My daughter Megan and I picked an interesting week to travel to Europe. We're in the Netherlands where I'm doing research for my doctorate in environmental health. We were here in the fall of 2010 as well. Unlike last fall, however, we haven't been able to eat raw produce this trip. At one point or another, cucumbers, lettuce, tomatoes and sprouts have been implicated, but none has been confirmed yet as the source (and none may ever be). So, no salads for us or for our friends. In home kitchens and restaurants across Europe, vegetables are being cooked, in response to the tragic E. coli outbreak that has thus far claimed 24 lives and sickened 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.
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