You'll probably see way fewer food recalls in the future.
On the afternoon of September 13, 2006, the Centers for Disease Control notified the Food and Drug Administration of a multi-state outbreak of E. Coli. They weren't yet sure, but they suspected it was linked to freshly cut spinach. In the following days, the FDA would issue unprecedented advice: Rather than recalling a specific spinach brand, or spinach in certain states, they told the whole country to stop eating spinach in all forms.
"Just overnight, basically, you saw the spinach market disappear," says Scott Horsfall, the chief executive officer of the California Leafy Green Marketing Agreement (LGMA). "Spinach was dumped from store shelves, taken off restaurant menus, you name it."
Despite the dramatic advisory, by the end of the outbreak, 102 people were hospitalized and 31 people developed a kind of kidney failure called hemolytic-uremic syndrome (HUS). Three people died, including a two-year-old boy from Idaho whose mother gave him a spinach smoothie.
"It wasn't the first foodborne illness that had been tied to leafy greens, and it wasn't the last," Horsfall says. "But it was certainly kind of a tipping point."
This spinach outbreak was widely publicized by the media, and brought into light a troubling fact about foodborne illnesses, caused by viruses, bacteria, and parasites. "Historically, the understanding was that foodborne outbreaks usually came from foods like shellfish, meats, poultry, other things like that," says Mike Mahovic, the chief of the fresh produce branch in the Division of Produce Safety at FDA's Center for Food Safety and Applied Nutrition. "It was not until probably the late '80s or early '90s that there was an understanding that produce could carry pathogens as well."
After spinach, more large produce outbreaks would strike. Tomatoes. Cucumbers. Cantaloupes. Cilantro. Data from 1998-2008 shows that about 46 percent of outbreak-associated illness comes from produce, 34 percent of that coming from vegetables. More deaths are attributed to poultry, but produce was clearly a category that needed attention.
"As we started to become aware as a country, in late 2010s, that more of the outbreaks were traced back to produce, congress took a recognition to that and said, 'We have not updated our food safety statutory laws since the 30s or 40s,'" Mahovic says. "That's where FSMA came about."
FSMA is the Food and Safety Modernization Act. Passed by Congress in 2010, and signed by the president in 2011, the law updates some existing food regulations, but also creates brand new mandates for growers to prevent contamination from widely recognized possible contamination sources: agricultural water, soil amendments (like manure), worker hygiene, contamination from wild animals or livestock, and equipment conditions.
"There's a recognition now that what happens on the farm matters," says Sandra Eskin the Director of the Safe Food Project at PEW Charitable Trust. "For example, the 2008 outbreak linked to peppers grown in Mexico. It was a salmonella strain called Salmonella Saintpaul, and they determined that it was because of the groundwater the farmers used." In that outbreak, people from 43 different states got sick, 286 were hospitalized, and two people died.
FSMA, crucially, will also hold imported produce, like those Mexican peppers, to the same standards as domestic ones, and overall it will be the first country-wide, mandatory set of rules for growing produce. I say "will be" because though it was signed into law in 2011, FSMA has not been implemented yet. The first phase won't be implemented until 2018, and full implementation won't be completed until 2022.
"There's been a pretty long phase-in period, because for many growers, this is stuff they've done throughout their career, but for some it's new," Eskin says.
At the end of July, FDA doled out $31 million to the states, the second multimillion dollar installment, to help state food and agriculture agencies communicate to their growers what the new rules entail, and how they'll be enforced. Many farms already adhere to Good Agricultural Practices (GAPs), which are voluntary guidelines written by the FDA since the 1990s—but FSMA will require more than that. It requires documentation of good practices, and for some farms, a dramatic change in the way they operate on a daily basis.
In 2011, Colorado cantaloupes with Listeria killed 33 people. In investigations after the fact, some probable causes of contamination in daily operation were identified: There was trash in a truck sitting close to the machines that washed the melons. That same machine was a retrofitted potato machine, and may have caused bruising. The conveyor belt was carpeted, and when it got wet, was a breeding ground for bacteria. Even though cantaloupe has a thick rind, called the netting, that rind is porous. The bacteria were either able to pass through it and inhabit the flesh of the fruit itself, or they took up residence in the netting and got on people's hands or knives when they cut and handled the fruit.
Eskin says that we'll never know the definite cause. And that's one of the problems with the way it is now. Our outbreak response is inherently reaction-based, rather than prevention-based. And there's good reason for that: The reaction process is critical and time consuming. To detect outbreaks, the CDC monitors something called PulseNet, a national database all medical professionals have access to and upload information on what they're diagnosing. When they see a sudden spike in a particular illness, it suggests that there is an outbreak. CDC reaches out to the states, who narrow down what activities the sick people have done. In the 2011 cantaloupe case, CDC found that a lot of people were reporting cantaloupe consumption in some way.
The FDA then has to trace back where people ate or bought cantaloupes, send field investigators to those facilities, and do microbial sampling. In the cantaloupe case, the contamination had already spread to 28 states—not just Colorado. FSMA hopes to address those problems before the FDA and CDC have to go on this kind of wild goose chase.
"Now we just focus on what was the produce item, and what was the pathogen, and not how did it get contaminated," Eskin says. "That root cause analysis is currently not done routinely. It's a whole other conversation. What we had was the Food and Drug Act. And it said if you put contaminated food into commerce, you violate the law. But that's after people got sick. The big piece here is that we need something that put an affirmative responsibility on the part of growers to prevent problems."
Horsfall said that from what he's seen at LGMA, he's optimistic that farmers will embrace these new responsibilities. The Leafy Green Marketing Agreement opened under the umbrella of the California state Department of Food and Agriculture in 2007 after the spinach outbreak. It's voluntary organization to join, but once a grower joined, they were required to follow the rules. Like FSMA, LGMA addresses known risk areas, water, and soil, and worker hygiene, and created very specific standards that could be audited or inspected.
"Getting the mindset changed across the country in all these different industries about the need to document things, and then to put in the programs in place to do it, is a huge challenge for people," Horsfall says. "But I talk to people today who can't say enough good things about their program and all the things they do, and all the extra steps they take, who ten years ago who might have come really reluctantly into the program."
There's a comparable Leafy Green Marketing Agreement in Arizona, and between the two states, their rules cover about 90 percent of the leafy greens grown in the country, like spinach, cabbage, spring mix, kale, and chard. Horsall says that the peace of mind LGMA has offered California, and all the other states which buy their leafy greens, is something he wants the whole country to have.
"I don't want consumers to even think about food safety," he says. "They should be able to go into a produce department look at all those healthy products, and not be concerned. That's where I think the federal government, through FSMA, is entirely on the right track. We should be doing everything we can do to make sure that risk is kept as low as possible. You'll never eliminate it completely, because you don't have a kill step with these products. But it should be something that a consumer can buy with confidence."
Until FSMA is live, Mahovic and Eskin have some general guidelines for produce safety. Check the CDC to see what's currently contaminated; right now it's best to avoid papayas, which have been recalled because of four types of salmonella. Mahovic says to always wash loose produce under running water, even when organic—organic produce isn't safer from foodborne illness. Keep refrigerated products cold. When buying produce, make sure the skin isn't broken or bruised.
"Produce doesn't have to be beautiful, but if the skin is bruised and you see that it's opened in some place, that's an opportunity for bacteria to enter," Eskin says. FDA has especially strict rules for sprouts, which are grown in water—but Eskin says that, personally, she doesn't buy them. "I should restate that we have a very safe food supply," she says. "I believe that. But I also know it could be safer."
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