Food Safety and Environmental Health Blog : Disease Prevention, Public Health, Sanitation Information & Analysis : Environ Health Associates

Doug Powell below writes in his Barfblog about the delay in CDC notifying the public about the source of the current SE outbreak in eggs. The CDC went public in mid August when apparently sufficent information existed in late July to implicate Iowa's Wright Egg Farms.

Other outbreaks in the recent past had the same scenario, a delay between identifying the likely source of outbreaks and public disclosure.

There might be a couple of explanations for the delay in the naming of names as a result of epidemiological findings. The strength of the epidemiological data sometimes is not strong enough to make confirmation completely bullet proof, remember we are dealing with relative risk.
Second, when an agency goes public they can be wrong and end up with well...egg on their faces, and much worse.

On the other hand, when there is a strong likelihood of a public health threat there might be good reason to go public even if all data crunching is not complete, a common supplier is certainly suspicious. I agree with Doug, the key is the strength of the data.

The FDA is investigating a nationwide outbreak of Salmonella in  shell eggs.

http://www.emergencyemail.org/newsemergency/anmviewer.asp?a=578&z=34&ref=fem

While many believe that contaminated water and feed and rodents are to blame, if you go further back into the causation you will find that the egg is contaminated because of the absence of salmonella pullorum in the gut of the chicken.

Programs to combat the one disease of chickens in the 1980's some believe led inadvertently to the colonization of the gastrointestinal tract and reproductive organs of chicks by the human pathogen, SE. It doesn't necessarily mean that the first event caused the other, but there is biological plausibility to this argument and the temporal association I think is striking. Especially, given this disease occurred in several parts of the world almost simultaneously. So the rodent that has been in the hen house for millennia causing limited human disease (through contaminated egg shells) becomes now a vector for a widespread invasive disease of poultry and humans and spreads to other food animals. Not to minimize the rodent's infectious properties and need for control, but human meddling with bacteria doesn't always turn out for the best for mankind. Interestingly, Salmonella pullorum is not treated with antibiotics, culling the bird is the intervention. 
 
Denmark has been successful in control of SE in broiler chickens, layer hens, and pigs through careful surveillance, culling, farm sanitation, pasteurization, and sanitary slaughter.
 
Denmark has now has the safest eggs in the world. And they achieved this only by an effective industry-government partnership, something we should take special note of, given the positive political climate in the US right now. See the paper from CDC below for a review of the Danish approach.
 
http://www.cdc.gov/ncidod/EId/vol9no7/pdfs/03-0024.pdf
 

8-4-10

An Open Letter to Carol B. Dover of the Florida Restaurant Association.

Dear Ms Dover:

In reply to your recent Tampa Tribune article

,http://www2.tbo.com/content/2010/aug/04/na-food-inspections-strong/
 

you failed to mention several important facts about your involvement in food safety and inspections in Florida. From an historical perspective, I have personally seen and experienced what you and FRA have done in regards the Division of Hotels and Restaurants (the Division), inspection. and food safety training. As you are a former Director of the Division, you should recall the following facts.

Prior to 1990, the Division, within the Florida Department of Business Regulation (DBR) shared the statutory responsibility for regulating restaurants with the Florida Department of Health and Rehabilitative Services (HRS) who contracted with the county health departments to perform the inspections. While there was duplication in this relationship, the county had the authority to bring legal action through DBR and DBR ultimately controlled the license, the county had only permitting authority.

In 1990, the Office of Restaurant Programs (ORP), a state level organization, was formed under HRS to regulate restaurants, taking the food safety program from the individual counties, but leaving the DBR licensing structure in place. ORP operated for 2 years and in that time completed all requirements for inspections. Additionally, the focus under the state brought uniformity to DBR enforcement and compliance was moving forward very rapidly. In 1992, Florida had few reported foodborne illness outbreaks, and this was also the last year all inspections were performed as required in Florida.

In 1992, you successfully prevailed upon the legislature to move the new and effective health program- ORP, to the licensing agency- DBR, your former agency. Your argument at that time was that 67 counties were performing inspection 67 ways which was a facetious argument because command was already centralized in Tallahassee . But those of us in the organization saw the real reason behind this move. That reason had to do with controlling the inspection process.

DBR’s takeover of the health department’s food program was disastrous. The first cycle produced only 50% of the required establishment inspections. The transferred inspectors from ORP had to receive additional training in lodging laws and rules as well as fire safety. Conditions in Florida’s restaurants deteriorated and in 1997 we had recorded over 350 outbreaks, 10 times as many outbreaks in just 3 years.

Under the leadership of the Divisions’ head staff, a revamping of the inspection process took place and the state’s Hospitality Education Program operating from only a $6.00 fee per establishment per year trained nearly all of the state’s food service managers. Regrettably, this year the Hospitality Education Program (HEP) was decommissioned. In recent years, the HEP program had been reduced to a minor role at the Division in spite of its outstanding record, and one can only speculate the reasons behind this

In 2000, your organization successfully passed legislation requiring all Florida food workers to be trained in food safety. While training is a good idea, your organization through its political power won the right to “preferred” training provider status and the industry narrowly escaped having all other current training programs in place at that time made illegal There is no coincidence here. The new requirements for training launched a very successful FRA SafeStaff program which generates millions of dollars a year for your organizations’ lobbying efforts.

Because of your record in Florida, it is difficult for me to see your statements in the Tribune about Florida’s food safety inspection program as anything but mere political posturing. The lack of credibility at the FRA is made even more acute as your organization has the capacity to do much good for the citizens and visitors of this state.

I understand you had for many years a sign in your office in Tallahassee that read “the only good regulation is no regulation”. I might add that the only good regulation is one that benefit’s the people, and where public health and safety is concerned, those decisions traditionally have been in the hands of qualified public health scientists and medical personnel. Many believe they should remain there..

While responsible representation from industry is vital to the legislative process, public health decision making should be open, and public health laws and rule making should be as free from political pressure as our current system can make it. Right now, I am afraid recent news reports show Florida again as a bad example of how to go about food safety.

Respectfully,

Roy E Costa RS MS(MBA)