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Publishers Platform: How can we stop outbreaks earlier

Would catching outbreaks before they are over save lives and give us quicker knowledge as to the cause?

Opinion

Looking at the Salmonella Tuna Scrape (they really need a better name for it) outbreak numbers yesterday, it got me spending some of my day at work today looking at CDC data over the last few years on outbreak surveillance, investigations, announcements and government or business recalls.

Looking at the data, it is fairly clear that most – but not all – outbreaks are not figured out until far into the Epi curve or not until the outbreak is winding down.  It raises the question how we can arm, local, state and federal investigators with the tools to figure out outbreaks earlier and prevent more illnesses.

In addition, I still have that nagging issue of recall effectiveness.  Again, many – but not all – recalls are not effective at stopping the consumption of the “recalled” tainted product – consumers consume it first.  What tools do pubic health officials, food manufacturers, retailers and consumers need to know so they know what has been recalled and what has not been?

Peanut Corporation of America Salmonella Outbreak 2009 – As of April 20, 2009, 714 persons infected with the outbreak strain of Salmonella Typhimurium have been reported from 46 states. The number of ill persons identified in each state is as follows: Alabama (2), Arizona (14), Arkansas (6), California (81), Colorado (18), Connecticut (11), Florida (1), Georgia (6), Hawaii (6), Idaho (17), Illinois (12), Indiana (11), Iowa (3), Kansas (2), Kentucky (3), Louisiana (1), Maine (5), Maryland (11), Massachusetts (49), Michigan (38), Minnesota (44), Missouri (15), Mississippi (7), Montana (2), Nebraska (1), New Hampshire (14), New Jersey (24), New York (34), Nevada (7), North Carolina (6), North Dakota (17), Ohio (102), Oklahoma (4), Oregon (15), Pennsylvania (19), Rhode Island (5), South Dakota (4), Tennessee (14), Texas (10), Utah (8), Vermont (4), Virginia (24), Washington (25), West Virginia (2), Wisconsin (5), and Wyoming (2). Additionally, one ill person was reported from Canada.  Infection may have contributed to nine deaths: Idaho (1), Minnesota (3), North Carolina (1), Ohio (2), and Virginia (2). Among the persons with confirmed, reported dates available, illnesses began between September 1, 2008 and March 31, 2009.  Recall: January 28, 2009 (red bar):

Jimmy John’s Salmonella Sprout Outbreak 2009 – As of May 7, 2009, 235 persons infected with the outbreak strain of Salmonella Saintpaul have been reported from 14 states. The number of ill persons identified in each state is as follows: Nebraska (111), Iowa (35), South Dakota (38), Michigan (19), Kansas (8), Pennsylvania (7), Minnesota (5), Ohio (3), Illinois (2), Virginia (2), West Virginia (2), Florida (1), North Carolina (1), and Utah (1).  Among the 234 persons with known illness onset dates, illnesses began between February 1 and April 15, 2009.  Recall: March 3, 2009 (red bar):

Wright County Egg Salmonella Outbreak 2010 – In July 2010, CDC identified a nationwide sustained increase in the number of Salmonella Enteritidis isolates with PFGE pattern JEGX01.0004 uploaded to PulseNet.  From May 1 to November 30, 2010, a total of 3,578 illnesses were reported.  Based on the previous 5 years of reports to PulseNet, the CDC would expect approximately 1,639 total illnesses to occur during this same period. This means there are approximately 1,939 reported illnesses that are likely to be associated with this outbreak.  There was one death.  Recall: August 13, 2010 (red bar):

Jimmy Johns Salmonella Sprout Outbreak 2010 – From November 1, 2010, through February 9, 2011, 140 individuals infected with the outbreak strain of Salmonella serotype I 4,[5],12:i:-, whose illnesses began (onset dates) since November 1, were reported from 26 states and the District of Columbia. The number of ill persons identified in each state and the District of Columbia with the outbreak strain is as follows: Arkansas (1), California (1), Colorado (1), Connecticut (1), District of Columbia (1), Georgia (1), Hawaii (1), Iowa (1), Illinois (70), Indiana (13), Kentucky (1), Louisiana (1), Massachusetts (2), Maryland (1), Missouri (23), Nebraska (1), Nevada (1), New Jersey (1), New York (2), North Carolina (1), Oregon (1), Pennsylvania (4), South Carolina (1), South Dakota (1), Tennessee (2), Virginia (2), and Wisconsin (4). Among 138 persons for whom information is available, reported illness onset dates range from November 1 to January 18, 2011.  Recall: December 29, 2010 (red bar):

Cargill Ground Turkey Salmonella Outbreak 2011 – A total of 136 persons infected with the outbreak strain of Salmonella Heidelberg were reported from 34 states with illness onset dates between February 27 and September 13, 2011. The number of ill persons identified in each state was as follows: Alabama (1), Arkansas (1), Arizona (3), California (7), Colorado (4), Connecticut (1), Georgia (2), Illinois (16), Indiana (2), Iowa (2), Kansas (3), Kentucky (2), Louisiana (1), Massachusetts (4), Maryland (1), Michigan (12), Minnesota (2), Mississippi (2), Missouri (7), Nebraska (2), Nevada (1), New Jersey (1), New York (3), North Carolina (4), Ohio (12), Oklahoma (2), Oregon (1), Pennsylvania (8), South Dakota (3), Tennessee (2), Texas (18), Utah (1), Vermont (1), and Wisconsin (4).  One death was reported.  Among persons for whom information was available, illnesses began on or after February 27, 2011.  Recall: August 3, 2011 (red bar):

Pine Nuts Salmonella Outbreak 2011 – A total of 43 individuals infected with the outbreak strain of Salmonella Enteritidis were reported from 5 states. The number of ill persons identified in each state with the outbreak strain was as follows: Maryland (1), New Jersey (2), New York (28), Pennsylvania (8), and Virginia (4).  Among 43 persons for whom information was available, illnesses began on or after August 20, 2011.  Recall:  October 26, 2011 (red bar):

So, readers and subscribers, what are the solutions to getting on top of outbreaks earlier and making recalls actually recalls?

The goal of course it to avoid the outbreak and the recall in the first place.

One other pet peeve, many of the people who are sickened in an outbreak are never told by local, state or federal health authorities that they are part of an outbreak.  Why is that?  I’ll save this for another day.

© Food Safety News
  • “All that is necessary for the triumph of evil is for good men to do nothing ”
    In our society today we are taught that it is always someone else at fault. Instead of being accountable and responsible for ones actions we call legal people that tell us to say nothing.
    As they slow the process down and more people get sickened or die needlessly.
    ” AND SO IT GOES “.

  • Dog Doctoer

    Ethanspapa, I am not sure where your comment fits into the discussion. The case of PCA, they knew they were shipping contaminated product shouldn’t they be held accountable?
    What about others who cut a corner because it was easier or cheaper and made people sick shouldn’t they are held accountable?
    Or do you buy your food and consider it contaminated and take appropriate steps to make it safe?
    Food Safety is a complex issue where everyone has a share in the responsibility but consumers should have a reasonable expectation of a safe product don’t you think?

  • You can blame it on traceability of the type we have today of one up and one down. No documentation at the point of growing/handling/processing/shipping (who, where, when how etc.) and no date and time stamps of records. Web-based search engine like ScoringAg and and a unique used only once in 100yrs. of a lot number/search code number which is searchable via the web whould bring order to the food/feed industry. Test and hold before shipping would be another great improvement. Sanitation records tied to the unique lot code and who done it is another.
    With very little data and the slowness of tracing back from one location to the next, no wonder we have problems. Most products have been sold after the fact. Most tracebacks can never find the specific site (5 feet) of the problem let alone the laborer, environment or the machine that was the cause. Complete commingling data is never visable either, packing houses and mills do it everyday.
    Yes, most final site tracebacks ( PIDC) never happen (FDA says the trail went cold or they said the possible contaminated product was destroyed) and if the above statements were taken seriously, with full traceback from field to fork, the complete process would be found much sooner and the product would have never been put on the retail shelf. What is needed is a full traceback search code (SSI-EID) that can reveal all data from the final shipper within seconds.