2013-05-21T07:02:23-04:00 Barbara Kowalcyk http://www.huffingtonpost.com/author/index.php?author=barbara-kowalcyk Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Barbara Kowalcyk Good old fashioned elbow grease. tag:www.huffingtonpost.com,2012:/theblog//3.1939085 2012-10-04T10:47:06-04:00 2012-12-04T05:12:01-05:00

Barbara Kowalcyk http://www.huffingtonpost.com/barbara-kowalcyk/
Actually there is a very good reason for the difference. While meat starts out sterile, it can become contaminated with bacteria -- like E. coli O157:H7 -- when it isn't handled properly during slaughtering or processing, and once contaminated, the only thing that will kill the bacteria is heat. With intact cuts of meat -- like steaks and roasts -- that contamination will be on the surface, not on the inside. Pathogens on the surface are much easier to kill, after all, the outside of the meat heats up much faster than the inside does, so the recommended temperature can be lower. However, with non-intact meat -- like ground beef -- surface bacteria can be moved moved or "translocated" to the inside of the meat where it is harder to kill, so a higher temperature is required. Sounds pretty straightforward, right? Intact meat gets cooked to a lower temperature of 145° and non-intact meat gets cooked to 160°.

Unfortunately, steaks and roasts are often not as they seem.

So, when is a steak not a steak and a roast not a roast? As soon as its surface has been pierced, a steak or roast becomes a non-intact cut of meat and should be cooked to a higher temperature. Many of us grew up learning to make our steaks and roasts juicer and more flavorful by piercing them with a fork and letting them sit in a marinade for a while. Now, you may not be fully aware of it, but stabbing the meat created a "hide-out" for bacteria like E. coli O157:H7. And it means that the pierced steak or roast should be cooked differently. Now, assuming that you know about the increased risk of illness, you can make an informed choice about how well you want to cook that steak or roast. But what happens when you don't know that the steak or roast you have just bought or been served was already tenderized? How do you make an informed choice then?

According to the USDA estimates, 18% of all beef steaks and roasts manufactured in the United States are mechanically tenderized. This mechanically tenderized process pushes hundreds of needles or sharp blades into steaks and roasts to make tougher cuts of meat more tender and therefore more palatable to consumers. It also takes any pathogens on the outside of the meat and pushes them to the inside - as shown by multiple scientific studies, including ones conducted by USDA. So, for food safety reasons, the "steak" or "roast" needs to be treated like ground beef and must be cooked thoroughly to kill any bacteria that are still alive inside the meat. Eating an undercooked steak or roast that has been mechanically tenderized has a higher risk of causing foodborne illness. Children, pregnant and post-partum women, senior citizens and anyone with a compromised immune system are particularly vulnerable and could develop serious life-threatening complications.

Currently, mechanically tenderized cuts of meat are not labeled, even though they look the same as non-tenderized products. Basically, they are non-intact cuts of meat that look intact. Consumers cannot tell the difference and, therefore, have no way of knowing that they need to be prepared differently. To be safe, these steaks and roasts cannot be grilled and eaten medium rare -- like intact steaks and roasts can be. Consumers need to know that there really is a difference in risk, which means "a steak is not always a steak and a roast is not always a roast." This is especially true when a major E. coli outbreak is in process, like today.

XL Foods Inc., a Canadian firm, has recalled all the beef produced in one of their slaughtering plants for unsanitary conditions, after a United States border checkpoint found E. coli O157:H7 in its testing. Over the past two weeks, Canada has expanded its original recall of beef trim (used in making ground beef) thirteen times. The most recent update, on October 1st, expanded the growing list of retailers and included all steaks, roasts and other cuts destined for retail sale. Mechanical tenderization was applied to some of the recalled steaks and roasts, which means that consumers eating mechanically tenderized Canadian XL Food products are at a higher risk for acquiring an E. coli O157:H7 infection. Four of Canada's reported eight illnesses are linked to steaks, and U.S. officials know that a large amount of product, including beef steaks and roasts, have been shipped to stores throughout the United States. Consumers should view all of the Canadian XL Foods' beef products as being potentially contaminated with deadly E. coli O157:H7 and should return or discard the product. More information about the recall is available here.

The recall of Canadian beef that began last month highlights mechanically tenderized meat as a critical food safety issue. For the past three years, consumer groups have worked to put in place labeling requirements for mechanically tenderized meats. Those efforts have paid off -- a rule that would require mechanically tenderized products to be labeled has recently been approved by the Secretary of Agriculture and sent to the White House for final approval. Consumers can write to the White House's Office of Management and Budget and tell the President's staff that USDA's label proposal for mechanically tenderized meat must be approved immediately. Labeling of mechanically tenderized meat products is a consumer protection that is fairly inexpensive to implement, but the benefits for labeling these products could be great.

Ultimately, consumers have a right to know what they are buying and eating. They must be given the information they need to make informed decisions about their food choices. After all, what you - the consumer - put into your mouth can directly impact your health. You have a right to know.


Barbara Kowalcyk Ph.D. is the CEO of the Center for Foodborne Illness Research & Prevention. Her story was featured in Food, Inc. and in 2010 was voted an Ultimate Game Changer by the Huffington Post.]]> tag:www.huffingtonpost.com,2011:/theblog//3.923838 2011-08-11T09:31:15-04:00 2011-10-11T05:12:01-04:00

Barbara Kowalcyk http://www.huffingtonpost.com/barbara-kowalcyk/ Co-authored by Michael Kowalcyk

Ten years ago today, our 2½-year-old son Kevin died from complications due to an E. coli O157:H7 infection. We later learned that Kevin's strain of E. coli O157:H7 matched that of a meat recall issued 16 days after he died. Unfortunately, we were never able to conclusively prove that Kevin consumed the recalled meat, which was the requirement to show liability in the state where he died. As many of you know from Food, Inc., Kevin's death and the challenges we encountered following his death propelled our family to advocate for Kevin's Law and eventually establish a new non-profit, the Center for Foodborne Illness Research & Prevention.

Kevin's Law was first introduced in Congress as the Meat and Poultry Pathogen Reduction and Enforcement Act of 2002 by Senators Tom Harkin, Dick Durbin and Hillary Clinton. It was later re-named Kevin's Law in honor of Kevin and our family's work to pass the legislation. Kevin's Law was a response to a court of appeals ruling that USDA did not have the authority to shut down plants that repeatedly produced meat and poultry products that were contaminated with Salmonella (the Supreme Beef case of December 2001). Kevin's Law required USDA to work with CDC to identify foodborne pathogens that impact human health, set limits for those pathogens in meat and poultry products, and then shut down plants that repeatedly fail to meet those limits. Despite being introduced in Congress three times, Kevin's Law never passed. Key elements of Kevin's Law were included in the recently enacted Food Safety Modernization Act, but that legislation applies only to FDA (with food safety oversight of dairy and produce), not USDA (with food safety oversight of meat and poultry).

Last week, Cargill announced a 36 million pound recall of ground turkey for an antibiotic resistant strain of Salmonella that has caused 77 illnesses and one death. Every day, new light is being shed upon the details of this recall and the associated outbreak investigation. According to published reports, USDA testing found this strain of Salmonella four times over the past year but did not take action. In fact, five months passed from the first reported illness to the recall. During that time period, many families -- and particularly children -- were unnecessarily put at risk of serious foodborne illness and even death. That is completely unacceptable. Government authorities should have acted sooner.

Unfortunately, the reality is that, due to the Supreme Beef ruling, USDA's hands are tied. Unless a pathogen is considered an adulterant, USDA cannot take action -- even if they find these pathogens during routine testing. Right now, E. coli O157:H7 is the only pathogen that is considered an adulterant. In January, USDA submitted a proposal to the White House Office of Management and Budget to declare six other E. coli strains as adulterants, but OMB has not responded. There is growing concern among public health officials in the United States about antibiotic resistant strains of Salmonella, but these are not considered adulterants either. Yet, in Europe, initiatives have already been introduced to reduce risks from antibiotic-resistant Salmonella.

Currently, USDA tests meat and poultry products for Salmonella and has limits in place for how much Salmonella can be in any particular testing sample of meat. The limits are woefully inadequate, and thanks to the Court of Appeals, they aren't enforceable anyway. USDA can't take action against a meat or poultry producer even if the limits are repeatedly exceeded.

For example, take ground turkey. When USDA tests for Salmonella, they take individual 1-pound samples on 52 consecutive days of production. Sometimes it takes a year to complete a set -- and the establishment gets a heads up that a sample is going to be taken! In addition, if 26 or fewer are positive, the sample set passes. If more than 26 are positive, the sample set fails. Basically, these are like open book exams -- not pop quizzes -- where a 50% is still passing! And even when a sample set fails, USDA does another set of testing. And they keep doing testing until a set passes.

Under Kevin's Law, USDA would have the authority to shut down a plant if it repeatedly exceeds acceptable limits. Right now, the testing continues until illnesses are actually linked to the product. As discussed in a previous blog, foodborne illness investigation is not easy and usually takes a lot of time, which is one of the reasons it took five months to issue this recall. Inter-agency communication problems also contributed to the delay in this situation.

The reality is that, if Kevin's Law had been passed, this outbreak may have been avoided or, at the very least, USDA would have been able to take action sooner. USDA needs the authority to take action when contaminated products are causing human illness. They need to be able to set limits for foodborne pathogens. They need to reduce those limits over time to prevent fewer pathogens from entering the food supply. And, they need the authority to shut down producers that repeatedly fail to meet those standards.

We find it a bit ironic that this issue would arise again on the 10th anniversary of Kevin's death. Our family has never given up on passing Kevin's Law. It is clear that USDA needs these authorities before more American families suffer. I urge Congress to consider re-introducing Kevin's Law, to pass Kevin's Law, and we ask that you join us in making this a reality.

Kevin, we love you and miss you. You changed our lives forever, and we will continue to honor your life and your memory by working to make our food safer.

Kevin's Mom and Dad,

Barbara and Michael Kowalcyk


Barbara Kowalcyk is the CEO of the Center for Foodborne Illness Research & Prevention. Michael Kowalcyk is an economist. He has advocated extensively for the passage of Kevin's Law.

Click here to donate to the Center for Foodborne Illness Research and Prevention (CFI)
]]> tag:www.huffingtonpost.com,2011:/theblog//3.886795 2011-06-29T10:09:58-04:00 2011-08-29T05:12:01-04:00

Barbara Kowalcyk http://www.huffingtonpost.com/barbara-kowalcyk/
"What's that?" you may ask. Well, when it comes to food safety and foodborne illness, molecular epidemiology is critically important. It is the backbone of outbreak investigations and foodborne disease surveillance. Molecular epidemiology uses molecular techniques to study the impact of genetic and environmental risk factors on the causes, trends and prevention of disease. In less scientific terms, it means using DNA to find out what causes disease and what can prevent it. Basically, epidemiologists are disease detectives, and molecular epidemiologists use genetic information to do their detective work.

Over the past weeks, as we watched the E. coli outbreak in Europe unfold, there has been a lot of commentary on the efficiency and effectiveness of the European and German responses. I read criticisms of the amount of time it took to identify the outbreak, the premature announcement that cucumbers were the source, the lack of a definitive source, and so on. As I was reading, it was clear that many people do not understand the challenges that epidemiologists face in investigating foodborne illnesses. As an epidemiologist-in-training, I want to share with you a crash course in epidemiology. Welcome to Foodborne Illness Investigation 101.

Investigating foodborne illness is a really tough thing to do. It takes a lot of time, rarely follows a linear path and often is unsuccessful. It's not surprising, since the deck is stacked against the investigator. When most people are sickened with foodborne illness, they immediately assume that the last thing they ate made them sick. If only it were that easy. Most likely it was something eaten several days before. For E. coli, it usually takes 3 to 10 days for symptoms to appear. For listeria monocytogenes, it can take up to 60 days -- that's right, two months.

Of course, most people don't head to the doctor right away. Think about it. How sick would you have to be to go to the doctor and have a stool sample taken? Once the stool sample was taken, it would have to be sent to the lab and cultured which takes another couple of days -- assuming the physician ordered the right test. Many foodborne illness tests are not automatically done -- even though many physicians assume that they are. Once the culture is complete, the physician and/or laboratory are often required to report positive results to public health officials but, again, there are often delays.

(Maybe now you can see why the foodborne illness numbers are just estimates. Public health officials really only hear about the sickest people -- the tip of the iceberg.) So, by the time you went to the doctor, had the lab test run, and public health officials were notified, the question is more likely what did you eat two to three weeks ago (and where). I'm sure you would be hard put to remember.

Enter the foodborne illness detective a.k.a. state or local health department epidemiologist. The bacteria have at least a two-week head start, and somehow the epidemiologist is expected to get ahead of it immediately. The investigation starts with an extensive interview with the patient about everything they ate, where they went, how many animals and sick people they had contact with, etc. The questionnaire is probably 10 pages long and takes a lot of time to complete. Meanwhile, a microbiologist will run additional tests so the genetic fingerprint of the bacteria can be uploaded into CDC's PulseNET database to see if it matches other cases. Of course, entering the data into PulseNET is voluntary -- completely voluntary. And since everyone is overloaded with work due to state budget cuts, it may take a while to get around to it even with the knowledge that timely entry into PulseNET is critical to identifying outbreaks. In fact, it's how the 2006 spinach and 2009 peanut butter outbreaks were identified.

A couple of days later CDC announces a national outbreak related to the strain the epidemiologist uploaded. CDC hosts a conference call. All the people sickened have to be re-interviewed, because every state uses different questionnaires and the data can't be combined to do the analysis that will help identify a source. (A while back, there was an effort to get all the states to use the same form, but only seven agreed to participate.) Re-interviewing patients will take time -- especially if the state has a de-centralized surveillance system. Investigation activities must be coordinated across different divisions and branches of government so it is not uncommon for "turf" issues to arise.

Local health departments might be asked to re-interview the patients using the standardized form. They too are understaffed and overworked but may be reluctant to seek state or federal assistance with patient follow-up, citing confidentiality concerns. There might also be a sense that patients will be more receptive to additional inquiries from a local health department person with whom they have spoken with previously. These factors can contribute to delays in the investigation progress. Remember the 2009 Salmonella tomato/pepper outbreak that lingered on for nearly three months? One of the reasons it took so long to find a source was that local health departments refused to share information with their state health departments, and both refused to share information with CDC. It's hard to do detective work if you don't know where the victims are.

Now, if you are lucky, you are an epidemiologist in the state of Minnesota, where you'll be able to take advantage of a centralized food safety system and Team Diarrhea (yes, it's really called that). Team D -- made up of graduate students from the University of Minnesota's School of Public Health -- swings into action at their command center and conducts standardized phone interviews. It's super efficient and, once they get involved, Minnesota usually figures out the source. It is unbelievable that Team D is on the chopping block in Minnesota's budget debate. Actually, every state needs a Team D.

Hopefully, by now, you are beginning to see why it can take so long to "solve" an outbreak and why so many end up being a "cold case" with only a list of potential suspects. As with regular detective work, centralized systems work in your favor and de-centralized ones increase the likelihood that you'll end up with no clear-cut answer. The recent outbreak in Germany is a perfect example. An editorial in Nature published last week explains how Germany's complicated, de-centralized surveillance system impacted that country's ability to respond to the E. coli outbreak.

Sadly, the German system sounds a lot like the system we have in the United States. The Germans have two federal ministries, two federal technical institutes, and 16 state ministries involved in foodborne illness surveillance. In the United States, there are 15 federal agencies and thousands of state and local agencies involved. In both countries, the coordinating agencies -- CDC and RKI -- receive information indirectly and have no direct authority over the sources of their information. At least the United States has PulseNET -- for now. Already under-funded, PulseNET is in serious jeopardy as state governments furlough staff and/or choose not to replace staff who leave. Without timely data being uploaded into the database, PulseNET cannot identify outbreaks and prevent others from being sickened.

Early on, some lamented that if a definitive source was not found the German outbreak would be a lost opportunity to learn about the epidemiology of foodborne disease. I disagreed. One of the lessons learned is that sometimes centralization and standardization is a good thing -- especially if you are a disease detective.

Barbara Kowalcyk is the CEO of the Center for Foodborne Illness Research and Prevention. She was voted the Huffington Post's Ultimate Game Changer in the food category in 2010.]]> tag:www.huffingtonpost.com,2011:/theblog//3.873107 2011-06-08T11:35:45-04:00 2011-08-08T05:12:01-04:00

Barbara Kowalcyk http://www.huffingtonpost.com/barbara-kowalcyk/ over 2,000 people.

This outbreak is especially concerning given the high rate of hemolytic uremic syndrome (HUS) and the fact that so many victims are adult women. HUS in adults is uncommon -- children are at highest risk of developing this serious complication of foodborne illness. It suggests that this is a particular nasty strain of STEC (shiga-toxin producing E. coli). HUS is a horrible disease that is characterized by cascading organ failure and can result, as in my son's case, in death. Those who survive often suffer long-term health effects, including end-stage kidney failure, diabetes and neurological complications.

One of the most troubling aspects of the ongoing outbreak in Europe is that it involves a strain of E. coli that often flies under the radar in the United States. In recent years, public health officials and food safety advocates -- myself included -- have been increasingly concerned about this class of E. coli, which is often referred to as non-O157 STECs.

In fact, numbers released this week by the Centers for Disease Control show that the United States has about the same number of non-O157 STECs as O157:H7 STEC. This means that it is time to change the way we handle these deadly pathogens. In 1994, Mike Taylor declared E. coli O157:H7 to be an adulterant in meat and poultry products when he was Undersecretary of Food Safety at USDA. In recent years, USDA has repeatedly been asked to address this and declare the "Big Six" non-O157 STECs to be adulterants as well, but so far no action has been taken.

Worse, the Office of Management and Budget (OMB) recently ruled that non-O157 STECs in beef products are not economically significant and delayed action on a proposal to declare them adulterants. I'm certain that Germany and Spain would disagree. Given the significant cost associated with STEC infection and its severe long-term health outcomes, these pathogens are clearly economically significant.

In Europe, the cost of this outbreak will likely run into the millions -- if not billions -- when you consider the impact on those sickened, the amount of public health resources used to track the illnesses and find the source, and the lost market share for the cucumber, lettuce, tomato and sprout industries. As this outbreak demonstrates once again, foodborne disease is economically significant -- especially in these hard economic times.

Every time I hear about one of these outbreaks, my heart breaks again for the families affected. I understand their pain and desperately wish that my efforts to improve food safety could have prevented these tragedies. While disheartened, I am all the more determined to prevent this from happening to others. I do not want those sickened to have suffered in vain. I hope their experiences will force the food industry and governments around the world to re-evaluate their food safety systems and move from the current reactive systems to a proactive one. Achieving that will take significant investments in food safety. With the current global economy, it may seem like we can't afford to do that right now, but the reality is that we can't afford not to.

Unfortunately, at a time when people around the globe are focusing on food safety, last week a key Congressional subcommittee proposed significant cuts to the FDA and USDA food safety budgets. If passed through Congress, these budget cuts will make it nearly impossible for FDA to implement the new, higher standards in the recently signed food safety bill or for USDA to take action on non-O157 STECs. The United States will be taking a giant step backwards.

It's always interesting to watch food safety events -- and U.S. politics in general -- unfold from Europe. Last fall, while I began my research project at the National Institute of Public Health and the Environment in the Netherlands, my family watched the passage of the Food Safety Modernization Act of 2010 and endured puzzled questions and disbelief that such solid legislation promoted such strife in the U.S. This time around there are more questions -- largely driven by reports that the United States feels that Europe is mishandling the outbreak investigation. I find this ironic since the U.S. doesn't really look for non-O157 STECs and we have had some highly publicized outbreaks that took months -- not weeks -- to solve.

Epidemiologic investigations are time-consuming and often lead public health officials down many different paths. Of course, the decentralized nature of Germany's public health system -- not unlike many U.S. states -- has not helped the situation. But, regardless of the errors that may have been made, I still think Europe -- especially Denmark and the Netherlands -- is ahead of the curve when it comes to food safety. The United States can learn from their experiences and should follow their lead. We can start by adequately funding food safety and declaring the "Big Six" non-O157 STECs adulterants.

Barbara Kowalcyk is the CEO of the Center for Foodborne Illness Research and Prevention. She was voted an Ultimate Game Changer in 2010.]]> tag:www.huffingtonpost.com,2011:/theblog//3.805283 2011-01-06T13:08:28-05:00 2011-05-25T18:25:24-04:00

Barbara Kowalcyk http://www.huffingtonpost.com/barbara-kowalcyk/
Foodborne illness is a serious public health issue. This legislation, now the law, will help us meet the food challenges of the 21st century. Given our limited resources, it is imperative that we move towards a risk-based food safety system that focuses on prevention and improving public health. This new law is the first step moving us toward such a system, as described in a recent National Academy of Sciences report which I co-authored.

Specifically, the law will require FDA, as well as food processors and producers, to identify areas of risk so that preventive measures can be developed and implemented. It requires FDA to inspect the facilities under its jurisdiction more frequently (every 5-7 years instead of every 8-10 years), and has provisions to improve food trace-back systems and foodborne illness surveillance efforts.

Important to my family, the law contains key elements of Kevin's Law, named in memory of our son who died in 2001. Even though Kevin's Law was introduced to address problems at USDA (and those problems still exist), FDA needs the same authority. In addition, the law requires imported food to meet the same standards as domestically produced food and contains provisions to address the needs of small farmers.

The FDA Food Safety Modernization Act passed both the House and the Senate with broad bipartisan support and support from stakeholders throughout the system.

The Center for Foodborne Illness Research & Prevention (CFI) is pleased with the opportunities that this new law provides to the FDA, and the protections it can bring to the American people. CFI worked tirelessly to encourage members of Congress to support the bill and provided information to personal office and committee staffs about foodborne illness, its long-term health effects, and the importance of these provisions for the health of our citizens.

Unfortunately, FDA does not currently have sufficient resources to implement the new provisions. In the coming months, CFI and our partners will refocus our energy and work with Congress and the agency to find the necessary resources to fulfill these critical, new priorities.


Barbara Kowalcyk is the Co-founder and director of food safety for the Center for Foodborne Illness
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