The strain of bacterium found recently at a Nestle's plant in Virginia is not actually the same as the strain blamed for an outbreak of illnesses in 30 states.
The FDA made the announcement today, and production at the plant is reportedly ramping back up. Here's a new AP story and a slightly fuller one from ABC News, the second of which brings a third strain of E. coli into the picture.
And perhaps more relevant considering the scarcity of facts, the list of recalled products, the Food and Drug Administration's basic page on the topic, plus one from the federal Centers for Disease Control and Prevention.
But if you're wondering how the investigators ended up pointing the finger at cookie dough in the first place, here's an informative blog post from a CDC officer investigating this outbreak. She writes: "There are no short cuts. We talk to the patients, we look at the combined information, and we generate hypotheses about the cause. Then we can refine our questions and go back to the patients again to see which hypothesis holds true."
And, as a bonus, here's Michael Jacobson, executive director of the nutrition watchdog Center for Science in the Public Interest, expressing outrage over Nestle's alleged recalcitrance in cooperating with the FDA during inspections at the plant in question.
And in other food safety news this week: "Administration moves to bolster food safety net."
None of which explains the source of the E. coli blamed in the outbreak.
-- Tami Dennis
Photo: Some people actually eat cookie dough without cooking it first.
The recalls are dwarfed by those recent, and now almost infamous, ones prompted by the Peanut Corp. of America. But they're starting to add up. Plainview Milk Products Cooperative of Plainview, Minn., has started another recall with ripple effects, this one of nonfat dried milk, whey protein and thickening agents sold over the last two years.
The reason? Possible salmonella contamination.
No illnesses have been linked to any of the products, which aren't sold directly to consumers but to companies with which the cooperative does business.
But because dry milk lasts a while, one of its main selling points after all, some could conceivably be in your cabinet.
Another month, another food-borne outbreak. In the most recent E.coli news, the bug has shown up in cookie dough and, possibly, beef.
In case you've wondered what it is that makes E. coliO157:H7 so very much more dangerous than the E. coli that resides in great numbers in our bowels (I have) here's a primer.
But first, a look at it under the electron microscope. Pretty, eh? (In reality it's not pink: that's a bit of artistic license.)
This toxin-producing trait doesn't come from the E. coli genes -- it comes, instead, from a virus that invaded the bacterium some time in the past. There are a whole class of bacteria-invading viruses, known as bacteriophages, in nature -- in the Soviet Union, people used to drink bacteriophage tonics that they'd get from their doctors, in the hopes that these would fight bacterial infections. Scientists are still investigating whether some phages (as they're known for short) may work effectively as antibiotic stand-ins.
The virus that directs formation of shiga toxin in E. coli isn't the kind that invades a cell, then immediately turns it to tatters while making thousands of copies of itself. Instead, the virus can sit there happily inside the bug -- its DNA stitched neatly into the genome of the bacterium -- steadily directing formation of the shiga toxin protein courtesy of two genes it carries.
What does shiga toxin do? Nothing nice. According to Todar's Online Textbook of Bacteriology (here's the link, in case you don't have it set as your home page), shiga toxin is 100,000 times more toxic than snake venom. It acts by inactivating a key part of a cell's machinery, stopping the cell's ability to make proteins. And thus the cell dies.
The toxin, as it's formed, leaks out of E. coli O157:H7. Then it binds to human cells and enters them: it so happens that it binds especially well to kidney cells, helping explain why renal failure can occur in E. coli O157:H7 food-poisoning cases. Cattle aren't bothered by the bug -- because their kidneys lack the receptor that allows the toxin to get into human kidneys and wreak such havoc.
So there you have it. Granted, none of this is the kind of thing that anyone in the throes of a dangerous food-poisoning episode would be particularly interested in knowing about.
The movie "Food, Inc." opens in several cities, including Los Angeles, on Friday. It's a critical look at the way food in the United States is produced. ("You'll never want to eat again," commented a colleague who's seen the movie already.)
Food, Inc. decries our processed-food diets, industrial farming, hormone-fed animals, cloned meat, genetic engineering and more.
A Reuters story describes how the food industry is fighting back against the movie, partly via websites of its own, such as one called safefoodinc.com, run by meat and poultry producers. You can see movies there too, with riveting titles such as "Turkey Production and Processing."
In an Associated Press story, director Robert Kenner suggests small ways in which individuals can change their habits to make a difference: "Go to a farmers market whenever you can. Eat a little less meat. Read labels when you go into a store. Shop the outer rows of the supermarket. Cook at home. Buy less processed food."
Adds author Michael Pollan, "Get involved in your school lunch program. Get junk food out of the whole school. Sign up with a listserv for one of the many groups that’s tracking this. Your congressman/woman needs to hear from you."
Clearly, we're eating in terrible ways in this country, and there are so many things that facilitate that, starting with our genetic predisposition to love high-calorie foods and to revel in variety, plus an industry that caters very efficiently to those desires: There are 47,000 products in a modern supermarket, according to the movie. Such temptation! And because of the way food prices are structured, some of the least healthful, most caloric choices are the cheapest.
And so many questions. It would be great if a local-food, everyone-eats-organic, no-pesticide way of farming could still get everyone on the planet fed. Maybe it could, but has anyone done the math? And does the movie mix in legitimate concerns with fears that aren't grounded in science? For example, a lot of data suggest that so-called cloned meat -- actually, meat from regular cattle whose fathers were clones -- is no different than "normal" meat. So, leaving aside the "yuck" factor and animal welfare issues for a moment, is there a food safety issue with cloning? And are organic farms less -- or more -- likely to give us E.coli or salmonella? I'd really like to know.
Those hard plastic bottles made of polycarbonate -- convenient and inexpensive -- do apparently let the controversial chemical bisphenol A leach out into the liquids being held, that much seems fairly clear.
Researchers at Harvard School of Public Health decided to test the connection between the containers' use and urinary concentrations of bisphenol A, or BPA. For a week, 77 students participated in a "washout phase" in which they quaffed their cold beverages from stainless steel bottles. They then took part in the hard-core phase of the study in which they quaffed their beverages from polycarbonate bottles.
Urine samples were tested before the polycarbonate phase and afterward. Yep, the stuff showed up. And how. BPA concentrations rose 69% after the polycarbonate-container week.
The researchers wrote:
"Despite within-person variability resulting from other sources of BPA exposure, a measurable increase in urinary BPA resulted from only one week of exposure to beverages contained in polycarbonate bottles. Replication of this study in other populations may help to inform public health policy regarding the use of BPA in polycarbonate food and beverage containers."
Of course, what effect such exposure could have on long-term health is still the subject of considerable debate. And study.
Here's the easy-to-digest Harvard School of Public Health news release.
And here's the full study, published in the journal Environmental Health Perspectives.
-- Tami Dennis
Photo: What you use to hold this stuff could affect the chemical makeup of your urine; the other potential effects are still being studied.
If you're among those Americans personally affected by the spate of food recalls involving, most notably, peanuts (a series that pained me deeply -- peanut butter Clif bars were not meant to be discarded nor returned) and, more recently, pistachios, you're not alone. But you don't seem to have a lot of company either.
Among the highlights of a new survey from Rutgers University's Food Policy Institute:
* Only 6 in 10 Americans had ever even bothered looking for a recalled product at home.
* Only 10% had ever found one.
Considering that almost 4,000 peanut products alone have been recalled in recent months, a fresh look at the pantry might be warranted.
Don't get Americans wrong. They say food recalls are important. Really. More than 90% would agree that recalls save lives. But about 32% think that maybe the government overreacts to them. And more than 20% suspect that most food recalls aren't serious enough to warrant their attention.
That lack of attention might explain why, when asked to assess how many recalls there had been both of meat and poultry products and of other food products in 2007, half of Americans surveyed guessed a total of 10 or fewer. The U.S. Department of Agriculture and the Food and Drug Administration said there had been 58 and 77, respectively.
Taking into account the vagaries of daily news, Americans' extraordinarily busy lives and the fact that, after a while, the recalls do seem to blend together, it's little wonder that many individual recalls escape notice. The media can offer the big picture about food safety and consumer impact, complete with context, but if you need specific product reports (and to trust that you'll get that information when you're ready for it) ... well, you'd best have those alerts land in your inbox, for perusal when you're ready.
The Food and Drug Administration lets you sign up for alerts, recalls and assorted safety notices as they relate to potential food-related illnesses, possible allergen contamination and more.
I received 17 e-mail alerts while writing this post. Seriously. They began with one about Albanese Confectionary Group and wrapped up, for now, with one about Azar Nut Co. All were pistachio-related except for one involving undeclared fish protein (found in Old Cape Cod Sweet and Bold Grilling Sauce) and another involving medical devices (intra aortic balloon pump catheters from Arrow International).
So while the numbers can be overwhelming, recalls are most useful if you actually know about them. Whether you choose to consume that Clif bar once you've been told is up to you.
As the survey summary states: "To be effective, food recalls must generate sufficient attention and motivation among consumers that they take appropriate protective actions. The results of this national survey suggest that for many Americans, this simply has not happened."
-- Tami Dennis
Photo: They're a thing of beauty. But to truly appreciate them, you need to know they're safe. Credit: Gary Friedman / Los Angeles Times
If you've ever had a brief ailment -- queasy, diarrhea, perhaps -- it's pretty likely you've wondered if it was something you ate. These days, food recalls have focused attention on contamination in the food supply.
One thing that's changed is the ability to detect and connect food safety problems.
Twenty-five years ago, if 700 people in 46 states reported getting salmonella poisoning – the numbers from the recent peanut-related outbreak – no one would have linked them, says Linda Harris, a microbiologist at UC Davis.
“Suddenly, especially when there’s a unique [DNA] fingerprint, it pops out as being a cluster of people. Now suddenly there’s a reason to investigate an outbreak,” she said.
It's estimated that 1 in 4 Americans gets food poisoning every year. About 40,000 cases of salmonellosis are reported annually in the United States, and an estimated 400 people die, according to the federal Centers for Disease Control and Prevention. The incidence of salmonella infection, which can be transmitted to people by many routes, has not declined in recent years, according to 2007 statistics, the CDC said in a report.
“We have to put it in perspective,” Harris says. “I don’t want the message to consumers to be, 'You’re going to have to take a stress reliever to go to the grocery store because you are wondering is it going to get me this time.' ”
But she also says that people don't always pay attention.
As a microbiologist, Harris says, she’s very interested in developments in food-borne disease. But if the recall were for tires or appliances, “I would be completely oblivious to it, so on some level I can appreciate that the average consumer has so much going on to pay attention.”
Just how oblivious?
A few years back, she says, an ice cream company recalled some of its products. Because it was a home-delivery company, it could contact its customers and tell them not to eat the ice cream. But people still ignored the warning.
Tests by Kraft Foods led to the recall of pistachios -- and the warnings to consumers not to eat them for now. But such testing and reporting are not required by law, and not every company is as aggressive, which is prompting calls for reform.
Reform is needed not only by government but also within companies, says Tom Kozenski, a vice president at RedPrairie, which develops recall software for retailers and manufacturers. Companies should be able to better track their products and should be doing more inspections – even though that could be costly.
Recalls can permanently hurt brands; some have gone bankrupt.
“Trust is a big thing, right?” he says. “If I had to throw away ‘Tom Kozenski Ketchup,’ I may never buy Tom Kozenski Ketchup again.”
Public health advocates are praising the $1 billion for disease prevention and wellness programs included in President Obama's economic stimulus package but say that it is only a fraction of the billions needed to keep the country healthy.
The United States spent about $35 billion a year on disease prevention in 2008, or about $17 per person, according to Jeffrey Levi, executive director of Trust for America's Health, a Washington-based advocacy group. That compares with $2.4 trillion spent on treatment.
According to the ounce-of-prevention argument, spending on the former would help whittle down the latter.
Public health spending covers a wide variety of programs, including inspecting restaurants, tracking tuberculosis cases, providing vaccines, preparing for disasters and promoting exercise and nutrition. Such services are intended to counter, among other things, food poisoning outbreaks, the spread of infectious diseases and the surge in chronic conditions such as obesity and diabetes.
But faced with a financial crisis, local and state governments are cutting public health spending. More than 11,000 public health jobs were eliminated in 2008, Robert M. Pestronk, executive director of the National Assn. of County and City Health Officials, said during a teleconference this morning. That, he said, is the equivalent of two states completely shutting down their public health departments.
The teleconference was called to publicize the release of a report called "Shortchanging America's Health: A State-By-State Look at How Federal Public Health Dollars Are Spent," produced by Trust for America's Health and the Robert Wood Johnson Foundation.
"It's essential that as the country considers ways to reform its health system, we not only think about providing quality healthcare to everyone but that a strong public health program has to be the cornerstone," Pestronk said.
There was one lucky break in the ongoing salmonella outbreak that has so far led to 637 confirmed illnesses in 44 states and may be linked to nine deaths:
The strain of salmonella involved responds to antibiotics.
Like the nasty bugs highlighted in a story in today's paper, salmonella belongs to a large category of bacteria called "gram-negative," referring to how they respond to a lab test called a Gram stain. These bacteria are especially hard to fight because they are wrapped in a double membrane and harbor enzymes that chew up many antibiotics.
Already somewhat resistant to antibiotics naturally, some of these microbes -- including Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii -- have mutated to become resistant to almost every known treatment.
Salmonella infections usually resolve in five to seven days without antibiotics. Often they require little treatment besides liquids to replace fluids lost in diarrhea. Severe cases may require intravenous fluids.
In the rare cases in which salmonella infections spread beyond the intestines, however, antibiotics are necessary. And some salmonella strains have become resistant, according to the national Centers for Disease Control and Prevention.
Four years ago, the Infectious Diseases Society of America sounded the alarm about the dearth of new wonder drugs to treat antibiotic superbugs. The report called on Congress to provide incentives to drug companies, who find it more profitable instead to focus on therapies for high cholesterol and other chronic conditions.
Fortunately -- if anything that involves so many illnesses can be called fortunate -- there are still antibiotics that work to treat the strain of Salmonella Typhimurium involved in the ongoing outbreak, should drugs be needed. If that were not the case, public health officials say, the outbreak could be even worse than it is.
-- Mary Engel
Photo credit: AP / The Indianapolis Star, Michelle Pemberton
Tami Dennis, who takes the word "skeptic" to previously uncharted territory, is the Times' Health and Science editor. She's adamant that pitches promoting awareness days, weeks or months are, by their nature, non-stories. And, because she's an adult, she refuses to use words like "veggies," "tummy" and "yummy."
Rosie Mestel, deputy Health and Science editor, studied genetics before abandoning flies, fungi and DNA for health/medical writing. Her hero is the biologist Ernst Haeckel, whose jellyfish paintings inspired snazzy chandeliers. Her favorite toast-spread is Marmite, a British delicacy made of yeast extract. Her least-favorite word is "millenniums."
Melissa Healy is a staff writer for the Health section reporting from Washington D.C. Healy's a veteran of The Times' National staff, having covered the Pentagon, Congress, poverty and social welfare, the environment, and the White House before shifting to Health in 2003. She writes frequently about mental health and human behavior, about federal health policy, prescription medication and ethics in medicine. More wonk than wellness freak, Healy chooses to believe in the health benefits of coffee and wine, and considers water a better work-out medium than beverage.
Karen Kaplan covers genetics, stem cells and cloning. She and colleague Thomas H. Maugh II comprise about 25% of the unofficial MIT-Alumni-in-Journalism Club, and she is proud to have taken more math (5) than English (0) courses in college. Her contributions to Booster Shots will, she hopes, appear more frequently than postings to her mommy blog.
Thomas H. Maugh II has been a science and medical writer at the Times for 23 years. Before that, he was on the staff of the journal Science for 13 years.
He has bachelor's degrees in English and chemistry from MIT and a doctorate in chemistry from UC Santa Barbara.
After a brief stint as a sports writer, Shari Roan turned to health journalism and has covered the topic for The Times for 18 years. She is the author of three books and the mother of two daughters, both teenagers who refer to her as a "health freak." She likes to jog, watch baseball and is very happy that dark chocolate contains some health benefit.
Jeannine Stein writes about fitness, sports medicine and obesity for the Health section. She’s a gym rat from way back and never met an elliptical trainer she didn’t like. Well, maybe one or two. She tempers exercise with a steady diet of reality television because she believes it’s all about balance.
