Causes of food diseases escape officials
By Thomas Hargrove
SCRIPPS HOWARD NEWS SERVICE
Published November 24, 2006

More than 50,000 people got sick or died from something they ate in a
five-year period -- a hidden epidemic that went undiagnosed by the
nation's public-health departments.
Americans play a sort of food-poisoning Russian roulette depending
on where they live, an investigation by Scripps Howard News Service
found. Slovenly restaurants, disease-infested food-processing plants
and other sources of infectious illness go undetected across the
country -- but much more frequently in some states than others.
Scripps studied 6,374 food-related disease outbreaks reported by
every state to the Centers for Disease Control and Prevention (CDC)
from Jan. 1, 2000, through Dec. 31, 2004. The causes of nearly
two-thirds of the outbreaks in that period were officially listed as
"unknown."
The findings translate into an alarming potential for danger. If
health officials are unable to connect illness to food, victims who
might eat from the same poisoned source cannot be warned. If food is
known as the culprit, but the specific disease lurking within is not
diagnosed, the victims might get even sicker or die without proper
treatment.
Families of children who got sick during the five-year period in
the study tell heart-rending stories of the heroic efforts they made to
convince the medical establishment they were victims of food illness.
"My daughter's death would have been listed just as a 'stroke' and
swept under the rug," said Todd Nelson, a Continental Airlines pilot
and father of a 19-month-old girl who died of E. coli. "But I wanted to
know what my daughter really died of. And I wanted somebody to blame."
The Nelson family thinks Ana Leigh Nelson ate infected hamburger
meat from a popular Minnesota restaurant in 2002. The family demanded
private tests that confirmed a rare strain of E. coli and then demanded
that the medical examiner change her death certificate to report death
from complications of food poisoning.
"We sort of fell through the cracks," Mr. Nelson said.
The study found that Kentucky, Oklahoma and Nebraska are virtually
blind to outbreaks of food sickness, rarely detecting that scattered
illnesses have common food causes.
In Alabama, Florida and New Jersey, the cause of food poisoning is
almost never found, even when dozens or hundreds of people became
violently ill or died from something they ate, according to the Scripps
study.
The CDC defines an "outbreak" as two or more people who got sick or
died after eating the same food. State and local epidemiologists are
diagnosing an average of just 36 percent of the nation's reported
outbreaks even though some outbreaks have hundreds of victims.
Alabama was the worst in the nation, diagnosing only 5 percent of
its reported outbreaks, the study found.
"It's a real struggle. We've never identified a virus at the state
level," Alabama state epidemiologist John Lofgren said.
The study found that health departments are more likely to make a
diagnosis when a very large number of people get sick. They failed to
determine the cause in 31 percent of the outbreaks that sickened 50
people or more. But the failure rate increases rapidly with smaller
groups.
Fifty-three percent of outbreaks affecting 10 to 49 people went
undiagnosed, while 75 percent of outbreaks that sickened nine or fewer
people were listed as "unknown"causes.
Several state and local epidemiologists said large outbreaks give
them more chances to isolate the exact disease involved. More victims
mean a better chance of obtaining blood, stool and urine samples that
can be tested for pathogens.
But epidemiologists concede that failures to diagnose food illness
are common, even when the only suspect for outbreaks of a widespread
intestinal disease is food. The Scripps study found that the disease
went undiagnosed in 4,054 of the 6,374 reported outbreaks. Those
unknown causes sickened or killed 50,968 persons.
"We did what we could do," said Lisa Dallmeyer, epidemiologist for
Peoria, Ill., after extensive local and federal lab tests failed to
discover why 95 public-school children started vomiting after eating
lunches served in December 2005 and January 2006.
Miss Dallmeyer said it "doesn't surprise me" that Illinois is
diagnosing the cause of only 27 percent of its outbreaks.
Every year, an estimated 5,000 Americans die from food-based
diseases such as salmonella, E. coli, shigellosis and campylobacter.
Another 325,000 people are hospitalized. The CDC estimates that
food-based sickness probably afflicts 76 million Americans annually.
Although the Scripps study found that the quality of the nation's
network of public-health departments varies, there were some bright
spots.
Wisconsin, Minnesota and Hawaii do a good job of diagnosing disease
outbreaks.
Wisconsin came out on top in the study by diagnosing the cause of
90 percent of its food-poisoning cases. Wisconsin also was the first
state to detect and report September's deadly E. coli outbreak from
infected raw spinach grown in California and shipped nationwide. The
outbreak killed at least three persons and sickened at least 199
others.
But the study found little to celebrate overall, because most
outbreaks go undiagnosed.
Federal officials and public-health specialists agreed with the
findings and conclusions of the Scripps study.
"Our surveillance systems were designed to ring a bell when there
is a problem. Are they perfect? Absolutely not. Could they be better?
Absolutely yes," said spokesman Tom Skinner at the CDC's Atlanta
headquarters after reviewing some of the study's findings. "We've
already come a long way, but certainly we can do better than this."
Mr. Skinner offered no explanation when asked why the CDC didn't
warn underperforming states and local health departments.
"The CDC, like most government agencies, is pretty conservative.
Why would they want to rock the boat?" said Ewen Todd, director of the
Food Safety Policy Center at Michigan State University. "It takes
someone who is independent to say: 'This is crazy.' "

Mike wrote:
> Causes of food diseases escape officials
> By Thomas Hargrove
> SCRIPPS HOWARD NEWS SERVICE
> Published November 24, 2006
>
> More than 50,000 people got sick or died from something they ate in a
> five-year period -- a hidden epidemic that went undiagnosed by the
> nation's public-health departments.
> Americans play a sort of food-poisoning Russian roulette depending
> on where they live, an investigation by Scripps Howard News Service
> found. Slovenly restaurants, disease-infested food-processing plants
> and other sources of infectious illness go undetected across the
> country -- but much more frequently in some states than others.

My theory is that a lot of this may be due to food allergies. We tend
to think of anaphylactic shock and dramatic episodes with epi-pens. But
Vasculitis is an example of other disorders that, while supposedly
rare, can be due to toxic and allergic reactions. Vasculitis symptoms
are often confused with flu or food poisoning and is often never
diagnosed until the patient is -uh- dead.

There are many connections between food and disorders and diseases that
we don't even know about. And we're having disorders and diseases that
we don't take seriously until they get acute or life-threatening.
Frankly, the testing involved is too damned expensive, and there just
aren't any easy diagnoses. There just ain't 'nuff research yet.

Symptoms of food allergies can be so minor that a person forgets about
them and doesn't tell the doctor. Or attributes it to bad food
hygiene, the flu, or some other minor upset.

In a catastrophic attack, If the patient is lucky enough to get to the
hospital and have doctors who don't waste time confusing this with flu
or minor food poisoning, or some other disorder the patient may win the
life lottery by being treated correctly, and that is a costly,
sometimes risky process, since it's hard to figure out what is wrong.

Watch an episode of "House".

Americans are overexposed to so many exotic and technologically
marvelous substances, not to mention bacterium and viruses, that we
don't know what the heck is happening with our immune systems. Lupus,
a supposedly rare and difficult to diagnose disease, is claimed by a
host of people. "Fibromyalgia" is another disease where no one can
even agree if it is a hoax or a legitimate disorder. The arthritis and
food connection has been talked about at length, yet there is still no
clear information.

We eat food and drink drink that our immune systems never knew, or
prepared our systems for, and we use products (and drugs) that aren't
even supposed to exist naturally. Then we shop health food stores and
obsessively look for the "organic" label.

(Frankly, the last time I saw a list, rating the hygiene of local
supermarkets, "Whole Foods" wasn't exactly at the top of the list.)

So, while the hygiene in food production and delivery is always
suspect, as far as I'm concerned, the research in autoimmune rejection
of food and drink is in need of some dollars and attention.

Thanks for letting me rant.
Happy belated Thanksgiving!

M.