Posted: February 26th, 2011 - 10:12am
Source: Leavitt Partners Blog

This week, the CDC published their report from the 2008 Salmonella Saintpaul outbreak that sickened approximately 1,500 people, resulted in widespread withdrawals of tomatoes from store shelves, and a month long investigation that ultimately indicated jalapeño and serrano peppers in addition to tomatoes.  This publication is the closest tomatoes will ever come to being vindicated as the source of this outbreak and contains vital lessons for public health officials, regulators and the produce industry.
The term “crisis” is overused, but in this case, the public health messages around the outbreak caused a crisis to those growing and trying to sell tomatoes.  Consumers do not differentiate messages and when they hear the words “Salmonella”, “Outbreak” and “Tomatoes” in the same sentence, they will stop buying tomatoes.  While pointing fingers can be satisfying to some, it does not solve the fundamental problems and there are at least four signification lesions to be learned from this “crisis”:
• Epidemiology can be wrong .  Epidemiology is a somewhat blunt tool for public health and while it serves a great purpose in narrowing the odds, it can sometimes fail in pointing a precise finger to the cause.  This does not mean we should abandon epidemiology, but rather it means we need to use it as an indicator and develop sharper instruments to focus in on the precise cause.
• The ability to rule out an implicated commodity is as important as the ability to rule it in as public health threat.  If, within the first 48 hours of tomatoes being implicated, it had been possible to track tomatoes back from retail/restaurant level to the farms we would have discovered that tomatoes were not the likely source.
• Our product tracking systems for some items, such as fresh produce, are failing us.  The fact that it took a month to come to the conclusion that the implicated tomatoes in this outbreak were leading in two different directions is unacceptable.  During this month, exposures continued, messages to consumers continued and the negative impact on the industry continued.
• That product tracking for some items is hard.  The produce industry has made a concerted effort to develop product tracking systems, at least to the case level.  To date, this has proven to be complex, expensive and not readily implementable.  We need an alternative approach to this, one that can be undertaken easily, cheaply and quickly.
We all have a tendency  to look back and say “if only we had done…..” we could have protected the public better and damaged the industry less.  At the end of the day, at the purist level, this is all about preventive controls, but the realist knows this will happen again and that prevention, while critical, is only part of the solution. The ability to shut these outbreaks down quickly using more sophisticated supply chain mapping is a key part of the response.  Developing the tools to do this that can be implemented by the industry (taking into account cost and ease) is critical.  Without that it is only a matter of time before we have another extended food safety ”crisis” leading to sick consumers and industry losses.