"When someone eats food that is contaminated and actually goes to a doctor, only 1 out of about 30 will get a stool culture, so those victims are the only ones who get counted," says Marler. In other words, if the FDA and CDC report 300 incidents of Salmonella poisoning, likely 30,000 people or more have been sickened.Marler's analogy can give you some idea of what the FDA and CDC are up against: "If Salmonella is the human race, Salmonella St. Paul is the Smith family and this particular outbreak is Bob Smith," he says. It is that specific.
The following explains the challenges health officials face:
"If a stool culture has tested positive, by law the laboratory or health care provider has to contact their local health department who then contacts the sick person and asks several questions, such as 'What have you been eating in the past 36 hours,' to find a pattern," says Marler. "Then the state gets involved and does a genetic fingerprint of that salmonella—called a Pulsed Field Gel Electrophoresis. The state in turn uploads that information (which looks like a barcode on the back of a cereal box) to the CDC."
Depending upon the local and state departments, the process of getting stool sample information and investigation to the federal agencies can take anywhere from a week to months. Why so long? Because several variables are involved and not all states are created equally.
"Variables such as how well the department is funded, what other issues are priority at the time, and even interest," says Marler. Minnesota was in the news recently because the Minnesota lab—known as the 'team diarrhea'--broke the case with jalapeno peppers. How did they do it? "They are very focused on food-borne illness and very good at tracking," says Marler.
He adds that every food-borne outbreak in the past 15 years has either been solved by Minnesota or Oregon. Many states could never figure them out—such as Texas and Mexico that have struggled with outbreaks in the past, and many people have been sickened in those areas. "The trackers in Minnesota saw people getting sick from salsa but the tomatoes were from a different batch and from a different state and/or the consumer ate canned tomatoes," says Marler, "so the common denominator with fresh and canned tomatoes is that they both used jalapeno peppers which were then traced back to a Texas supply/manufacturing facility.
So these issues make the hunt for the source of the outbreak even more difficult. First, only a small percentage of sickened people are reported, so the database is limited. Second, having to rely on local and state departments who may not recognize food-borne illness as a priority is problematic.
Once the federal agencies have the information, the CDC looks carefully to find a pattern. For instance, how many cases of Salmonella St Paul, and the same genetic fingerprint of that bacteria, come from Mexico or New York?"
Early in the recall, Marler's lawfirm was contacted by many victims and he recognized a common denominator right away. "A lot of people were eating Mexican food and salsa so tomatoes were the main ingredient," he says. "And there have been a few salmonella related tomato outbreaks over the last 10 years." (Lawyers and Settlements reported tomato contamination linked to Coronet Foods in 2005 and Sheets convenience stores in 2007--both companies settled.)
"So we weren't surprised when tomatoes were recalled," says Marler. "With food cases, it is rare to find a smoking gun—a contaminated product, mainly because only about 1 out of 100 tomatoes or other food is leftover to test: people eat it and that is how they got sick! (Although Minnesota found the smoking gun—the jalapeno pepper.)
"The initial FDA and CDC decision to recall tomatoes was based on the evidence of the common denominators [above]. Making things even more difficult, the tomato industry had lobbied hard to thwart trace-back of their product; the industry doesn't want to have to keep track."
Given these obstacles, it is no wonder the FDA is confused when it tries to look backward. Marler believes the agency made the right decision at the beginning of the outbreak. But people were still getting sick. "Either it never came from tomatoes or it started with tomatoes and now it is something else," Marler opines. "It started to look like people were getting sick from consuming salsa and guacamole in restaurants.
"The unknown question is whether tomatoes were ever the culprit and if it was always a jalapeno outbreak (but there has never been an outbreak linked to peppers)."
Marler adds two other probable theories:
1. This outbreak was originally tomato-related and certain tomatoes passed through this particular warehouse, contaminating the peppers and the peppers continued the outbreak.
READ MORE TOMATO SALMONELLA LEGAL NEWS
Clearly, this is not a simple solution and we may never know exactly what happened.
As for the tomato growers, they have asked Congress for compensation but Marler predicts that might depend on whether or not the tomato industry agrees to trace-back in the future. The tomato growers also made the recall difficult. "The tomato industry wants its tomato and to eat it too," says Marler, laughing.
And restaurants are asking suppliers to send them a check for all the tomatoes that went into the garbage. In turn, the supplier is asking the farmer to send them a check. Meanwhile, the grocery stores are hiring lawyers...pity the poor farmer.