The Centers for Disease Control and Prevention (CDC) says illnesses from E. coli O157:H7 fell to a five-year low in the U.S. last year.  CDC attributed the improvement to a combination of government and industry efforts to curb contamination. The CDC has been tracking E. coli O157:H7 cases since the Jack in the Box incident in 1993 killed 4 children and sickened over 700.  The contaminant was confined to beef until a few years ago when it started appearing on field vegetables.  One of the most unexpected cases was last year’s recall of Nestle Toll House cookie dough, ultimately traced to contaminated flour.

Campylobacter, Listeria, Salmonella, Shiga toxin-producing E. coli (STEC) O157, Shigella, and Yersinia infections have declined overall since 1996.  But the incidence of infections caused by Salmonella, Listeria, and Campylobacter has essentially been unchanged since 2004, causing some concern.  Why the steady advances in the science behind defeating these infections haven’t moved the dial is a question that needs an answer as soon as possible.

Confirmed cases of E. coli O157 have finally reached a government-stated goal of less than 1 of every 100,000 people, according to the CDC report.  The agency’s Foodborne Diseases Active Surveillance Network (FoodNet) identified 459 cases in the 10 states it audits.  Translated to nation-wide numbers, those data suggest over 70,000 people are hospitalized every year and approximately 60 die.  Continuing, chronic health problems suffered by survivors are an unknown factor, contested in court too often by the legal community.  The most notorious is the tragedy that struck Stephanie Smith in 2007.

Her story earned Michael Moss and other New York Times staff members a Pulitzer Prize for explanatory journalism. Their report on the effect a contaminated hamburger had on the life of a young dancer turned a harsh light on defects in federal regulations and might have been the catalyst that led to recent changes in government oversight.

Writing about the prize-winning story, the Associated Press said, “Moss used confidential corporate and government records to tell the story of a single hamburger patty that infected 22-year-old Stephanie Smith with E. coli in 2007 and left her paralyzed.”

The CDC report, which delighted meat industry trade associations, was questioned by two of the food safety system’s most vocal critics.  “The findings of this report show that although there has been some progress, significant work remains to improve our food safety system,” said Rep. Rosa DeLauro (D-CT). “We have seen the E. coli incidence go down in the past only to rise the next year.  While there was a decrease in E. coli we saw increases in other critical foodborne illnesses like campylobacteriosis and vibriosis. These trends clearly show the need for an improved food safety system.”

Food safety lawyer Bill Marler, always ready to look on the flip side of things for a darker story, blogged, “Perhaps we simply stopped counting the real number of E. coli O157:H7 cases?

His blog pointed out that “the number of state health department epidemiologists, and the tasks they can perform, have decreased since 2006, according to a study published by the CDC on Dec. 18, 2009.  So, less funding, fewer epidemiologists means you count fewer E. coli O157:H7 cases?  How convenient–the fewer you count, the better you look.”

“So, a 25 [percent] decrease in E. coli O157:H7 illnesses at the same time state health department epidemiologists are decreasing? Hmm, sounds like ‘fuzzy math’ to me.”

Fuzzy math or not, DeLauro’s call to improve the food safety system might become a reality soon.  FSIS is preparing to implement new, more aggressive traceback procedures when meat samples at grinding plants test positive for E. coli O157:H7.

Dr. Daniel Engeljohn of FSIS said the real issue is the degree to which the agency traces the source of E. coli when samples test positive.

“It is a difference in how we do it with an investigation related to illness.  What we announced is a substantive change to more thoroughly investigate traceback to the slaughter supplier, more so than what we do today.”

Engeljohn’s plan will give FSIS a two-day head start, allowing immediate action when they get a preliminary or “presumptive” finding of E. coli in routine testing of ground beef.  Currently FSIS waits 48 hours for the presumptive test to be confirmed.  With the rapid consumption patterns of fresh ground beef, that 48 hour time lapse can allow most, if not all, the product to enter commerce and be consumed.

Montana Senator John Tester thinks the approach Engeljohn announced is still too weak and is introducing a bill that would require traceback to the original source–not just the facility that sold trimmings to a grinding plant.  He wants investigators to get to the slaughter facility where E. coli most likely was introduced.  Currently, a valid traceback system isn’t required by USDA.

Indeed, restrictions on the degree of traceback and packer prohibitions on testing incoming product at the grinding plant have left a huge hole in the food safety net.
Tester’s traceback plan should end a glaring shortfall in FSIS’s ability to combat E. coli O157:H7.  Last summer, a letter sent from Phil Derfler, Assistant Administrator for the Office of Policy and Program Development, to Ken Petersen, Assistant Administrator for the Office of Field Operations, underlined the problem.

Derfler’s letter, contents released by the North American Meat Processors Association last June, addressed the responsibilities of an establishment that receives and processes raw beef to control E. coli O157:H7 as opposed to the establishment that supplies the beef.

The letter states that if primals are to remain intact, E. coli O157:H7 is not considered a hazard that should be specifically addressed by the establishment that receives them.  However, if any of the product is to be ground the “responsibility for controlling this hazard falls largely on the receiving establishment”.  The ‘sending’ establishment has no responsibility.

In other words, a small processor doesn’t have to worry about E. coli being present on meat shipped in from his supplier unless the bacteria are present.  Only then does he have to worry about it, especially if he intends to grind.  It’s a peculiar government-granted conundrum.

The letter states that the key point is that “receiving establishments must perform on-going activities to verify that its HACCP plan is being effectively implemented and maintain documents that support that those activities and the frequency with which it performs them are appropriate to accomplish their intended purpose”.

However, the letter also states that this does not mean the supplying establishment has no responsibility for the safety of primal cuts, particularly if it knows the primals are intended for use as non-intact products. 

Derfler’s letter represented no change from FSIS’ thinking at the time. Because no new regulations were issued for controlling E. coli O157:H7, the North American Meat Processors Association said it was becoming increasingly difficult for further processing establishments to justify the decision that E. coli O157:H7 is a hazard not reasonably likely to occur on the subprimals they receive.

In fact, without stricter upstream cont
rols, E. coli contamination should be deemed a hazard likely to occur.  Maybe Engeljohn’s plan with an assist from Tester can solve the Catch 22 faced by small- to medium-sized suppliers of ground beef?