April 21, 2009 The Pump Handle 0Comment

Our country’s food-safety system may leave a lot to be desired, but the New York Times’ Gardiner Harris reminds us that we should be grateful to the epidemiologists who let us know an outbreak is occurring at all. And it turns out that many of these alarm-sounding professionals work in Minnesota. “If not for the Minnesota Department of Health, the Peanut Corporation of America might still be selling salmonella-laced peanuts, Dole might still be selling contaminated lettuce, and ConAgra might still be selling dangerous Banquet brand pot pies,” Harris reports.

Detecting a food-borne outbreak requires several steps: getting samples from those sickened, having the samples analyzed, and bringing results together so that patterns of illness become recognizable. Once an outbreak is identified, health workers can start contacting victims to ask them what they ate before becoming ill, and then investigators use that information to pinpoint the source. Harris notes that hurdles can arise at each of the points in this process:

Most people sickened by food do not bother to see a doctor. Many of those who do are not asked to provide a stool sample, and when asked, some refuse.

When patients are willing, laboratories may not be. In Utah, for instance, only 18 of the state’s 1,388 medical laboratories process stool tests, said Dr. Pat Luedtke, director of the Utah public health laboratory. Well-meaning doctors who wish to send stool samples sometimes must pay the postage because insurers often refuse to pay for a test that largely serves a public health function; many doctors do not bother.

By the time public health officials notice that a growing number of such samples carry the same genetic fingerprint — a clear sign that a popular food is contaminated — weeks have passed. By then, victims’ memories of what they ate have faded. So rapid and thorough responses by health officials, a rarity in many states, are crucial.

Harris contrasts Minnesota, which diligently reports and investigates hundreds of cases of food-borne illnesses each year, to Kentucky, whose public health commissioner blames tight budgets for the state’s “historically poor record of reporting” and explains that they’re “working hard to change our culture.”

Minnesota and the other states that pour resources into disease surveillance provide an important benefit to the rest of the country. (From the Times graphic, it appears that Alaska, Florida, Maryland, and Washington state also have high rates of reporting food-borne illnesses.) Will they be able to keep these programs intact as their revenues fall?

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