Editor’s note: This is part of series of articles and opinion columns we are publishing in recognition of September as Food Safety Education Month.

How many times have you thought through every detail of an experience and asked yourself, “What could I have done differently?” Probably thousands. But how many times have you combed over every moment and asked yourself what your family, your community, your doctors, a farmer, the health department, and the federal government could have done differently? 

Since the fall of 2006, when I ate a spinach salad and contracted hemorrhagic E. coli O15:H7, I figured out the answer to that question: Food safety education would have made the difference. 

Lauren Bush survived the 2006 E. coli outbreak that was traced to fresh spinach. After her life-threatening illness she became an advocate for victims and their families. She also supports the enactment of stronger food safety requirements. Photo courtesy of Lauren Bush

After two weeks in the hospital, four months in recovery, and almost losing my colon, I learned that something we must all rely on to survive can betray us. Before this experience, my family and my small community in western Kentucky thought that foodborne illness was only a potential problem if you didn’t cook your hamburger or you put raw chicken on the counter and missed a spot during clean up.

We didn’t know that a peanut butter sandwich, a spinach salad, or any number of other foods that can’t be washed or cooked can cause severe illness, hospitalization, or even death. I am hopeful that the hundreds of times in the last 12 years that I’ve talked about my experience to friends, neighbors, coworkers, and strangers that it made even a few more people aware of the risks, to pay attention when outbreaks are underway, and to practice precaution, where possible. Refresh your knowledge and practices at home with the Core Four Practices of clean, separate, cook, and chill and never consume raw or undercooked food in restaurants.  

As a patient of two urgent care centers, two emergency rooms, one hospital, and after interacting with the dozens of attending physicians, residents, nurses, and technicians in general practice, internal medicine, surgery, gastroenterology, radiology, the laboratory, and more — not one of these professionals questioned if foodborne illness could be the cause. No one asked what I had eaten or connected the dots of my symptoms in a holistic manner. It is essential that all medical professionals receive more than one lecture on a medical diagnosis that impacts an estimated 1 in 6 Americans every year and that can quickly become life threatening, especially for children and the elderly. A more comprehensive approach to food safety education training in coursework is necessary, as well as a required continuing education component to ensure awareness of the latest best practices in early identification and treatment.

Almost two weeks after I was home from my second hospital stay due to complications, the follow up call from the health department consisted of two questions — did I eat spinach and when was it consumed? While it is understandable that in the midst of a national outbreak the public health community must be as efficient as possible, the human connection and critical thinking was entirely missing from this interaction. What about questions like, did anyone else in my household eat the product? Did I still have the product? Where was it purchased? When was it purchased? How much did I consume? Did I need any additional information or resources?

Not just during outbreaks, but in all reported cases, we need our health departments to be the knowledgeable detectives who piece together the information as quickly as possible to prevent more families from getting sick. That is impossible if we are merely checking boxes on a form. Similar to our medical professionals, health department personnel should also have mandatory comprehensive training and continuing food safety education so they are ready with these types of questions when the food system fails.

In the years since the outbreak, I was privileged to be a member of the advocacy coalition that passed FSMA, the Food Safety Modernization Act. This landmark legislation for produce focuses on prevention, rather than reactionary methods and grants the Food and Drug Administration recall authority, increases the number of inspections, requires additional record keeping for higher risk foods, and much more. While FSMA set an undeniable precedent, there is much more to be done. 

Quality food safety education on the farm and in processing and packing facilities sets the foundation to prevent foodborne illness from occurring at the source, but we can never remove all risk. My experience, along with millions of other families every year proves that food safety education is the critical difference. 

Note on the author: Lauren urges families who have been impacted by foodborne illness to contact Stop Foodborne Illness for resources and support.


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