Congress voices frustration as Salmonella toll rises

Jun 13, 2008 (CIDRAP News) – The US Centers for Disease Control and Prevention (CDC) said yesterday that the number of people sickened in a nationwide Salmonella outbreak linked to raw tomatoes has climbed to 228 in 23 states, while federal lawmakers voiced frustration over what they saw as slow progress toward improving produce safety.

The illnesses are linked to a relatively rare strain, Salmonella enterica serotype Saintpaul. In early June the Food and Drug Administration (FDA) warned consumers not to eat raw red plum, red Roma, or red round tomatoes, or products that contain any of those varieties, unless the growing areas are on a list posted on the agency's Web site.

David Acheson, the FDA's associate commissioner for foods, said yesterday that officials couldn't guarantee that they would be able to trace the contamination to the farm level, though that's the goal, the Los Angeles Times reported today. The story said the FDA has focused on growing regions in central Florida and Mexico.

The uniqueness of the strain and wide distribution of cases suggest that the contaminated tomatoes were marketed throughout the United States, the CDC said in a press release yesterday.

Investigators have not yet found contaminated products in consumers' homes or food service institutions; the link to raw tomatoes was made through epidemiologic studies.

"Consumers should be aware that raw tomatoes are often used in the preparation of fresh salsa, guacamole, and pico de gallo, and are part of fillings for tortillas and are used in many other dishes," the CDC cautioned.

Because of reporting delays and lack of stool specimens from many people who have Salmonella infections, the CDC said its case total probably underestimates the number of people sickened in the outbreak. "Some of these unreported illnesses may be in states that aren't on today's map," the agency said.

Based on interviews with 161 people, illness onset dates ranged from Apr 10 to Jun 1. At least 25 people were hospitalized. Though no deaths have officially been linked to the outbreak, a Texas man in his sixties who died of cancer was infected with the outbreak strain, which may have contributed to his death, the CDC reported.

FDA efforts questioned
Meanwhile, frustration over another foodborne illness outbreak linked to produce bubbled over yesterday in Washington at a House Energy and Commerce subcommittee hearing.

In November 2007—in the wake of several high-profile food contamination incidents—the Department of Health and Human Services (HHS) proposed a food safety plan consisting of 14 broad recommendations and 50 action steps. But some lawmakers said the FDA bears part of the blame for ongoing outbreaks, the Associated Press (AP) reported today. Rep Marsha Blackburn, R-Tenn., said, "You've had time. We're still waiting."

During testimony, the Government Accountability Office (GAO) presented an 18-page report that the committee had requested to gauge the FDA's progress on implementing its food safety plan. The GAO said in the report that the FDA has not articulated the resources it needs or the timeline for implementing the plan.

For example, the GAO said the FDA reported it planned to spend about $90 million over fiscal years 2008 and 2009 to enact key parts of the plan. However, the price tag for the FDA to inspect each of the 65,500 domestic food firms it regulates would total about $524 million. On the other hand, the report said the FDA's plan to inspect firms based on vulnerability and risk was "efficient and effective."

The GAO said that since 2004 it has made 34 food safety recommendations to the FDA, but the agency has implemented only seven of them, though in some instances it has taken partial steps. For example, the GAO has recommended that the FDA establish equivalence agreements with foreign countries to shift some of its oversight burden. It said the FDA still has not forged any such agreements, an authority that would require approval from Congress.

On Jun 9, HHS Secretary Mike Leavitt said the Bush administration had increased its fiscal year 2008 budget request by $275 million to support the FDA's new food and medical product safety initiatives, including the food safety plan. The request raised the total proposed increase in the FDA's' 2009 budget request to $404.7 million, a 17.8% increase from the 2008 budget.

Aside from the infusion of financial resources, Leavitt said that some of the food safety plan's components would require new authorities from Congress, such as the ability to mandate food recalls if companies don't initiate them voluntarily.

Committee subpoenas food-testing records
During the hearing, committee members voted unanimously to subpoena nine companies that analyze high-risk food imports, according to an AP report today. The committee has been investigating claims that some of the laboratories are skirting FDA rules by repeatedly testing food until acceptable results are obtained.

Rep. Bart Stupak, D-Mich., said nine of the 10 companies declined to voluntarily submit their records to the committee for fear of breaching confidentiality agreements with food import companies, the AP report said.

See also:

Jun 12 CDC press release

Jun 12 GAO report

Jun 10 CIDRAP News story "President seeks more food safety funding for FDA"

Jun 4 CIDRAP News story "Tomatoes suspected in multistate Salmonella outbreak"

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