At the risk of beating this issue to death, I found yet another blog post I did several years ago on the issue of transparency in how public health deals with the public’s right to know.
Is there a good reason to keep a company’s name secret when it is linked to a foodborne illness outbreak?
I have a great deal of respect for Robert Tauxe, MD, MPH, Deputy Director of the Division of the CDC that is charged with prevention and control of foodborne, waterborne and fungal infections. He has been in the diarrheal trenches for a very long time – since just after E. coli O157:H7 made its quiet entrance in McDonald’s restaurant (unnamed at the time) hamburgers in Michigan and Oregon to the deadliest Listeria outbreak linked to tainted Colorado cantaloupes. Over many years he has had the responsibility for overseeing the 76 million (or is it 48 million) sickened, 325,000 (or it is 125,000) hospitalized, and 5,000 (or is it 3,000) deaths yearly due to foodborne illness – that is a lot of responsibility.
I have had the pleasure over that last two decades to on occasion share the food safety stage with him (although you get the sense that the feeling is less than mutual). And, I cannot think of anyone who looks better in a bow tie.
It is therefore with mixed emotions, and the knowledge that I likely make my relationship with public health – both federal and state – even more tenuous, that I question his quotes in today’s MSNBC dust-up over the disclosure or non-disclosure of “Mexican-style fast food restaurant chain, Restaurant Chain A” that is a source of a Salmonella outbreak that sickened 68 people in 10 states. Here is what he had to say to MSNBC:
Dr. Robert Tauxe, a top CDC official, defended the agency’s practice of withholding company identities, which he said aims to protect not only public health, but also the bottom line of businesses that could be hurt by bad publicity. The CDC, the Food and Drug Administration and state health departments often identify companies responsible for outbreaks, but sometimes do not.
“The longstanding policy is we publicly identify a company only when people can use that information to take specific action to protect their health,” said Tauxe, the CDC’s deputy director of the Division of Foodborne, Waterborne and Environmental Diseases.
“On the other hand, if there’s not an important public health reason to use the name publicly, CDC doesn’t use the name publicly.”
Because companies supply vital information about outbreaks voluntarily, CDC seeks to preserve cordial relationships.
“We don’t want to compromise that cooperation we’ll need,” Tauxe said. …
Tauxe acknowledged there’s no written policy or checklist that governs that decision, only decades of precedent.
“It’s a case-by-case thing and all the way back, as far as people can remember, there’s discussions of ‘hotel X’ or ‘cruise ship Y,” he said.
I too was quoted in the article above and was repeatedly asked if I thought that the CDC was bending to company pressure to keep the restaurant name quiet. I said emphatically no! But that did not make it into the article. So, not to put words in Dr. Tauxe’s mouth (and granted he may have had more to say), but as best as I can tell, these are his arguments for disclosure and non-disclosure and my thoughts in italics:
A. Although there is no written policy, it is the way we have done things for years;
Why do I hear my mom saying, “just because so and so does that does not mean you should too.” Like all government policies (and neckwear) – change is good.
B. Since the outbreak has concluded, there is not an immediate public health threat;
Frankly, that is true in most foodborne illness outbreaks. In nearly every single outbreak investigated by the CDC the outbreak is figured out far after the peak of the illnesses happened. However, disclosure gives the public information on which companies have a strong or weak food safety record.
C. Disclosing the name of the company jeopardizes cooperation from the company in this and future outbreaks; and
If a company will only cooperate if they are placed in a witness protection program and with promises of non-disclosure, it does not say much for our government’s and the company’s commitment to safe food.
D. Bad publicity may cause economic hardship on the restaurant.
True, but not poisoning your customers is a better business practice.
I would also add a couple more reasons that I have received via email (mostly anonymously):
1. The source was an unknown supplier, so naming the restaurant might place unfair blame on the restaurant;
This one does make some sense. However, this is the unnamed restaurant’s first problem with a faulty supplier, or is this a pattern? And, even if it is the first time, perhaps some of the unnamed product is still in the market?
2. Since the outbreak involves a perishable item, by the time the CDC announces the outbreak, the tainted product has long been consumed;
This one I have heard a “bunch” of times – especially in leafy green outbreaks. However, why should the public be left in the dark about the type of product that sickens as well as the likely grower and shipper so they can make future decision who to buy from?
3. Going public with the name of the restaurant compromises the epidemiological investigation by suggesting the source of the outbreak before the investigation is complete;
I completely agree with this one. This is a tough call, and one that must create the most angst for public health officials – they decide the balance between having enough data to go forward to protect the public health or wait for more data. The point is do not go forward until the investigation is complete.
4. Public health is concerned of making an investigation mistake like, it’s the tomatoes, err, I mean peppers; and
See my answer to 3 above. This is why under the law; public health officials are immune for liability for the decisions that they make in good faith to protect the public.
5. Public health – especially surveillance – is under budgetary pressures and there is simply not the resources to complete investigations; and
There is no question that this is true. I have seen it in dropped investigations over the last few years. Labs are not doing genetic fingerprinting to help reveal links between ill people. And, many tracebacks are stopped by the lack of people power to do the research necessary to find the “root cause” of an outbreak.
For me it is easy – the public has a right to know and to use the information as it sees fit, and people – especially government employees – have no right to decide what we should and should not know. CDC, FDA and the state health departments of Texas, Oklahoma, Kansas, Iowa, Michigan, Missouri, Nebraska, New Mexico, Ohio and Tennessee should do their jobs.
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