Effect Measure

It's now two and half months since CDC and US FDA declared an end to the infamous tomatoes-no-it's-peppers salmonella outbreak of last summer. The outbreak itself was even longer: 3 months. There were some 1400 reported cases but probably many more that escaped detection. That's typical for foodborne disease outbreaks.

In case you've forgotten, here's a summary, courtesy Georgetown University's Produce Safety Project (PSP):

Although CDC and FDA initially pointed in early June to tomatoes as the cause of the outbreak based on epidemiological data, no contaminated tomato was ever found. In July, CDC and FDA identified jalapeno and serrano peppers as being responsible for illnesses, and the only microbiological evidence of food contaminated by Salmonella Saintpaul was, in fact, found in jalapeno and serrano peppers. However, as a result of the initial identification of tomatoes as the vector for the disease, the tomato industry, a significant sector of this country's agriculture economy, was another major casualty. Estimates of the economic cost to that industry in Florida alone have been more than $100 million and in Georgia close to $14 million. [3] A less tangible, but still very real, impact of the outbreak may well be its long-term effect on consumer confidence in fresh produce in general and fresh tomatoes in particular. (PSP)

The Georgetown PSP (supported by Pew Trusts) examined statements, press releases, conference call transcripts and other more or less public material. Their preliminary take is that there were three main areas of concern:

• The produce safety system

  The FDA recognized that the system was not working but the PSP took issue with the agency's contention that it was up to Congress to fix things, pointing out that FDA has previously taken steps to safeguard the food supply with existing legislation. It was a failure of will, not a failure of authority;

• FDA's and CDC's effectiveness and capacity

  The timeline from the first reported cases to the first public statements to the recognition of what was, wasn't and was perhaps the vehicle revealed a confused, disjointed and uncoordinated response.

  For instance, the epidemic curve (or "epi curve") published in the CDC outbreak report shows that some 50 percent of the confirmed cases began before the FDA nationwide consumer advisory on June 7 recommending that consumers avoid eating certain tomatoes. While there was a drop in cases after that announcement, it appears that the most sustained drop began around June 24. Maybe this drop was a factor of the incubation period for the illness, or maybe it points to an off-target intervention. A post-mortem analysis should examine this question. In addition, the discussion in the CDC outbreak report of cluster investigations in mid- to late-June raises questions about why FDA and CDC officials continued to maintain so steadfastly and for so long that tomatoes were the leading suspect for being the vector for Salmonella Saintpaul.

• Communicating with the public and the industry

  Disjointed and confusing are the words the PSP uses to characterize FDA and CDC risk communications, with five agencies (two federal, three state) announcing the outbreak in the space of four days, each with different facts and messages. The descriptions were also inconsistent:

  Then, three weeks into the public-communications effort, the CDC significantly changed - with no explanation -- the manner in which it presented outbreak data, from raw number of cases in a state, to cases per million in a state, to a range of cases per state.

  Whatever the proper way to express events, CDC was clearly caught off guard and had no consistent message or approach.

The PSP report is interesting in that it doesn't focus on the most obvious failure, the failure to find the source and vehicle of the outbreak: Tomatoes? Peppers? Serrano peppers? Jalapeno peppers? Tomatoes and peppers? That failure was a symptom of a deeper problem, a problem that now will have to be faced and solved promptly by a new administration. The food safety system and the agencies tasked to carry it out is broken.

As if there wasn't enough on Obama's plate. He also has to worry about the generous helping of contaminated food the Bush administration dished onto it.