Silence of the lettuce

If there’s one result from the Salmonella Saintpaul outbreak this summer it’s this: public health types sure are reluctant to finger fresh produce in outbreaks of foodborne illness.

On Tuesday, a spokesman for the bureaucrats club know as the Canadian Food Inspection Agency confirmed they are looking to U.S. suppliers of E. coli-infected romaine lettuce that has been linked to 153 illnesses across southern Ontario, “but he had few other details.”

On Monday, something called the Produce Safety Project, an Initiative of The Pew Charitable Trusts at Georgetown University concluded in a report that weaknesses in food safety policy, organization and communications were all displayed during this summer’s outbreak of Salmonella Saintpaul.

The report, "Breakdown: Lessons to Be Learned from the 2008 Salmonella Saintpaul Outbreak," represents an in-depth review of the public record of last summer’s Salmonella Saintpaul outbreak that caused illnesses in more than 1,400 people across the country.  For a full copy of the report and the executive summary click here: http://www.producesafetyproject.org/reports?id=0001

Highlights and recommendations from the report include:

The need for the Food and Drug Administration (FDA) to use its existing statutory authorities to establish mandatory and enforceable safety standards for fresh produce.  While FDA officials said the outbreak showed the need for these standards, they said Congress needs to pass legislation to grant it explicit authority to do so.  However, the report notes that FDA has already used existing authorities to put in place preventive safety standards for seafood in 1995 and for juice in 2001.

The need for organizational reforms throughout the public health system for a more coordinated outbreak response. The report raises questions about how timely and effectively data was shared between public health agencies and if it contributed to a delayed identification of jalapeno and serrano peppers as a vehicle for Salmonella Saintpaul.

The need to have established and unified risk communication plans in place before an outbreak. The report documents "dueling" public health messages from various agencies announcing the outbreak, and questions why the Centers for Disease Control and Prevention changed its presentation of data numerous times in the middle of the outbreak.

I haven’t read the report in detail but will get to it.  And while everyone is pointing fingers, recall that epidemiology is a messy thing, but it can prevent people from barfing. Self-censorship could be worse.

Both CFIA and FDA need to establish clear and transparent protocols on when to go public in outbreaks of foodborne illness. No one will be happy, but it will provide a basis for discussion and a way to move forward; once it’s written down, it can be improved.