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The Editors of Effect Measure are senior public health scientists and practitioners. Paul Revere was a member of the first local Board of Health in the United States (Boston, 1799). The Editors sign their posts "Revere" to recognize the public service of a professional forerunner better known for other things.

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Another multistate salmonella outbreak, this one from ?

Category: CDCConsumersEnvironmental healthFDAFoodFood safetyInfectious diseaseRegulationRegulations
Posted on: January 9, 2009 7:46 AM, by revere

You may be surprised to learn (I was) that the US is having a large (almost 400 people) multistate (42) salmonella outbreak (S. typhimurium, often but not always associated with poultry and dairy products). So far 67 hospitalizations, with patients spanning the age spectrum (ages 1 to 103).DNA fingerprinting has established all cases are related (a common source or sources). Oh, and one more thing. It didn't just begin. Apparently it's been going on since sometime in September.

Like the plat du jour, this is the salmonella outbreak du jour. Last summer we were treated to the tomatoes-cilantro-jalapeno peppers fiasco (see here, here, here). Then the microwaveable frozen chicken entrees. Don't forget the pet food. Now salmonella oubreaks happen all the time. The are usually local, and even the local ones can be fairly large. But what we are seeing here are large and multistate outbreaks. This is not a local food vendor gone wrong. This is a whole system gone wrong. The food safety system is broken and it doesn't even seem able to stop outbreaks once discovered, much less prevent them. In the current outbreak CDC and its sister food "safety" agencies have yet to identify the source:

"It is often difficult to identify sources of foodborne outbreaks. People may not remember the foods they recently ate and may not be aware of all of the ingredients in food. That's what makes these types of investigations very difficult," said CDC spokesman David Daigle. The U.S. Centers for Disease Control and Prevention, the Food and Drug Administration and the U.S. Department of Agriculture are working to determine the source of the outbreak. (Alice Carver, eFluxMedia)

I'm guessing they know a lot more than they are telling us. This has been going on now for a few months. But they obviously feel burned by the tomato/pepper/cilantro episode from the summer. That's understandable. The announcement to stop eating tomatoes before they had positively nailed it cost farmers and producers a lot of money. Personally, I think erring on the side of caution was proper, but clearly they aren't going to chance a repeat. It would give me more confidence if they would just say that, but agencies don't like to admit they screwed up, so we won't hear it. Why they won't tell us which states are affected, though, is a mystery. Maybe they could just tell us which states aren't affected. It's probably just communications incompetence and stupidity. That's the easiest and most plausible explanation.

Meanwhile, there's another big multistate salmonella outbreak and no specific plans I've heard to fix the FDA and USDA. CDC could sure use some new leadership, too. So much to do. So little time.

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1

I'm guessing they know a lot more than they are telling us.

That's an understatement. They haven't said which states, nor have they said what food is suspect. Why did they even bother telling us there's an outbreak? I'm glad they have the public's best interest in mind!

Posted by: C. Corax | January 9, 2009 9:01 AM

2

State departments of health have to comment on whether or not they are investigating the outbreak after the CDC releases an official statement. If you need to know, try contacting a state health department for a comment. That being said, don't expect them to tell you what they believe is the vehicle.

As we learned in the Pew Report on the Jalapeno outbreak of 2008, government agencies failed the public by releasing inconsistent messages at different times. This devastated tomato farmers when in the end, they turned out to be free of contamination. I'd be willing to bet that while officials do know much more than they're telling us right now, they are just waiting for the appropriate time to release good epidemiologic and laboratory-confirmed proof of the source of the outbreak. There is no need to cause public panic and devastaate markets before reaching a significant conclusion.

Posted by: Evan Henke | January 9, 2009 10:55 AM

3

Well, it looks like the Minnesota Department of Health has once again cracked a national outbreak of Salmonella. As Revere and I noted, it doesn't look like federal agencies are willing to agree that peanut butter is in fact the source until Minnesota provides definitive proof that the S. typhimurium they found matches the outbreak strain's PFGE subtype, likely to avoid another premature food advisory. At least the team of infectious disease epidemiologists in Minnesota have the guts (and presumably the proof) to put themselves out on the line in the name of the public's health.

Posted by: Evan Henke | January 11, 2009 4:56 AM

4

CDC has their statement up now, with an update scheduled for the 15th. In it, they list the 42 states and their case counts. Here: http://www.cdc.gov/salmonella/typh0109/010909.html
The short version is:

Among the 380 persons with dates available, illnesses began between September 3 and December 31, 2008, with most illnesses beginning after October 1, 2008. Patients range in age from

Posted by: MoM | January 11, 2009 12:07 PM

5

Try again to get the whole post...

CDC has their statement up now, with an update scheduled for the 15th. In it, they list the 42 states and their case counts. Here: http://www.cdc.gov/salmonella/typh0109/010909.html
The short version is:

Among the 380 persons with dates available, illnesses began between September 3 and December 31, 2008, with most illnesses beginning after October 1, 2008. Patients range in age from <1 to 98 years; 49% are female. Among persons with available information, 18% were hospitalized.

Posted by: MoM | January 11, 2009 12:09 PM

6

MoM: Post going up between 3 and 4 pm EST with more complete info on this.

Posted by: revere | January 11, 2009 12:48 PM

7

What I was going to say a couple days ago, thwarted by update:

I'm guessing they know a lot more than they are telling us.

Which is in its own way vastly preferable telling us a lot more than they know, which seems to be what happened last summer.

Posted by: caia | January 11, 2009 5:56 PM

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