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Publisher’s Platform: CDC – Sandwiches or Tacos?

Does the CDC like tacos more than sandwiches?  Or, is it hopefully something else?

First, let’s be clear, confidential patient information should never be disclosed absent the patient agreeing to it. And, second, a report should not be issued if there is no outbreak linked to a product and/or manufacturer.  However, once an outbreak is tied to a particular product or manufacturer, the public has a right to know what or who is poisoning them, yes, even if the risk has passed for the moment.  Consumers need to be able to make market decisions based upon safety records of the suppliers of food to them and their families.

I know, I have been harping on this transparency thing over the last few weeks after the CDC, once again, failed to name the “Mexican-style fast food restaurant chain, Restaurant Chain A” for the second time in two, and arguably three, Salmonella outbreaks that were eventually tied to Taco Bell.
 
Then the CDC announced another outbreak, an apparently ongoing outbreak: “This investigation is ongoing, but preliminary results of the epidemiologic and traceback investigations indicate eating raw clover sprouts at Jimmy John’s restaurants is the likely cause of this outbreak.”

Investigation Announcement: Multistate Outbreak of Shiga Toxin-producing Escherichia coli O26 Infections Linked to Raw Clover Sprouts at Jimmy John’s Restaurants:”

The CDC reported a total of 12 persons infected with the outbreak strain of STEC O26 reported from 5 states. The number of ill persons identified in each state is as follows: Iowa (5), Missouri (3), Kansas (2), Arkansas (1), and Wisconsin (1).
 
A few weeks earlier the CDC announced this outbreak: “This particular outbreak appears to be over”), as a final report “Investigation Announcement: Multistate Outbreak of Salmonella Enteritidis Infections Linked to Restaurant Chain A:”

As of January 19, 2012, a total of 68 individuals infected with the outbreak strain of Salmonella Enteritidis have been reported from 10 states. The number of ill persons identified in each state with the outbreak strain was as follows: Texas (43), Oklahoma (16), Kansas (2), Iowa (1), Michigan (1), Missouri (1), Nebraska (1), New Mexico (1), Ohio (1), and Tennessee (1).

On the face of the above two descriptions, the only clear reason to out Jimmy John’s and not Taco Bell is that the “Restaurant A” outbreak report was completed and the Jimmy John’s report might still be added to.  However, I think you could well argue the opposite.  During an ongoing investigation, you do not want to introduce bias and telegraph to potential victims where they may or may not have eaten or what they may or may not have eaten.  So, perhaps there are other reasons?

According to the CDC, in the Jimmy’s John’s sprout outbreak, of the 11 ill persons with information available, 10 (91 percent) reported eating at a Jimmy John’s sandwich restaurant in the 7 days preceding illness.  Eight (80 percent) reported eating a sandwich containing sprouts, and nine (90 percent) reported eating a sandwich containing lettuce (interesting that they called out sprouts and not lettuce).

The “Restaurant A” – Taco Bell outbreak was less definite on a percentage basis.  According to the CDC, among 52 ill persons for whom information was available, 60 percent reported eating at “Restaurant Chain A” in the week before illness onset.
 
Although 60 percent is less that 91 percent (genius right?), the CDC still found that ill persons (62 percent) were significantly more likely than well persons (17 percent) to report eating at “Restaurant Chain A” in the week before illness. The CDC also found that no specific food item or ingredient was found to be associated with illness due to common ingredients being used together in many menu items. However, among ill persons eating at “Restaurant Chain A,” 90 percent reported eating lettuce, 94 percent reported eating ground beef, 77 percent reported eating cheese, and 35 percent reported eating tomatoes (so, not a ground beef outbreak?).

Again, on the face of it, having a 91 percent assurance that most of the people recalled eating at Jimmy John’s and only 60 percent recalled eating at Taco Bell – I mean “Restaurant Chain A”– seems like a good rationale to keep the name of the restaurant from the public.  But is it?  Is 60 percent the cutoff for the CDC to just not name names?  Should the CDC have announced the outbreak or even named “Restaurant Chain A” at all?

Or, perhaps it is because in the Jimmy John’s outbreak the CDC (or FDA) identified a single seed lot versus no common supplier for “Restaurant Chain A.”  Honestly, that might cut in favor of naming the seed supplier in the Jimmy John’s outbreak and not naming Jimmy John’s, and not naming the suppliers in the “Restaurant Chain A” outbreak, but naming “Restaurant Chain A” as Taco Bell.

Damn, this all gives me a headache.

I did find this CDC statement in the “Restaurant Chain A” – Taco Bell outbreak:

Restaurant Chain A, as well as their food suppliers and distributors, were very cooperative in providing extensive information to public health officials as various leads were explored.

Maybe, Jimmy John’s did not play nice?  Or was it because this is Jimmy John’s fifth problem with sprouts.  But, then wait, how many times has “Restaurant Chain A” – Taco Bell had issues?  Well, unless you read my blog, you would never really know, and that is the problem.

Any other ideas?

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