In E. Coli Fight, Some Strains Are Largely Ignored
For nearly two decades, Public Enemy No. 1 for the food industry and its government regulators has been a virulent strain of E. coli bacteria that has killed hundreds of people, sickened thousands and prompted the recall of millions of pounds of hamburger, spinach and other foods.
But as everyone focused on controlling that particular bacterium, known as E. coli O157:H7, the six rarer strains of toxic E. coli were largely ignored.
Collectively, those other strains are now emerging as a serious threat to food safety. In April, romaine lettuce tainted with one of them sickened at least 26 people in five states, including three teenagers who suffered kidney failure.
Although the federal government and the beef and produce industries have known about the risk posed by these other dangerous bacteria for years, regulators have taken few concrete steps to directly address it or even measure the scope of the problem.
For three years, the United States Department of Agriculture has been considering whether to make it illegal to sell ground beef tainted with the six lesser-known E. coli strains, which would give them the same outlaw status as their more famous cousin. The meat industry has resisted the idea, arguing that it takes other steps to keep E. coli out of the beef supply and that no outbreak involving the rarer strains has been definitively tied to beef.
The severity of the April outbreak is spurring a reassessment.
“This is something that we really have to look at,” said Senator Kirsten Gillibrand, Democrat of New York, who plans to introduce a bill that would pre-empt the Agriculture Department by declaring a broad range of disease-causing E. coli to be illegal in ground beef and requiring the meat industry to begin testing for the microbes. “How many people do we have to see die or become seriously ill because of food poisoning?”
The issue will be one of the first faced by President Obama’s nominee to head the department’s food safety division, Dr. Elisabeth Hagen, who is scheduled to testify Thursday in her Senate confirmation hearing.
Part of the problem is that so little is known about the rarer E. coli strains, which have been called the “big six” by public health experts. (The term refers to the fact that, after the O157 strain, these six strains are the most virulent of a group of related E. coli.) Few food companies test their products for the six strains, many doctors do not look for them and only about 5 percent of medical labs are equipped to diagnose them in sick patients.
A physiological quirk of E. coli O157 makes it easy to test for in the lab, and many types of food are screened for it. The other E. coli strains are much harder to identify and testing can be time-consuming. The Agriculture Department has been working to develop tests that could be used in meat plants to rapidly detect the pathogens.
The lettuce linked to the April outbreak tested negative for the more famous form of E. coli, but no one checked it for the other strains, according to the Ohio company that processed it, Freshway Foods. It turned out that the romaine was infected with E. coli O145, one of the more potent of the six strains.
Emily Grabowski, 18, a student from Irondequoit, N.Y., ate some of the lettuce at her college dining hall and ended up in the hospital with kidney failure. Recuperating at home, she wonders now if she could have been spared her ordeal. “If they had tested it and they had caught it,” she said, “I wouldn’t have had the E. coli.”
Earthbound Farm, the nation’s largest producer of organic salad greens, is one of the few companies that does screen for the full range of toxic E. coli, and it has found a worrisome incidence of the rarer strains. Out of 120,000 microbial tests last year, about one in 1,000 showed the presence of unwanted microbes, mostly the six strains.
“No one is looking for non-O157 to the level we are,” said Will Daniels, Earthbound Farm’s senior vice president for food safety. “I believe it is really going to emerge as one of the areas of concern.”
Earthbound Farm was not involved in the April outbreak.
The O157 strain of E. coli is a frightening bug, causing bloody diarrhea and sometimes kidney failure, which can be fatal. Some of the six strains cause less severe illness, but others appear to be just as devastating as the O157.
The toxic E. coli bacteria originate in the guts of cattle, putting the beef industry on the front line. The O157 strain achieved notoriety in 1993 when four children died and hundreds of people were sickened by tainted hamburger sold at Jack in the Box restaurants. The next year, the Agriculture Department made it illegal to sell ground beef containing the O157 bacteria.
The beef industry now routinely tests for the O157 strain, but there is no regular testing for the other six strains.
Avoiding 'another Jack in the Box'
It is unclear how prevalent the six strains are in ground beef. Preliminary data from a department study found the pathogens in only 0.2 percent of samples. By comparison, the O157 strain already banned shows up in about 0.3 percent of samples, according to other government data.
But tests commissioned by William Marler, a Seattle lawyer who represents victims of food poisoning and has pushed the department to ban more E. coli strains, found the six strains in 0.7 percent of ground beef samples bought at supermarkets.
The E. coli bacteria can be killed by thorough cooking to 160 degrees.
Tracking the impact of the rarer E. coli strains on human health is difficult because few medical labs test for them, and health officials say illnesses caused by them are vastly underreported.
Data from the Centers for Disease Control and Prevention showed at least 10 food-borne outbreaks from 1990 to 2008 involving the six strains, carried in foods like salad or strawberries. Investigators suspected ground beef as the cause of a 2007 outbreak in North Dakota, but the link was not confirmed.
The April outbreak is a signal of a broader problem, said Michael R. Taylor, deputy commissioner for foods at the Food and Drug Administration.
“We need to be developing our tools and abilities to assess” the full range of toxic E. coli, he said. The agency, which regulates produce, is waiting for Congress to pass a law that would greatly expand its food safety authority.
It is not clear how E. coli travels from cattle to produce, but scientists think it may occur through contact with manure, perhaps tracked through fields by wild animals, or through tainted irrigation water.
For its part, the Agriculture Department has said it is reluctant to ban the broader range of E. coli in beef until it has developed tests that can rapidly detect the pathogens. It expects to complete those by the end of 2011 and then study how often the six strains show up in the beef supply.
But an official said the timetable was not rigid. “I don’t want to give the impression that we’re going to wait months and months for these tests, and months and months to see what’s in the beef supply,” said Dr. David Goldman, an assistant administrator for the Office of Public Health Science of the department. “In terms of policy options, it’s not like we have to do one and then the other.”
James H. Hodges, executive vice president of the American Meat Institute, an industry group, said that the industry had put in place many procedures to keep E. coli O157:H7 out of ground beef, like washing carcasses in hot water and lactic acid.
Those steps also work against the other E. coli, Mr. Hodges said, pointing to the lack of outbreaks of illness connected to them. “It certainly tells me that both the government and the industry is targeting the correct organism,” he said.
Dr. Richard Raymond, who was the department’s head of food safety from 2005 to 2008, said he stopped short of banning the rarer E. coli from hamburger because he thought that he would not have been able to defend the decision against industry criticism until rapid tests were developed.
But he said the April outbreak could push regulators to act. “I don’t think the U.S.D.A. wants to see another Jack in the Box,” Dr. Raymond said.