by revere, cross-posted at Effect Measure

The FDA is saying they still aren’t sure how over 1200 Salmonella stpaul cases resulted from food chain contamination but they are saying its from jalapeno peppers grown in Mexico. This from a press release July 25:

The U.S. Food and Drug Administration is advising consumers that jalapeño and Serrano peppers grown in the United States are not connected with the current Salmonella Saintpaul outbreak.However, the FDA continues to advise consumers to avoid raw jalapeño peppers–and the food that contains them–if they have been grown, harvested or packed in Mexico.

[snip]

The more narrow advisory the FDA is issuing today is based on evidence gathered during a multi-week, intensive investigation conducted in partnership with the U.S. Centers for Disease Control and Prevention and public health authorities in several U.S. states to find the source of the contamination that led to the outbreak. The collective review of the current traceback investigation and harvesting dates, matched with the dates that people became ill, have combined to indicate that the contaminated jalapeño pepper originated in Mexico.

Additional traceback and traceforward information obtained this week has led to the determination that the Agricola Zarigoza produce-distribution center in McAllen, Texas–from where FDA took the positive jalapeño pepper sample–was not the original source of the contamination. (FDA Statement, July 25, 2008 )

 

This leaves us with a lot of questions. There is said to be a single contaminated pepper discovered at a small distribution system in McAllen, Texas (or is it a single pepper? see below). The FDA says that pepper came from Mexico and that no other peppers have been found anywhere. But they also say that the distribution center “was not the original source of the contamination.” Presumably they don’t know the original source. But then how do they know that just because the pepper came from a farm in Mexico the Salmonella did too? Maybe the pepper got contaminated the same way 1200 plus people got contaminated, from some as yet undetected source. How do they know that no US grown pepper could not have become contaminated, too, if they don’t know the source? In fact, how sure are they that peppers are the food vehicle?

There may be perfectly good answers to these questions. The problem is that the FDA isn’t providing enough information to allow anyone outside the agency to judge. Or maybe even those inside the agency. Consider this little item from the industry friendly site of consultant Jim Trevor:

Was the detection actually a single jalapeño pepper or from a single composite sample of several taken from the distributor? I thought this must be a mistake in reporting by media.No, it definitely was not a mistake in reporting. After initially pointing out that “one of the jalapeño pepper samples” had tested positive for Salmonella Saintpaul, FDA’s Dr. David Acheson, M.D., Associate Commissioner for Foods, said clearly — and in the singular:

“The discovery of this positive pepper was a result of the past weeks of investigations by FDA scientists and field agents…”

And…

“The pepper that we found was positive was grown on a farm in Mexico…”

One positive jalapeño in a sea of negative samples is very odd, so we have tried to get clarification. First, when asked, FDA spokespeople told us it is a composite sample — but they would not tell the world how many peppers were composited to make this sample. Then they said the word “composite” might be wrong and they would get back to us — which they never did. The FDA is also not withdrawing or clarifying Acheson’s singular comments although we gave them the opportunity to do so. So it is very odd. (The Perishible Pundit)

 

While we disagree with this site about the value of properly done epidemiology and timely notification when there isn’t conclusive evidence (we think notification and warning are warranted), we agree strongly that the FDA (and CDC) has been less than informative regarding this large outbreak. Even worse, they have conducted themselves in ways that positively invite skepticism and weaken their credibility with the consuming public, public health professionals and the produce industry. Raising questions on every side of this issue is quite a feat.

Meanwhile the best work seems to have been done by State health departments, not CDC and not FDA. The first break came on a traceback to the McAllen facility from a cluster of cases from patrons of a restaurant done by students at the University of Minnesota School of Public Health working with the Minnesota Department of Health. Yesterday we learned that the Colorado Department of Health and Environment that a pepper with Salmonella stpaul had been found in the home of one of the cases. The pepper was bought at a Denver Wal-Mart at the end of June and the person fell ill on July 4. So this ties peppers to the outbreak much more tightly than the “single pepper” at the McAllen facility. Where the pepper came from we don’t know yet. CDC says they are working with FDA and state health departments to find the source of this pepper. Two questions. If they don’t know where the pepper came from yet how does FDA know US grown peppers are safe?

And when will CDC and FDA institute a policy of honestly and clearly informing the public in a timely manner? Probably not for at least 175 days. After that we’ll have to see.