The University of Minnesota’s “Team Diarrhea” or “Team D” may soon serve as a model for other food safety centers around the country.
A number of similar centers proposed in legislation introduced by Sen. Amy Klobuchar (D-MN) last year would investigate suspected food safety issues, such as Salmonella and E. coli outbreaks, with an approach similar to that of Team D, which is a collaborative effort between the Minnesota Departments of Health and Agriculture and the University of Minnesota School of Public Health.
In Minnesota, doctors are required to report all suspected cases of foodborne illness to the Department of Health. Upon receiving the report, each case is investigated by a team of University of Minnesota graduate students with Team D. Students contact patients and ask a series of questions about their symptoms and what foods they consumed before becoming ill.
What factors contribute to Minnesota’s excellent track record in successful food illness outbreak investigations? According to Carlota Medus a principal epidemiologist with the Foodborne, Vectorborne, and Zoonotic Diseases branch in the Acute Disease Investigation & Control Unit of the Minnesota Department of Health, a number of things come into play.
“Multiple factors contribute to Minnesota’s successful investigations,” Medus told Food Safety News. “Centralized reporting of illnesses to the state; test results sent straight to Team D; epidemiologists assigned specifically to foodborne illness investigation, and interviewing all cases in real time.”
In addition to the aforementioned steps Medus explained, once Team D finds a pattern in interview data, new surveys are created by using the information that patients disclose in interviews, then all of the patients are re-interviewed with the pointed survey.
“We’re talking to someone fairly quickly after their illness so they’ll have better recall,” said epidemiologist and co-leader of Team D, Stephanie Meyer. “We’re also getting the details that we need to do the best kind of follow-up,” she said.
Last year, Team D’s investigations helped determine the source of the Salmonella outbreak eventually linked to peanut butter by asking patients a series of questions. Investigators noted that peanut butter was the one commonly consumed food amongst the patients.
The Minnesota Department of Agriculture’s investigation led officials to suspect that the Salmonella came from King Nut peanut butter produced by the Peanut Corporation of America in Georgia. The team of investigators tested a large tub of the product and found the potentially deadly bacteria.
“We call it the smoking tub,” Heidi Kassenborg, director of dairy and food inspections at the Department of Agriculture, said. “It was contaminated, so we really needed to pull the product at that time.” The outbreak resulted in nine deaths across the U.S., including three from Minnesota. Over 700 people became ill with Salmonella during the outbreak.
Minnesota health officials were also responsible for determining that jalapeño peppers, rather than first-suspected tomatoes, were the source of another Salmonella outbreak in 2008. That incident was one of the largest Salmonella outbreaks in recent years, with hundreds of people across the country falling ill.
In an interview about the legislation she introduced to create more centers like Team D, Knobluchar told a local Minnesota television station, “We’re proud of what our team does, it seems ridiculous that people have to die in Minnesota before it gets solved. What’s unique about Minnesota is they work like a team and really treat it as a mystery and try to solve it right away.”
In the majority of other states, local health departments are charged with looking into probable causes of foodborne illness, but a lack of time and resources sometimes prevents the incidents from being investigated quickly.
Medus told Food Safety News that the creation of food safety centers like Team D around the country could work, but the model would have to change to fit each state’s reporting system along with making sure the center was following other state health codes and regulations.
“The model can be applied in other states, you would just have to modify the fit to how each state is set up. For example, currently many states only have a handful of epidemiologists at the state and local level, which makes it very difficult to coordinate what’s going on in the state, so it would be something that would have to change over time,” she said.
The FDA Food Safety Modernization Act, S. 510, proposes numerous changes to make the domestic food system safer by requiring more inspections and give the FDA greater authority to enforce mandatory recalls. The Senate is expected to work on this legislation anytime now.