Tuesday, November 21, 2006

A russian roulette of food poisoning in American states

A russian roulette of food poisoning in American states
Thomas Hargrove, Scripps Howard News Service (Nov. 21, 06)
http://www.shns.com/shns/g_index2.cfm?action=detail&pk=FATALFOOD-11-21-06
More than 50,000 people, according to this story, got sick or died from something they ate in a hidden epidemic that went undiagnosed by the nation's public health departments over a five-year period. An investigation by Scripps Howard News Service was cited as finding that Americans play a sort of food-poisoning Russian roulette depending on where they live. Slovenly restaurants, disease-infested food-processing plants and other sources of infectious illness go undetected all over the country, but much more frequently in some states than others.

Scripps studied 6,374 food-related disease outbreaks reported by every state to the federal Centers for Disease Control and Prevention from Jan. 1, 2000, through Dec. 31, 2004. The causes of nearly two-thirds of the outbreaks in that period were officially listed as "unknown."
The findings translate into an alarming potential for tragedy. If health officials are unable to connect illness to food, victims who might eat from the same poisoned source cannot be warned. If food is known as the culprit, but the specific disease lurking within is not diagnosed, the victims may get even sicker or die without proper treatment.

The poor track record of so many state labs also raises chilling questions about their ability to spot or deal with a food-borne terrorist attack.
Families of children who got sick during the five-year period in the study tell heart-rending stories of heroic efforts they made to convince the medical establishment they were victims of food illness. Todd Nelson, a Continental Airlines pilot and father of a 19-month-old girl who died of E. coli, was quoted as saying, "My daughter's death would have been listed just as a 'stroke' and swept under the rug. But I wanted to know what my daughter really died of. And I wanted somebody to blame."

The Nelson family believes Ana Leigh Nelson ate infected hamburger meat from a popular Minnesota restaurant in 2002. The family demanded further private tests that confirmed a rare strain of E. coli and then demanded that the medical examiner change her death certificate to correctly report death from complications of food poisoning. The study found that Kentucky, Oklahoma and Nebraska are virtually blind to outbreaks of food sickness, rarely detecting that scattered illnesses have common food causes.

In Alabama, Florida and New Jersey, the cause of food poisoning is almost never found, even when it is known that dozens or hundreds of people became violently ill or died from something they ate, according to the Scripps study. Alabama was the worst in the nation, diagnosing only 5 percent of its reported outbreaks. Alabama State Epidemiologist John Lofgren was quoted as saying, "It's a real struggle. We've never identified a virus at the state level." After learning of the study's findings, Kentucky officials ordered changes to their disease-reporting system. "We really hadn't been categorizing food- and waterborne outbreaks," admitted Kentucky Epidemiologist Kraig Humbaugh.

During the five-year period studied, Florida reported only seven people sickened by E. coli outbreaks, a suspiciously low number for a state of its size. The story goes on to say that although the Scripps study found that the quality of the nation's network of public health departments varies alarmingly, there were some bright spots. Wisconsin, Minnesota and Hawaii do a good job of diagnosing disease outbreaks.
Wisconsin came out on top in the study by diagnosing the cause of 90 percent of its food-poisoning cases. Wisconsin also was the first state to detect and report September's deadly E. coli outbreak from infected raw spinach grown in California and shipped nationwide. The outbreak killed at least three people and sickened at least 199 others.

But the study found little to celebrate overall since most outbreaks go undiagnosed. Federal officials and public health experts agreed with the findings and conclusions of the Scripps study. Tom Skinner at the CDC's Atlanta headquarters after reviewing some of the study's findings, was quoted as saying, "Our surveillance systems were designed to ring a bell when there is a problem. Are they perfect? Absolutely not. Could they be better? Absolutely yes. We've already come a long way, but certainly, we can do better than this."

Skinner offered no explanation when asked why the CDC didn't warn underperforming states and local health departments.
Ewen Todd, director of the Food Safety Policy Center at Michigan State University, was quoted as saying, "The CDC, like most government agencies, is pretty conservative. Why would they want to rock the boat? It takes someone who is independent to say: 'This is crazy.' "
Todd agreed that the quality of public health is erratic in the United States and that the state health programs are especially poor in the South, adding, "Our laboratories are pretty good. But, overall, the whole public health system is not working very well. There are no national standards for the surveillance and reporting of food illnesses."

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