Jalapenos, the Real Culprit?
Monday, July 07, 2008 at 6:30 am
It’s been nearly three months since the first of more than 900 people fell ill with salmonella poisoning in the outbreak that the Food and Drug Admin. has linked to tomatoes. Now, it seems likely that it wasn’t tomatoes that done it. But, it could be the jalapenos.
“Unfortunately, I’m becoming increasingly confident in saying this outbreak is going to end up being one in which the initial data got the regulatory folks going down the wrong path,” said Dr. Tim Jones, the state epidemiologist of Tennessee, which has had a handful of cases linked to the outbreak. “There’s a decent chance it’s not tomatoes at all.”
At a news conference last week, officials from the Food and Drug Admin. and Centers for Disease Control said they were expanding the probe beyond tomatoes, “to include items that are eaten with tomatoes.” When asked if, in other words, the culprit might not be tomatoes, CDC spokeswoman Lola Russell demurred. “We’re not saying that.” She added, “It would be premature to list any other particular food item.”
FDA officials hinted strongly that some other component of salsa might be the source of the bacteria. If that’s the case, it could well be jalapenos, which are stored and kept long enough to keep infecting people for months. Tomatoes — and for that matter, cilantro — are usually thrown away within a few weeks. The Wall Street Journal had some of the story here and NPR followed up here.
Federal warnings about tomatoes have cost the food industry upward of $250 million thus far, so it isn’t surprising that CDC isn’t eager to point fingers at another vegetable. Restaurant owners, tomato growers and packers are up in arms over this drubbing. “They killed an industry,” said Batista Madonia, president of East Coast Brokers and Packers, a major tomato grower based in northern Florida. “My business is off 75 percent, and who knows if it will recover. Look at the spinach thing. It ended a year ago. But whenever I eat spinach, there’s still something in the back of my mind that says it’s dangerous.”
Many have complained about the FDA’s lack of transparency, and fault officials for failing to consult industry and academic experts. FDA and CDC needed to publicize more of their data during such investigations, and “take advantage of outside expertise that could speed these investigations,” said Roberta Cook, a tomato marketing expert at the University of California-Davis. “These things are important for protection of public health — and to avoid devastating entire commodity industries for no reason.”
“So little information is being released by FDA,” said Tony Dimare of Dimare Fresh, a major Florida-based tomato producer, “that you, me, no one outside of the inner circle of FDA, knows what’s going on. Meanwhile, in Florida, we’ve been tainted, thrown under the bus and guilty by association for being in production at the time of the outbreak. My fear is if the investigation lingers long enough, it’ll affect the start of the next Florida season, in September. This thing is just a total blunder by FDA.”
CDC and FDA haven’t disclosed the data they’re looking at, but state epidemiologists I spoke with say that most of the cases — by no means all — have been traced to Mexican restaurants, where salsa and chips flow freely. In addition, most of the evidence points to Mexican crops.
Tracking a disease involves a laborious, time-consuming culturing and typing of the bacteria, followed by interviews in which sick or recovered patients are asked to remember what they ate two weeks earlier. This may be where federal investigators got off on the wrong foot.
The first investigations were done in New Mexico, where people on Navajo reservations got sick. Most remembered eating tomatoes, but it’s possible that state public health officials narrowed the target too soon. This mistake — if it turns out to have been a mistake — was passed along to the CDC. It then designed questionnaires for those sickened with Salmonella saintpaul based on the premise that it came from tomatoes — not what the tomatoes were eaten with.
Epidemiologists at CDC and state public health agencies frequently express impatience with the length of time it takes the FDA to do trace-backs, and the agency’s close-to-the-vest style when carrying out such investigations. But in this case, epidemiologists may have led FDA down the wrong path.
“Trace-backs are hard enough,” said Jones, of Tennessee, “They are virtually impossible if things aren’t narrowed down accurately at the beginning.”
The longer the investigation goes on, the more likely it is to turn up red herrings. There is probably always a low-level background rate of Salmonella saintpaul poisoning in the U.S. — cases that may be being counted now as part of the outbreak. Another confounder, in a long outbreak, is secondary cases spread by someone already sickened with the disease.
“Let’s say you trace a couple cases to an Italian restaurant,” said Jones. “But maybe the waiter ate salsa at a Mexican place a few days earlier, then stayed on the job because he didn’t feel that sick.”
Last week, the CDC quietly revised the questionnaire that state health officials are using in the salmonella investigation to include other foods — particularly those served in tomato-based salsa and pico de gallo.
Jones suspects — he calls it nothing more than a hunch — that peppers are the most likely culprit. The outbreak has gone on nearly three months — far longer than any one batch of tomatoes would be on the market, especially since most restaurants and stores ditched tomatoes that were for sale when the FDA first announced the outbreak. New Mexico health officials have repeatedly cultured tomatoes eaten by sick citizens there, but they have been unable to culture Salmonella saintpaul.
The outbreak hasn’t been linked to any particular chain — which bolsters the idea that it was a fresh produce item, rather than a finished product, that is responsible. And trace-backs to Mexican and Florida tomato operations appear not to have found any evidence. Adding this up points the finger to jalapenos. Maybe.
“Tomatoes and cilantro go bad pretty quick. But I can keep jalapenos in my fridge a month and a half and they’re still edible, said Jones, “So that floats higher on my list.”
When asked for comment, FDA spokeswoman Kimberly Rawlings referred this reporter to the FDA Website.
In the climate of budget-cutting and politicization that has characterized the federal bureaucracy under President George W. Bush, many are eager to point the finger of blame at the White House. But, so far at least, there’s no evidence that the investigation’s troubles have anything to do with politics.
Investigating food-based disease outbreaks is difficult. Produce isn’t generally labeled or tracked from the field to the store or restaurant. And tomatoes take a particularly circuitous route to market. They often go from farm to packing house to repackagers, who remove tomatoes from the 25-pound boxes the packers put them in, then ship them in containers arranged by shape, size and color, to meet the demands of different retailers. Some are processed further before going to restaurants.
The increase in food-related disease outbreaks in recent years may be nothing more than the result of better detection. Molecular fingerprinting allows scientists to link sicknesses that occur across the country to a single contaminated field. That does make an outbreak seem worse that it would have seemed at a time when not all the cases were picked up by sensitive tests.
“In the past, you’d get a bad case of diarrhea and you’d say, ‘I got the flu, I ate something bad,’” said Mark Munger, an official with Andrews and Williamson Fresh Produce in San Diego. “I’m not criticizing the way things are now. But these outbreaks should be put into perspective. We’re dealing with major obesity crisis in this country. It’s bad for consumers to think they can’t eat fresh fruits and vegetables. Wash them, sure. But, for the most part, keep eating them.”
The produce industry is demanding hearings in Congress and tomato growers are expected to ask for financial relief. Florida’s tomato industry was already hurting because of high fuel and fertilizer costs, tomato diseases and labor conflict.
To think that a little pepper could lay them so low.
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