?

A: This is very comparable to U.S. outbreaks with other vegetables. It was most likely through contaminated water or manure. This bacteria comes mainly from cattle, it can make it onto product by being spread onto the crop, which is wrong, or by contaminated water used for irrigation … something was done improperly.

EHEC E. coli come from cattle. Other big outbreaks have been related to meat because you get fecal contamination at the slaughterhouse. But major outbreaks related to green crops, that we eat without heat treatment, have also been linked to manure, whether on the land or in the water.

Q: Do you think the misuse of manure is common in the EU? Or are we talking about a few bad actors?

A: It’s a few actors, but some of them can be very big producers. It’s not to say that it’s a mean farmer –I ‘m not suggesting bad motives — but it could be poor management. Or maybe a farmer doesn’t know his water is contaminated. You can’t see the contamination. You have to regulate upstream…

Q: You mean regulate how animal agriculture facilities deal with waste?

A: Absolutely. Yes.

Q: How does your foodborne illness surveillance system differ from the U.S.?

A: It’s different in different countries. In Denmark, food regulatory and public health sides work together. They normally get together every week. When there’s an outbreak they meet more often, there’s lots of direct coordination. CDC does not always work directly with FDA or USDA. The way our system is set up might be more efficient … Germany is similar to the U.S., they have states, or lander, so different authorities are involved.

Q: But the EU, overall has a similar system to CDC, Eurosurveillance...

The U.S. has been at the forefront the last 10 or 15 years. They’ve been able to find outbreaks faster than anyone. Pulsenet is extremely efficient. [Eurosurveillance] repeated that. Pulsenet is still more efficient, but it’s difficult to compare …The problem [with Pulrsenet] is that it’s not in all the states, so it’s not perfect. But in the U.S. you are able to detect so many outbreaks.

[On why you don’t see these kinds of outbreaks in Asia, Africa, or the Middle East]: If you don’t look, you don’t find. The U.S. is efficient at looking, EU is moving in that direction, and we will see more recognition of these outbreaks in Asia and Africa.

Q: Are some of the countries within the EU bad at detecting outbreaks?

A: Not all are the same. I wouldn’t say they’re not good, but some of the Eastern systems are just starting up. They need to time to get up and running, it’s just like anything else…

Q: Is this unfolding outbreak highlighting holes in the system, do you foresee meaningful reforms coming out of this?

A: Knowledge of timing on manure on the ground … [manure] is good, it’s ecological, it’s a natural way of giving plants additional nourishment, but the timing is key especially when using it with crops that we know will be eaten by human beings raw. Timing is key. We know that pathogens can live on green crops a very long time, so therefore it is very important to improve knowledge for prevention. Timing is extremely important and the other part is contaminated water. If cattle runoff contaminates water upstream, a cucumber farmer might not have a clue.

Q: How is the EU doing improving food traceability? If you have a problem in Denmark, how rapidly can you trace back to the source?

A: That’s improving significantly in all parts of the EU. There’s a very good system in place. We have numbers for all humans and all animals — all animals have ear tags. It’s getting better and better. For other [agricultural] products there are systems in place — they are not perfect, but they are getting better. We also have a rapid alert system. If there’s a problem it is immediately reported to the EU and then [point people in each country] are notified. Every day they get reports, mostly minor infractions, but they already have an efficient system in place if there is a major problem.

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