Effect Measure

The big news is that the UK has its first large outbreak of H5N1 in commercial poultry, a turkey farm in Suffolk. Retailers there are already moving to reassure the public. Although this is the UK’s largest turkey farm, large chains have been quick to say they do not sell its birds. The Talking Points have been ready for some time. You have nothing to fear but fear itself. It is perfectly safe to eat an infected bird if you cook it properly.

The US poultry industry is also ready, although they have assured us they are safe because they have excellent biosecurity. Just like the UK farms assured us. Good biosecurity is not all the US poultry industry has. They’ve also got a helluva lot of infected chickens, although not infected with H5N1. It’s salmonella and campylobacter, both human pathogens. This, from Consumer Reports:

In the largest national analysis of contamination and anti biotic resistance in store-bought chicken ever published, we tested 525 fresh, whole broilers bought at supermarkets, mass merchandisers, gourmet shops, and natural-food stores in 23 states last spring. Represented in our tests were four leading brands (Foster Farms, Perdue, Pilgrim’s Pride, and Tyson) and 10 organic and 12 nonorganic no-antibiotics brands, including three that are “air chilled” in a newer slaughterhouse process designed to re duce contamination. Among our findings:

Campylobacter was present in 81 percent of the chickens, salmonella in 15 percent; both bacteria in 13 percent. Only 17 percent had neither pathogen. That’s the lowest percentage of clean birds in all four of our tests since 1998, and far less than the 51 percent of clean birds we found for our 2003 report.

No major brand fared better than others overall. Foster Farms, Pilgrim’s Pride, and Tyson chickens were lower in salmonella incidence than Perdue, but they were higher in campylobacter.

There was an exception to the poor showing of most premium chickens. As in our previous tests, Ranger–a no-antibiotics brand sold in the Northwest–was extremely clean. Of the 10 samples we analyzed, none had salmonella, and only two had campylobacter.

Among all brands, 84 percent of the salmonella and 67 percent of the campylobacter organisms we analyzed showed resistance to one or more antibiotics. (Consumer Reports)

Overall the rate of laboratory confirmed infections is down a bit from 2001, although everyone admits that only a fraction of foodborne illnesses are reported. Only a fraction of the reported cases identify a source and an agent. Consumer Reports found the organic and antibiotic free chickens to have strikingly higher rates of salmonella than the conventional birds (around 25% compared to 5%), but both had antibiotic resistant bugs, a legacy of decades of growth promoting antibiotic use in the poultry industry. (The one exception was organic Ranger brand, which had no salmonella in ten samples.)

But the major chicken contamination was with campylobacter, contaminating 81% in this sample compared to less than 50% in a similar survey in 2003. Here’s CDC’s portrait of a campylobacter foodborne infection:

Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within 2 to 5 days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts 1 week. (CDC)

CDC estimates about 1 million cases a year and 100 deaths. So this isn’t small potatoes in terms of illness and economic cost. At the moment USDA does collect data on campylobacter in processing plants, although this is allegedly coming soon. As Consumer Reports notes, whatever worked for salmonella is not working for campylobacter. Regulation has brought salmonella down substantially. The same needs to happen with campylobacter.

The punchline here is that protection against campylobacter and salmonella is the same as it is said to be for H5N1: proper preparation and cooking of poultry. Heating the bird to an internal temperature of 165 degrees F. is sufficient to kill most pathogens, including those three. There is good case evidence that eating uncooked or undercooked parts of infected birds can lead to H5N1 infection in susceptible individuals. So can preparing the birds for cooking. Birds contaminated with salmonella and campylobacter are safe if properly prepared and cooked, but more than a million cases a year of infection with these organisms continue to occur. You make the inference.

Those are my Talking Points.

Comments

  1. #1 Leni
    February 5, 2007

    Hmm. Vegetarianism is looking better and better every day.

  2. #2 Patch
    February 5, 2007

    1 million cases. That’s a big number.

    But to be statistically significant we’d need to know what the total consumption is. In other words, 1 million infections out of how many times chicken is consumed? What is THAT number? Less than 1%? 5% maybe? 10%? More?

  3. #3 revere
    February 5, 2007

    Patch: It’s not really a question of statistical significance. You are inqiring about the distinction between absolute numbers and risks. A small risk on a large base produces a large number (1 million in this case). All depends on whether you are focused on the risks to the individual (small in terms of probability) or the aggregated burden to the community (large in terms of suffering and economic costs).

  4. #4 The-Best-Bird-Flu-Blogs-Team
    February 5, 2007

    Patch, UK produces app. 20 Million Turkeys and 850 Million Chickens each year.

    What is very important is, that the source of this infection be discovered asap.

    If it is found that the H5N1 has been around in the UK for a while now and that it was just that it was not discovered earlier, then that is a very serious problem for the entire poultry industry in the UK.

    Here is a blog with some interesting questions. JM :

    The great Bird-Flu Who-Done-It?
    Posted 2/5/2007 10:06:54 AM

    Still no clue as to the mysterious source of the H5N1 infection at the Bernard Matthews farm at Suffolk UK.

    The company hotly denies any links of the infection with it’s Saga Foods farms in Hungary, where there were several outbreaks of the H5N1 virus, over the last few weeks.

    This, in spite of the fact, that exactly the same strain of the H5N1 virus was found last month, in geese in Hungary.

    DEFRA (Department for Environment, Food and Rural Affairs) is currently looking in to the possibility of the workmen having brought the virus on their shoes in to the infected turkey shed.

    Well, that suggests that there is H5N1 present on the ground in the UK or, at least in the Suffolk area!

    That is not good!

    Then there is the possibility of a small wild bird sneaking in to the shed via the ventilation shaft.

    You see, this is not the wild bird migration season.

    So if there was an infected bird in that area, then it had been around for a while and was a local wild bird.

    Of course where there is one infected local wild bird, there could be more of them.

    That is not good at all!!

    British Cats are known to be partial to a bit of Turkey when they can get it.

    So what about the possibility of a cat getting in to the shed, or a rat which is more likely.

    The game is definitely afoot in the Shires of England.

    Hope the case of the mystery Bird Flu virus can be solved soon before there are more fatalities.

  5. #5 Mike the Mad Biologist
    February 5, 2007

    I guess I’m going to have to blog about this: I think there are some serious problems with the CR article (and the results just aren’t that surprising).

  6. #6 revere
    February 5, 2007

    MIke: Good. That would be useful. We’ll await with interest. For those of you who don’t know, MadMike is an expert on antibiotic resistance and knows much more about this topoic than we do. He lives over at Mike the Mad Biologist here on ScienceBlogs.

  7. #7 Ron
    February 5, 2007

    What got me about the TV coverage of the UK situation was the health official who came out with the brilliant suggestion that people need to keep their poultry “inside”! No mention of the fact that the turkeys in question *were* apparently inside and under measures of “biosecurity”. There is no evidence to suggest that keeping poultry inside will be of any use in preventing the spread of H5N1. In fact, confined poultry may be the original source of HPAI. We may just be improving conditions for the spread of H5N1 by locking birds up.

    Though it is highly probable that H5N1 was originally brought to England by migratory birds, it is not very likely that this outbreak was transmitted directly. We must suspect an endemic presence and pretty poor surveillance (not exclusive to England).

  8. #8 Attack Rate
    February 5, 2007

    Is your talking point that “people don’t practice good kitchen hygiene and fail to properly prepare food” or “as people practice poor kitchen hygiene, advising that properly cooked poultry is safe is a bad move”? You could infer either.

    I too will await MadMike’s post with interest. I too have some serious issues with the article you refer to.

  9. #9 Tom DVM
    February 5, 2007

    Poultry and ground beef are the only cases where you purchase a lethal weapon in a grocery store and get blamed if it goes off, injuring you.

    Authorities never bother to uncover the source just blame the unsuspecting victim.

    There has been a lot of work done in Northern Europe to solve these problems.

    The one successful company is probably using their techniques.

    It used to be an art and profession to slaughter meat…it now is a minimum wage job.

    In Canada, 95% of food poisonings are mistaken for influenza…the cost to the Ontario economy estimated at more than 500 million per year.

  10. #10 revere
    February 5, 2007

    Attack Rate: Actually my Talking Point was that we currently aren’t protected by kitchen practices from salmonella and camp. so why should we think we are protected from H5N1? Yes, people could be more careful. But they aren’t. Tom’s point is well taken.

  11. #11 DeLuca
    February 5, 2007

    Revere, I am meticulous in the kitchen and follow procedures as though I were in a lab but in reality one doesn’t have kids and pets running through the lab or interested adults peeking into your test tubes. To safely cook H5N1 poultry I think I’d need a biosecure kitchen. It isn’t that most folks don’t want to be careful, it is simply beyond our abilities.

  12. #12 DeLuca
    February 5, 2007

    I meant to say H5N1 “infected” poultry..

  13. #13 Another
    February 6, 2007

    Be careful of the belt at the grocery store. The place where you put food on before you get to the register. It usually has chicken blood on it. I have worked at grocery stores in the past, and most spills on the belt is from chicken blood coming out of the package. When I wiped it off with cleaner (just regular cleaner), the paper towel would be somewhat bloody and dirty looking.

  14. #14 palamedes
    February 7, 2007

    Answer;

    I can’t speak for everywhere, but in the Greater Seattle area, most of the larger grocery stores have a thing about wanting you to bag your meat before you bring it to the register, even if it’s already wrapped in a plastic/styrofoam combo.

  15. #15 Path Forward
    February 7, 2007

    Re: “English Bird Flu”

    I wonder how soon U.S. poultry officials are going to issue THEIR knee-jerk talking points, about how unlikely it is that the English Bird Flu will infect U.S. poultry flocks. It would be a refreshing change from the industry’s current meme about “ASIAN Bird Flu”….”

  16. #16 Ian Forrester
    February 8, 2007

    Seems now it is likely that the infection was brought to the farm by partially processed birds from a plant in Hungary where there is a lot of H5N1 around.

    From the Independent, February 9, 2007:

    ” Britain’s first outbreak of bird flu may have been caused by semi-processed turkey meat imported directly from Hungary, where the disease is prevalent, the Government said last night.

    Large quantities of the meat – 38 tonnes of it a week – have been brought in to the processing plant of the Bernard Matthews turkey farm at Holton in Suffolk, where a week ago thousands of live turkeys in an adjacent shed were found to be suffering from the H5N1 strain of the virus.

    The revelation, in the statement from the Department for Environment, Food and Rural Affairs (Defra), is a remarkable about-turn. Earlier this week, the Environment Secretary, David Miliband, assured the Commons that there was “no Hungarian connection”. The question had arisen because the Bernard Matthews company has a large Hungarian subsidiary which produces turkeys under the brand name Saga, and avian flu has recently been found in Hungary.

    Mr Miliband had said the outbreak had probably been brought to Britain by wild birds. Last night’s statement shows government vets now consider the Hungarian link to be a prime hypothesis for the outbreak. It also makes the wild-bird theory extremely unlikely – as Britain’s bird experts have always said.

    The Hungarian theory has been further strengthened by tests indicating that the virus in Suffolk and the virus in Hungary are identical”.

    The full article can be found at:

    http://news.independent.co.uk/uk/health_medical/article2251356.ece

  17. #17 revere
    February 8, 2007

    Ian: Saw this but also saw there is some confusion about this. Defra doesn’t want wild birds to be the source and the statement the virus is “identical” is given in another story as “the virus could very well be identical.” So I’m not too quick to say which way the virus went (it could have gone from the UK to Hungary and just disovered first in Hungary) or how (wild birds or some other source) until we see more data. Too many agendas at work here. The idea that it speads by poultry product movement is consistent with a lot of other data, however, so I agree this is a connection that needs to be intensively followed up and I await more info.