By: Kathleen Gensheimer, MD, MPH
Two years ago, FDA put the Coordinated Outbreak Response and Evaluation (CORE) Network in place to improve the response to outbreaks of foodborne illness. In fact, the very day FDA announced the group’s formation, CORE was already responding to one of the deadliest foodborne illness outbreaks in decades. Sadly, that outbreak of Listeria monocytogenes linked to cantaloupe caused 33 deaths. However, through the coordinated efforts of the FDA, the Centers for Disease Control and Prevention (CDC), and state and local governments, the outbreak was stopped and lives were saved.
Recently the New England Journal of Medicine published an article on that outbreak, so I thought I should revisit FDA’s role in the response and its actions to help prevent future outbreaks like this.
Just before the Labor Day weekend in 2011, Colorado state health officials announced that the number of listeriosis cases in that state was three times more than normal for August. FDA worked with the CDC and state partners on the issue and it was suspected that illnesses, spread over several states, might be linked to Colorado-grown cantaloupe.
FDA quickly mobilized its field investigators and subject matter experts. Cantaloupe samples FDA collected from stores were found to be contaminated with Listeria monocytogenes. FDA reviewed records to determine the potential growers of these cantaloupes. Investigators from FDA and the state of Colorado inspected one of these growers, Jensen Farms, and collected cantaloupe samples and swabs of surfaces at the Jensen Farms packing house. Those samples were found to contain Listeria monocytogenes with the same DNA fingerprint that had been isolated from people who became ill. Shortly afterwards, Jensen Farms began a product recall.
While FDA monitored recall activities, it also coordinated an environmental assessment at Jensen Farms. With Jensen Farms’ cooperation, experts in food safety, health, and agriculture from FDA, CDC, the Colorado Department of Public Health and Environment, the Colorado Department of Agriculture, and the Prowers County Department of Health worked to identify conditions or procedures potentially contributing to the outbreak.
This team found, among other things, that the packing house floor allowed water to pool, the design of equipment made it difficult to clean and sanitize, and the temperature of the cantaloupe when they were refrigerated allowed moisture to form on them and may have allowed bacteria to grow. To inform the food industry and help them avoid similar problems, FDA made these findings public. As a result, the industry took a number of steps to enhance cantaloupe safety, one of which was to issue updated national food safety guidelines for cantaloupes.
In addition, this year FDA initiated inspections and sampling at cantaloupe packinghouses in the United States to assess the current practices and conditions that may affect the safety of cantaloupe distributed to consumers.
Since that first test of FDA’s improved foodborne outbreak response, FDA has responded to more than 80 outbreaks of varied scope, severity and complexity.
For example, in an outbreak linked to scrape tuna in sushi, a product recall protected consumers from more than 58,000 pounds of tuna that was potentially contaminated with Salmonella. In another outbreak related to Salmonella in peanut butter, we used a new authority granted by the FDA Food Safety Modernization Act (FSMA) to suspend the registration of a food processor, which effectively prohibits the distribution of potentially unsafe food domestically or abroad.
Over the past two years, we have learned what works best and improved procedures to continue to protect consumers from contaminated food. That progress would not have been possible without the close collaboration with our many partners at the local and state public health and agriculture level, as well as with our federal partners within CDC, U.S. Department of Agriculture and FDA.
We look forward to continued partnership and progress in the years to come.
Kathleen Gensheimer, MD, MPH, is Chief Medical Officer and FDA’s Director of Outbreak Investigation and Response