Last week, in the wake of the State Supreme Court’s ruling in Brayton et al. v. Pawlenty et al., Minnesota Governor Tim Pawlenty issued Executive Order 10-07, which seeks to prioritize core government functions in anticipation of shutting down non-core government functions to save money for the state’s significant budget deficits.
The detection of communicable diseases like E. coli, Salmonella, and Campylobacter are within the purview of the Minnesota Departments of Health and Agriculture, which includes the nation’s most dynamic and competent illness detection unit: “Team Diarrhea.” This critical group of illness sleuths, in conjunction with the state’s public health lab, are not only involved in, but are instrumental to, the detection of many outbreaks of not only state, but also national scope. Thus, in the wake of endless food poisoning outbreaks and recalls, the price of Governor Pawlenty’s anticipated shutdown of any aspect of Minnesota’s public health machine may be millions of dollars in medical costs, many illnesses, and maybe even worse.
On March 6, 2009, Elizabeth Weise and Julie Schmit profiled Team Diarrhea in a USA Today article titled, “When Food Illnesses Spread, Minnesota Team Gets the Call.” The article details Team Diarrhea’s role in cracking the national Salmonella Typhimurium outbreak linked to peanut products sold by Peanut Corporation of America. The outbreak ultimately caused nearly one thousand confirmed illnesses, nine deaths, and probably tens of thousands of other related illnesses. USA Today reported:
“Minnesota’s prowess in investigating food-borne illness outbreaks–in contrast to less successful efforts by other states–exposes weaknesses in the nation’s ability to quickly track and contain outbreaks, food safety specialists say.
“That’s because the national system for identifying food-borne illnesses relies on the efforts of hundreds of local, regional and state health departments, all with differing capabilities, budgets, priorities and procedures. If an outbreak starts in a region ill-prepared to investigate cases, it may not be stopped as quickly as if it had started elsewhere, food safety officials say.”
Just how many people were spared the agony and cost of severe illness as a result of Team Diarrhea’s actions will never be known for sure, but the answer may well be measured in the thousands, in terms of illnesses prevented, and millions, in terms of medical costs saved. The article went on to state:
“Minnesota’s fast work has protected the public from contaminated food before. Last year, its team was among the first to blame hot peppers–not tomatoes, the initial suspect–for the largest [S]almonella outbreak in a decade. In 2007, the team found pot pies to be the source of another [S]almonella outbreak. In both cases, Minnesota took less than a month to find what turned out to be a confirmed culprit when people had been falling ill in other states for months.
“When it comes to food-borne illness investigation, ‘Minnesota is leap years ahead of … most of the rest of the nation,’ says James Phillips, head of infectious diseases for the Arkansas Department of Health.”
Notably, part of Minnesota’s success in stopping outbreaks cold is the regulatory and legal framework that the State of Minnesota has wisely put in place. By law, hospital laboratories in Minnesota are required to send stool samples that test positive for many communicable diseases on to the State Public Health Lab, which continues the detective work by identifying the strain and DNA fingerprint of the particular type of bacteria involved. This is critical in the detection of outbreaks because, for the most part, only illnesses from genetically related strains of bacteria indicate an ongoing outbreak.
In contrast, the same cannot be said for approximately 40 percent of other states. In the above-referenced article, USA Today reported, for example, that Texas, which had more than one-third of all illnesses in the pepper Salmonella outbreak, does not require hospital and clinic labs to send positive samples on to the state lab for further DNA and strain identification. “Instead, Texas only requests that labs send samples to the state lab, and they’re not always sent.”
The list of Minnesota’s successes in major public health events and outbreaks is long and distinguished, and the cost of shutting the machine down may be, with no exaggeration, illness and death–and devastating losses to food businesses who are undoubtedly well-served by Minnesota’s competent work. Just ask the tomato industry, which lost more than $100 million due to its erroneous association with the 2008 Salmonella saintpaul outbreak. Who knows how many more tomato farmers would have unnecessarily lost their livelihoods without Minnesota’s help.
And one more statistic to support the argument that a shutdown of Minnesota’s public health machine poses extreme risks to the entire country’s health and well-being. Texas is one of the largest states in the country, with 22 million people. In 2006, Texas reported a grand total of 4 food poisoning outbreaks to the CDC. Wyoming, whose population totals half a million, also reported 4. Minnesota, with less than one-fourth the population of Texas, reported 79.
Nobody can fault Governor Pawlenty for trying to save money, particularly in this economic climate. But, speaking for the entire nation and all its residents who are undoubtedly served by the Minnesota health machine remaining in place and fully operational, we ask that you consider the grave threat to public health that closing the machine down would cause.