Bonnie Henry - Soap and Water and Common Sense

BEAR MEAT BITES BACK was the headline in a Canadian newspaper near the end of September 2005. It had been the trip of a lifetime for ten hunters from across France who set out for the wilds of northern Quebec, to hunt for bear, and it was a successful one too. The group feasted on barbecued black bear that evening in the lodge. Most had their meat prepared medium or medium rare, despite its gaminess. A few days later two of the hunters took the remains home to France to share with family and friends. Sadly, none of them foresaw the terrible impact this simple act would have only days later.

Within two weeks all ten hunters were complaining of symptoms ranging from muscle aches and headaches to high fevers, severe muscle pain, facial swelling, and inflammation of the brain. Several required extended treatment at a Paris hospital. One hunter had shared the delicacy with six relatives in central France, and half of them became ill about a week later. The other hunter shared his prize meat with seven friends soon after returning to his home in southern France, and one of the guests began suffering from the same symptoms.

All in all, fourteen of the twenty-three people who feasted on the black-bear meat contracted an illness from a parasite called Trichinella, a common boarder in bears, wild cats (such as cougars), foxes, dogs, wolves, seals, and walruses. Trichinella enters the human intestinal tract, where it releases its progeny into the blood. The larvae then migrate to the muscles, where they can live relatively protected from antibiotics for decades. Trichinellosis, the disease the parasite causes in humans, has been around for centuries, and we have known how to prevent it for almost as long thoroughly cooking meat effectively kills the parasite. This story of international disease spread serves to remind us of the inherent risks in our food supply, and it is a small but potent example of the complexity of our global food economy.

SINCE SCIENTISTS BEGAN tracking food-borne illnesses around the world, it has become painfully clear that nothing is immune to the many divisions of Microbes Inc. Common bacteria that cause food-borne illness include Salmonella and Shigella, which cause serious gastrointestinal illness, often resulting in bloody diarrhea (a sign of the severe inflammation the bug causes in the intestines), and Escherichia coli (E. coli), whose many strains can cause everything from mild diarrheal illness to a severe systemic disorder called hemolytic uremic syndrome (HUS), which causes bloody diarrhea and kidney damage and can be fatal.

In the Virus Division the most common bugs to cause disease through food include the Noroviruses, which bring on a short but explosive illness, symptoms of which include watery diarrhea and vomiting, and hepatitis A, a virus that affects the liver and can cause prolonged illness that may be passed on to others through contaminated food and water. In addition, several parasites have invaded our food and water systems, including Cyclospora and Trichinella, the bug that so affected the French hunters. Finally, some bacteria have the ability to produce potent toxins in humans. They go by names such as Clostridium perfringens, which causes the short but nasty illness that is often referred to as food poisoning.

Food is a fundamental human need, and much of our existence is spent in one way or another searching for sustenance. Since the beginning of time we have been locked in an intricate dance with the divisions of Microbes Inc. to find food that provides us with the nutrition we need without giving the bad bugs direct entry into our systems, where they can make us sick. With the globalization of our food supply and the complexity of our food production systems, it has become increasingly difficult to achieve and maintain this delicate balance.

In 1925 the United States Public Health Service began systematically collecting and publishing information on illnesses and outbreaks related to the consumption of unpasteurized milk, and in 1938 they added information on outbreaks caused by food. The collection and analysis of this data led to the enactment of important public health standards to protect food and milk supplies. One of the first and most effective measures to be made law was the Pasteurized Milk Ordinance, which protected thousands of children from common diseases spread through contaminated raw milk. Meat inspection programs and animal husbandry and slaughter standards soon followed.

These programs went a long way towards protecting meat, fish, poultry, milk, and water from contamination, but over time the move to industrialized farming and large-scale food production allowed the bugs to flourish once again. Even highly processed foods are not immune to the havoc of the many divisions of Microbes Inc., and the wide geographic distribution of our food supply means that when outbreaks do occur, they can be catastrophic on a global level. Recently, for example, plants in China produced and distributed processed foods contaminated with the industrial chemical melamine, which affected people in many parts of the world. And as we will see, even the most advanced food safety and inspection programs can fail, leading to widespread illness.

In 2007 the U.S. Centers for Disease Control and Prevention estimated that more than seventy-six million Americans became ill after ingesting contaminated food, and five thousand died. In the United States alone treatment for food-borne illnesses costs the health-care system $7 billion annually. Surveillance of food- and water-borne outbreaks is a key public health function in most Western countries, including the United States, Canada, Australia, and Europe. Recently many countries have introduced sophisticated electronic tracking systems that incorporate detailed laboratory tests to allow public health investigators to trace patterns of illness in a number of locations. For example, the system can link an outbreak in Vancouver to people who have contracted the same bug from the same source in Chicago. It is hoped that making these links more rapidly will allow officials to take action sooner to prevent the spread of disease.

Some of the newer laboratory tests help identify bugs by their genetic fingerprint; the microbes can then be traced from the contaminated food to the infected people. In the past few years this system has led to the detection of Salmonella in almonds that were distributed across North America and to an outbreak of E. coli from prepackaged luncheon meats. Despite stringent regulations around food production and distribution, data from the surveillance system show that a whopping 6,647 food-related outbreaks were reported in the United States in 2006. This number marks a steady increase in reported outbreaks since the CDC started collecting these data in the 1930s. And this is just the tip of the iceberg: many small outbreaks arent even reported to public health officials.

Lets take a walk through the Food and Water Department of Microbes Inc. and not only expose how global food production and distribution have led to a sharp increase in outbreaks, particularly in the Western world, but also find out what we need to do to protect ourselves and our families.

Bacteria cause some of the most severe and long-lasting illnesses related to food. In fact, over half of food- and water-borne outbreaks reported to public health officials every year are caused by this division of Microbes Inc., and the many strains of Salmonella are undoubtedly the disease-causing leaders.

Salmonella is a bug that causes nausea, vomiting, diarrhea, and severe stomach cramps that can last for up to two weeks. This workhorse of Microbes Inc. has adapted to survive and proliferate in many foods, but first and foremost in chickens and eggs. Throughout history there has been a direct link between