Food Poisoning Law Blog

Contrary to what most people would think, young (inner) lettuce greens may pose a greater risk of E. coli O157:H7 contamination than older (middle) leaves, according to a study conducted by researchers at Produce Safety and Microbiology Research Unity, Albany, California and the University of California, Berkeley. The study found that E. coli O157:H7 consistently colonized on young (inner) romaine lettuce leaves at a rate ten-times greater than on the middle leaves of the romaine lettuce. The reason may be nitrogen content. Young-leaf exudates used in the study were found to have about 2.9 times more nitrogen than the middle-leaf exudates. 

According to the researchers involved in this study, “Our results indicate that leaf age and nitrogen content contribute to shaping the bacterial communities of preharvest and post-harvest lettuce and that young lettuce leaves may be associated with a greater risk of contamination with E. coli O157:H7.”

Reference: M.T. Brandl, R. Amundson. 2008. Leaf age as a risk factor in contamination of lettuce with Escherichia coli O157:H7 and Salmonella enterica. Applied and Environmental Microbiology, 74. 8: 2298-2306.

At the public meeting held by the USDA’s Food Safety and Inspection Service, plans were announced to begin testing for non-O157 Shiga Toxin-Producing E. coli, or non-O157 STECs. The announcement comes in response to the growing amount of outbreaks associated with E. coli.  Although most dangerous outbreaks, especially among beef, are related to E. coli O157:H7, non-O157 STECs can pose just as many problems to the food industry. The USDA does not currently collect any data to track non-O157 STECs, so the testing will be done primarily to study the bacteria and collect as much data as possible.

The new testing procedures will be done primarily for collecting data. As of now, the USDA does not plan on declaring non-O157 STECs as adulterants like O157:H7, but will use the data collected to determine that at a later date.  The USDA will test samples that tested positive for O157 and also those that did not.  No recalls will be issued by the USDA if a sample tests positive only for non-O157 STECs.

Samples will be tested for six different strains: 026, 0111, 0103, 0121, 045, and 0145. These strains have been shown to cause the greatest number of illnesses among non-O157 STECs.  If the USDA declares these strains as adulterants after collecting data, products contaminated with they will undergo the restrictions applied to O157:H7.  According to Meatingplace, the USDA has prepared the following checklist if non-O157 STECs are labeled as adulterants:

• define applicable products from slaughter/dressing and further processing operations
• issue a Federal Register Notice in the form of an interpretive rule
• establish an effective date that ensures sufficient time to address seamless implementation for both domestic and imported products
• issue compliance guidelines
• issue policy implementation instructions and train FSIS inspection personnel
• conduct outreach to the regulated industry

Foodconsumer.org provided information from FoodNet showing that the number of cases and incidence per 100,000 population in 2007 for non-O157 STECs were 260 per 100,000, or .57%.  The incidence for O157 STECs was 1.20%. However, CIDRAP has stated that states such as Virginia and Idaho (not part of FoodNet) have shown that the prevalence of non-O157 STECs is already equal or greater than the prevalence of O157:H7. This information provides raw numbers, showing that non-O157 STECs are almost as big, if not bigger, a problem as O157 STECs.

A study on PubMed shows that even if non-O157 STECs aren’t as prevalent as O157, they may be just as dangerous.  After examining 940 non-O157 cases of human illness between 1983 and 2002, researchers discovered that the six strains the USDA will be focusing on are indeed the most prevalent in human illness. The data also showed that many of the bacteria were producing Shiga toxin 1 and Shiga toxin 2.  Shiga toxin 2 had a strong association with causing hemolytic uremic syndrome (HUS). According to the data, the 0111 strain caused the most cases of HUS and also caused 3 outbreaks reported in the United States.

Much of the danger associated with E. coli O157:H7 involves its ability to cause HUS, which can often be fatal.  Research shows that non-O157 STECs can also cause HUS, making them just as dangerous as O157:H7.  Non-O157 STECs also contained genes for intimin, which has been shown to increase the risk of bloody diarrhea.  These are serious symptoms, which pose a great health risk to consumers.  More research and the new plan from the USDA to test for these bacteria can only help to better understand illness rates and to better protect the American consumer.

Startling new research contributes more information about the effectiveness of antibiotics to kill bacteria, specifically in livestock.  Researchers from Harvard were trying to find microbes that could be used to convert waste into biofuels when they discovered that bacteria covered in antibiotics were not only unaffected by the drugs, but actually consumed them.

According to Discover, the researchers gathered 11 soil samples that had varying levels of man-made antibiotics to see if more drug-consuming bacteria could be found. They found that in all samples, bacteria, including Shigella and E. coli, existed that lived entirely off of the consumption of antibiotics. Some of the bacteria were thriving in conditions that contained more that 100 times the normal dose of antibiotics given to humans and more than 50 times the amount necessary to consider a bacterium resistant.

This research not only adds fuel to the fiery debate over the use of antibiotics, but suggests that bacteria resistance isn’t the only problem.  If bacteria actually eat the drugs and the genes from these bacteria spread into pathogenic bacteria, standard treatments could become entirely ineffective.

The nationwide outbreak of Salmonella Litchfield has sickened at least 50 people in 16 different states, leading to ban of imported cantaloupe from Honduras, the product implicated in the outbreak. The cantaloupe in this outbreak has been traced back to its producer in Honduras, Agropecuaria Montelibano.  Shippers and distributors of the product have recalled the cantaloupe, including Dole (Dole cantaloupe recall) and Chiquita (Chiquita cantaloupe recall). The same cantaloupe has led to an outbreak in Canada as well.

An outbreak of this scale is not new to cantaloupe. Multiple outbreaks in the past have linked various Salmonella contaminations to cantaloupe. In this decade alone, there were 47 cases in a 2000 outbreak, 50 cases in 2001, and 58 cases in 2002, all involving cantaloupe contaminated with Salmonella. These cases were linked to S. Poona, possibly through water contaminated by reptiles that carry the rare serotype.  All the melons involved were from Mexico, which spurred a banning of cantaloupe from the Mexican farm that produced the melons.

2006 saw an outbreak of S. Oranienburg in the Northeastern region of the United States and parts of Canada, affecting 41 individuals. From 1973-2003, 11 outbreaks of Salmonella in cantaloupe were reported to the CDC. There are many other documented outbreaks in cantaloupe, including the following:

• 2001 – Salmonella Poona, 46 cases (including 2 deaths) in 14 states
• 2000 - Salmonella Poona, 43 cases in 7 states
• 1998 - Salmonella Oranienburg, 22 cases in Ontario, Canada
• 1997 - Salmonella Saphra, 24 cases in California
• 1991 - Salmonella Poona, >400 cases in 23 states and Canada
• 1990 - Salmonella Chester, 245 cases in 30 states

Cantaloupe and Salmonella have a long history together in causing massive outbreaks in the United States in Canada.  The CDC and FDA are well aware of the dangers associated with cantaloupe, but history seems to repeat itself over and over again.  2005 research addressed the three outbreaks from 2000-2002 to discover why Salmonella seems so attracted to cantaloupe.  The research showed that the Salmonella bacteria form what is called a “biofilm” which are colonies of the bacteria that covered in polymers.  Most sanitizers are ineffective at getting rid of the biofilm from the cantaloupe surface, especially water-based sanitizers.

Even if Agropecuaria Montelibano had washed the cantaloupe, there is still a very good chance that biofilms of Salmonella were still present on the cantaloupe surface.  Even after purchase of the melons and washing them in water, cutting into the melon could easily have spread the bacteria into the fruit that was on the surface.

Honduran President Manuel Zelaya ate a cantaloupe on public television as a display of his confidence in the safety of his country’s fruit.  The urge for U.S. consumers not to eat Honduran fruit has led to the laying off of almost 2000 workers and criticism that the warning from the FDA is tied to President Zelaya’s close relationship with Venezuelan President Hugo Chavez.  These allegations have been denied.

No matter what the motivations for the recall are, it is important that consumers are informed of the risks associated with the product. This outbreak is just another on a long list of cantaloupe-related Salmonella outbreaks.  Perhaps this outbreak will lead to more research so that cantaloupe outbreaks can be prevented in the future.

Click here to learn more about the current Salmonella Litchfield outbreak.

All information in this article was compiled using the following links:

http://www.ars.usda.gov/research/publications/publications.htm?SEQ_NO_115=172325

http://www.ncbi.nlm.nih.gov/pubmed/15083723

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5146a2.htm

http://www.cdc.gov/enterics/publications/439-Olson2007.pdf

http://www.fda.gov/bbs/topics/NEWS/2008/NEW01808.html

In the wake of the country’s largest ground beef recall in history, the USDA is considering applying a new rule to inform consumers of retailers which supplied recalled products.  This rule, however, would only cover Class I recalls, or those which the USDA considers most dangerous.  The Hallmark/Westland beef recall of 143 million pounds of ground beef shows the issues associated with this new rule. The recall was considered a Class II recall, and would not have fallen under the rule, so that consumers would not have known where the beef was supplied.

Hallmark/Westland, however, is a California-based company, falling under California jurisdiction, a state which releases a list of retailers in all recalls. Consumers could find information through the state of California and its nearly 150 page list of retailers.  Because the recall involved ground beef, it is almost impossible for consumers to determine whether or not their purchases are part of recall due to repackaging at retailers.  When the USDA and FSIS release a recall, they often give information on where the recalled product was manufactured, but with the ground beef, the consumer is still completely in the dark.  This means that if this new rule is passed, and there is another recall like Hallmark/Westland, but not in the state of California, consumers would have no idea whether or not they were purchasing recalled beef.

Food industry groups believe that expanding the rule, or even including the rule as it is would negatively affect the market for competitive reasons. If retailer information was public knowledge, competitors would know which retailers to approach with better prices.  Without the rule, the food industry could go on as normal at the cost of withholding vital information of foodborne illness from the American public. Dr. Richard Raymond, USDA undersecretary for food safety, believes that is important for consumers to have as much information about recalls as possible.

According to Time,

In an interview this week Raymond said that it was "common sense to assume" that some consumers may have fallen ill because they didn't have access to names of retailers selling tainted meat. But he disputed the suggestion that industry opposition — expressed in written and public comments, meetings with the White House Office of Management and Budget, and other venues — has stalled the rule.

Recall information is one of the most important ways to ensure the health and safety of consumers. Giving retailer information in Class I recalls is most definitely a fantastic start, but limiting it only to those recalls would mean an absence of knowledge in some of the largest recalls issued, such as the Hallmark/Westland recall.  The food industry may not like having all the information public knowledge, but the information would greatly improve public health and perhaps spur greater care for quality products on the manufacturer’s part.

Salmonella infection is never pleasant, but for most healthy people who are exposed to the bacteria suffer from gastroenteritis and recover.  For patients with AIDS, however, the same bacteria that result in uncomfortable food poisoning for most is often fatal.  Scientists from the UC Davis Medical School have discovered what mechanisms the HIV virus uses that allow for the lethal aspects of Salmonella.

According to Science Daily,

The results of the study, which will be published online by Nature Medicine March 23, revealed that viral infection of the intestine results in the depletion of a type of white blood cell, called Th-17, in the gut mucosa. This T helper lymphocyte produces IL-17, a cytokine or chemical messenger that plays a crucial role in the inflammatory response, recruiting other immune system cells to the site of infection.

In healthy patients, the bacterial infection is defeated in the gut, but with AIDS patients, this battle is lost and the infection spreads into the bloodstream.  When the Salmonella spreads to the bloodstream, it is known as NTS bacteremia.

The scientist tested their theory by examining rhesus macaques infected with simian immunodeficiency virus (SIV), a model for HIV.  The animals that were not infected with SIV were able to combat infection by producing Th-17 cells in huge amounts, whereas those with SIV were unable to do so.

The team of researchers also used mice that lacked the IL-17 receptor, an arm of the mucosal immune response, to confirm that IL-17 deficiency leads to increased systemic dissemination of Salmonella.

By narrowing down the mechanisms and pathways and understanding how Salmonella can become in fatal in the growing number of individuals who have AIDS, scientists will hopefully be able to curb the number of fatalities.  Future research will examine more specifically how healthy patients are able to get rid of Salmonella infection in the gut and apply what they learn to decrease the mortality rate from Salmonella poisoning in AIDS patients.

Widespread problems of Salmonella and E. coli 0157:H7 are not only rooted in food safety.  There have also been issues lately with the treatment of infections due to these and other pathogens. More and more strains are becoming resistant to traditional antibiotics, bringing the need for new drugs and treatments to the forefront of the issue.  The National Institutes of Health has awarded the University of Texas Southwestern a $6.5 million grant to explore new treatments to combat a variety of pathogens.

Current antibiotics are developed to attack the process of DNA replication in bacteria, or protein synthesis, or cell wall synthesis.  UT Southwestern is researching another area.

“We are investigating a new target area in bacteria that appears to be vulnerable to a small molecule that has never before been used as a drug,” said Dr. Vanessa Sperandio, associate professor of microbiology and principal investigator on the new grant. “The drug compound has shown promise in fighting at least three different bacterial species including Salmonella, E. coli and Francisella tularensis, which causes tularemia.”

Sperandio also says that the five-year grant will allow her research to be ready at the preclinical level.  Early tests have been positive, but only further research will determine if the treatment can be used to treat human disease.  The research focuses on how bacteria like E. coli communicate biochemically inside the body, especially among good and bad strains for human health.  The research also targets any signals E. coli 0157:H7 sends that would trigger disease.

The Texas Department of State Health Services has finished its investigation of six gastrointestinal illnesses that occurred in the Bastrop area the first week of March and reports finding no common source of infection, no additional matching illnesses and no evidence of a continuing health threat.

DSHS laboratory tests of samples from the six cases did not detect a toxin, virus or bacterium that could have caused the illnesses.

On March 7, after being notified of the six illnesses, DSHS issued a health alert advising anyone in the area with severe diarrhea to seek medical attention.

Initial testing by a private laboratory had indicated shiga toxin as the cause of the illnesses. But subsequent tests by the commercial lab and by the DSHS laboratory in Austin were negative for the toxin, which can be produced by several types of bacteria.

Samples have been sent to a U.S. Centers for Disease Control and Prevention laboratory to see if more advanced testing can identify an organism. DSHS testing can detect live organisms. The CDC test can detect remnants of a dead organism.

Results of the CDC tests are not expected for several weeks.

The Pennsylvania Department of Agriculture has warned consumers to discard raw milk purchased from Fisher’s Dairy Farm in Portersville, PA due to a high risk of Listeria monocytogenes contamination. The dairy’s permit to sell raw milk was revoked in 2006, but state inspectors purchased raw milk from the dairy on March 6. Samples taken from the milk tested positive for Listeria four days later. Symptoms related to Listeria can be quite severe, resulting in death and miscarriage. No illnesses have been reported in this case.

We contacted the Texas Department of State Health Services for any updates on the illnesses caused by a shiga toxin.  Six people, including three children, were sickened. One of the children died.

The symptoms due to this toxin include severe or bloody diarrhea and abdominal cramps, usually showing up one to nine days after exposure to the bacteria.  Anyone experiencing these symptoms should immediately seek medical attention.

The FDA has suspended the temporary permit assigned to Castleberry’s Food Company.  The plant had to stop operations in the summer of 2007 when cans of chili produced at the plant were found to contain the bacteria that leads to botulism.  The FDA suspended the temporary emergency operating permit given to Castleberry’s, forcing the plant to shut down entirely, according to NBC Augusta.  There has been no information released when the plant will reopen, if at all.

The contamination of Discover Cuisine Red Curry Chicken & Jasmine Rice due to Listeria has led to recalls by three major companies.  Costco Wholesale is recalling 10,368 pounds of the frozen entrees, Inovata Foods is recalling 3,780 pounds, and Meijer Distribution Center is recalling 2,184 pounds.

All of the recalled products contain the following information:

12-ounce packages of “Discover Cuisine Red Curry Chicken & Jasmine Rice.” Each package bears the Canadian establishment number “Est. 302” inside the Canadian Food Inspection Agency mark of inspection as well as a “Best By” date of “12 18 08.”

The Hallmark/Westland ground beef recall, largest in U.S. history, revolves around the failure of the company to abide by federal regulations and the failure of federal inspectors to catch the violations earlier.  The recall questions the effectiveness of our nation’s food safety policies and whether or not they need to be improved or altogether changed.

According to the Baltimore Sun,

"The video of the Hallmark plant is evidence of what can happen when packing plants are left to police themselves without the government oversight they need," said Trent Berhow, vice chairman of the National Joint Council of Food Inspection Locals, which represents 6,500 U.S. Department of Agriculture inspectors.

"When the company is in charge of creating their own records and doing their own food safety checks, they're not going to find problems themselves," he said.

The USDA currently has in place a variety of rules and regulations that establishments need to implement.  Much of this in slaughterhouses requires taking note of which areas of the plant are vulnerable for harboring disease, coming up with a plan to fix it, and then implementing the plan.  The majority of the responsibility lies with the company, while the government officials are in place to verify that actions are being done.

This system poses a huge problem when companies aren’t being honest about keeping up with federal regulations and when there aren’t enough inspectors to make sure everything is going according to plan. The government implemented stricter policies under the Bush administration, which have somewhat been effective. The beef industry maintains that the Hallmark case is unique and does not exemplify practices throughout the industry, but there are other opinions to be had.

"What happened out in California was a good example of a plant sneaking things by," said William G. Hughes, lawyer for the National Association of Federal Veterinarians, which has 950 members. "You have to have sufficient inspection staff to guarantee that nothing is going to go wrong."

"There's a lot of room for improvement, but I don't think there's a lot of alternatives," said Caroline Smith DeWaal, director of food safety at the Center for Science in the Public Interest. "The industry plays a vital role in ensuring the safety of its products, and the government's role should be to ensure that's done correctly."

Whether or not the food safety system needs a drastic retooling or just some strict improvements remains debatable. However, the Hallmark/Westland recall has brought the issue to the forefront of the American conscience and shows the dangers of a faulty system.

Hallmark/Westland Meat Packing, the target of the nation’s largest beef recall ever, has been especially disturbing due to their contract with the USDA to supply beef to the School Lunch Program.  It is concerning that the government has been letting unsafe products into our nation’s schools.  Although 143 million pounds of beef were recalled from Hallmark/Westland, The Wall Street Journal reports that School Lunch Program has been at risk for years.

The Government Accountability Office has cited multiple reports that go back to 2003 criticizing the USDA for poor food safety standards and choosing to buy products from establishments known to violate food safety standards. According to The Wall Street Journal,

In a 2003 report, the GAO, the investigative arm of Congress, said "195, or about 3%, of the total of 7,390 foodborne outbreaks that were reported nationwide, between 1990-99, occurred in schools." The GAO traced about half of 40 large outbreaks to poor sanitation in school kitchens.

In the wake of the Hallmark/Westland recall, the beef industry has been asserting that the incident was unique and not representative of the industry as a whole.  However, the data suggests otherwise. Other officials also have reported that the USDA did not take proper precautions to prevent the purchase of meat contaminated with pathogens such as E. coli and Salmonella. The USDA also did not demand documentation from establishments to verify the quality of their products, some establishments did not even have any documentation to provide.  Contracts for the School Lunch Program were also awarded to establishments that the USDA knew had food safety problems, such as samples that had tested positive for E. coli.

However, the USDA’s Agricultural Marketing Service which is responsible for purchasing beef for government use maintains that their procedures are effective at protecting those who take advantage of government food programs. The AMS also maintains that testing procedures are strict and that AMS does all they can to purchase safe food. But the information from multiple reports and the recent Hallmark/Westland recall suggest there are many problems that need to be addressed to ensure the safety of the School Lunch Program’s beef.

The California Department of Public Health has warned consumers not to eat alfalfa sprouts manufactured by Salad Cosmo and J.H. Caldwell and Sons due to possible Salmonella contamination.  Routine testing discovered the possible contamination and the companies have voluntarily recalled their products.

According to CDPH,

Salad Cosmo USA Corp. of Dixon, Calif., has recalled Salad Cosmo Alfalfa Sprouts distributed to retail stores, including SaveMart Supermarket and wholesale distributors throughout California and Washington.  

The Salad Cosmorecalled alfalfa sprouts are packaged in 2.5-ounce plastic containers with white and green labels and clear 1-pound bags with blue labeling.  Both packages are labeled Salad Cosmo Alfalfa Sprouts. The products have “Use By” codes: 0219, 0220, 0221, 0222, 0223, 0224, 0226, 0227, 0228, 0229, 0302 and 0303.  The codes are located on the front label of the 2.5-ounce packages and on the left side of the 1-pound bags near the product name.

J.H. Caldwell and Sons Inc. of Maywood, Calif., has recalled Always Fresh and Alfa One alfalfa sprouts distributed to wholesale distributors and retail grocery stores in California, including Beach Market, KV Mart and Superior Warehouse, and to Trader Joes grocery stores in California, Arizona, New Mexico, Nevada, Oregon and Washington.  

The J.H. Caldwell and Sons recalled alfalfa sprouts are labeled Always Fresh and Alfa One. The products are packaged in 4 ounce  and 5 ounce containers and in plastic bags.  The recalled product codes are 202182, 202192, 202202, 202212, 202222, 202232, 202242, 202252, 202262 and 202272.  The code is printed on the side of the containers and on the back of the plastic bag.

Alfalfa sprouts are especially dangerous when it comes to bacterial contamination because optimal conditions for growing the sprouts also allows for rapid bacterial growth. Because sprouts are also most often eaten raw, consumers are at greater risk to contracting infections from the bacteria, in this case Salmonella.  No illnesses have been reported due to these recalls.

Costco Wholesale, a Washington firm, has recalled approximately 10,368 pounds of frozen chicken entrées that may be contaminated with Listeria monocytogenes, according to a U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) Costco recall announcement.

The following product is subject to recall:

Four-pack of 12-ounce packages of "Discover Cuisine ™ Red Curry Chicken & Jasmine Rice." Each package bears the Canadian establishment number "Est. 302" inside the Canadian Food Inspection Agency mark of inspection as well as a "Best By" date of "12 18 08." The item number "2880" also appears by the UPC code on the package.

The frozen chicken entrées were produced on Oct. 18, 2007, and were sent to retail establishments in Alaska, Idaho, Montana, Oregon, Utah and Washington.

The problem was discovered through FSIS microbiological sampling. FSIS has conducted a regulatory microbiological testing program on poultry products since 1983.
When FSIS analysis finds a positive sample, any product represented by that sample must be reprocessed or destroyed. If all product implicated by a positive laboratory result is not under the establishment's control, as in this case, then “steps must be taken by the producing establishment to remove adulterated product from distribution channels and/or commerce, which may entail a voluntary recall” (http://www.fsis.usda.gov/Science/Micro_Testing_RTE/index.asp).

Our question with regard to this recall and the related recall by Meijer Distribution Center, a Michigan firm, is why it over 4 months after the production of the recalled frozen chicken entries for the companies to voluntarily recall the products. Most of these products are conveniently already eaten.

According to CNN, DuPont & Co. will be working with the USDA’s Agricultural Research Service (ARS) to develop a new test to detect the potentially lethal E. coli 0157:H7 bacteria. The research team will work at the U.S. Meat Animal Research Center (USMARC) in Clay Center, Nebraska.

More than 30 million pounds of ground beef were recalled last year due to E. coli 0157:H7 and the research will use the Qaulicon BAX system to test for the bacteria.  The system is already used to detect fooborne pathogens such as E. coli, Salmonella, and Listeria, among others.

According to the DuPont website,

“We are committed to providing the meat industry with testing applications that use the best science available.  This agreement allows us to work with experts from the USDA ARS toward our common goal of an E. coli O157:H7 test that is even faster, more accurate and more efficient,” said Kevin Huttman, president, DuPont Qualicon.

"Our mission is to develop scientific information and new technology to solve high priority problems for the U.S. beef, sheep and swine industries," said Mohammad Koohmaraie, USMARC director.  "In the case of E. coli O157:H7 detection, we're looking at collaborative ways to quickly develop a new test."

The Wall Street Journal has reported that the chances of Hallmark/Westland shutting down for good may be greater than originally speculated.  Anthony Magidow, general manager of the company, explained that customers are already stopping payments on products involved in the recall.  The plant has already temporarily shut while undergoing investigation and according to Magidow, the company is running on very little cash.

The company was a leading supplier of beef to the National School Lunch Program and officials from the USDA have already made it known that they intend to make Hallmark/Westland cover costs for destroying and replacing recalled meat for the federal program.  Magidow also stated that if the USDA does demand payment the company will most definitely have to shut down for good.  There were no comments from Steve Mendell, president and owner of Hallmark/Westland.

Health officials from the Yuma County Health District (Arizona) have issued a warning concerning a contamination of Salmonella in beef tri-tip cuts.  According to the Yuma Sun,

Becky Brooks, director of the Yuma County Health District, is urging anyone who took home some of the meat from the Hospice of Yuma roping roundup, barbecue and western dance at the Yuma County Fairgrounds to dispose of it.

Leftover meat from the event was also donated to the Crossroads Mission. An investigation was launched after the Yuma Regional Medical Center, the mission, and other individuals notified the health department of 92 cases of gastrointestinal illness. The health department tested 20 individuals, 10 of which tested positive for Salmonella, the other 10 still pending.

The CDC recently released a comprehensive report that assesses federal funding distributed to states after the terrorist attacks of September 11, 2001.  The report analyzes the use of money and improvements made in each state to determine preparedness to deal with disease outbreaks, natural disasters, and other public health emergencies.

The report, “Public Health Preparedness: Mobilizing State by State,” examines the use of about $5.6 billion given to states since 2001.  According to CIDRAP, improvements states have made since 2001 include:

• Every state is now equipped to receive and evaluate health emergency reports at all times, whereas only 12 states had "24/7/365" capability in 2001.
• All states have public health laboratories that can communicate quickly with clinical labs today, compared with only 20 states in 2001.
• Every state now has a plan to receive and distribute drugs and other supplies from the Strategic National Stockpile.
• All states are now conducting year-round influenza surveillance, considered critically important given the threat of pandemic flu.

Every state was evaluated in the report, including major urban areas such as Washington, New York City, Chicago, and Los Angeles County.  Recent years have also seen a distribution of money specifically designate to deal with a possible influenza pandemic.  With increased funding, states and urban areas have also undergone improvements involving the number of epidemiologists available. According to CIDRAP,

• The number of public health epidemiologists working in emergency response has more than doubled, from 115 in 2001 to 232 in 2006.
• Users of the Epidemic Information Exchange, a CDC-based communication system that helps track disease outbreaks, have increased more than 5-fold, from 890 in 2001 to 4,646 in 2006. Most are in state and local public health.
• State and local public health labs that can detect biological agents now number 110, compared with 83 in 2002.
• In 2005, health departments in all 50 states and Washington DC trained personnel on their roles during an emergency, compared with only 14 states in 1999.

Professionals in the public health world praise the report, seeing it as a stepping stone to evaluate the situation states are in to deal with a variety of issues. Since the increased funding in 2001, the program has been influential in dealing with foodborne illness.  The state of Wisconsin was the first to track the outbreak of E. coli 0157:H7 in spinach in the fall of 2006. The CDC report states that the increased funding enabled the state to make the detection.

Although progress has been made, CIDRAP also reports challenges left to face.

• Disease surveillance systems need strengthening. For example, last year 16 states reported no plans to exchange health data electronically with regional networks of healthcare providers.
• For disease surveillance, health departments need to make sure they have a legal framework permitting them to share health information with other jurisdictions.
• The public health lab workforce needs help, with 31 state labs reporting difficulty recruiting qualified scientists.
• Health departments are having trouble finding and keeping qualified epidemiologists, according to a 2006 survey.
• Health departments need to maintain a system of all-hazards planning, training, exercising, and improving, which should equip them to help at-risk groups such as the elderly.
• Though many cities now have systems that allow different response agencies to communicate, more progress is needed in that area.

The full version of the CDC report can be found at http://www.bt.cdc.gov/publications/feb08phprep/