How Do Officials Find An E. Coli Oubreak's Source?

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An outbreak of a nasty strain of E. coli in Germany has killed more than two dozen people and sickened more than 2,700 others. German authorities are still struggling to determine the source of the virus. Melissa Block talks to food safety expert Dr. David Acheson, formerly of the Food and Drug Administration, about the forensics of tracking down food contamination.

MICHELE NORRIS, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

MELISSA BLOCK, host:

And I'm Melissa Block.

The outbreak of E. coli infection in Germany continues to spread without any answers as to the source. Twenty-seven people have now died from this especially aggressive strain of E. coli. And German authorities reported 318 new cases of infection, bringing the total to more than 2,700.

For more on the forensics of tracking down food contamination, I'm joined by David Acheson, formerly with the Food and Drug Administration. Dr. Acheson is an expert on food-borne pathogens and infectious disease, and he's now a food safety consultant. Dr. Acheson, welcome to the program.

Dr. DAVID ACHESON (Former Chief Medical Officer, FDA): Great, pleasure to be with you. Thank you.

BLOCK: I'd like to talk first about the virulence of this outbreak. Hundreds of patients have been hospitalized with very serious complications, including kidney failure. Are you surprised by the potency of this strain of E. coli?

Dr. ACHESON: Frankly, Melissa, I am surprised, yes. We've had many unfortunately significant E. coli outbreaks in the United States. And often you'll see fairly high levels of kidney failure - which is what we're seeing in Germany - but it's usually in the 10 to 15 percent range. This is more like 25 to 30 percent. So there's clearly something about this bacteria that is particularly virulent in this context.

BLOCK: Now, the German government has come in for a lot of criticism for how they've been handling this outbreak. People have said it's too slow, that it's being handled on a state-by-state basis, rather than by the federal government.

What's your take on how Germany has been managing this investigation?

Dr. ACHESON: Well, for one reason or another, it's evident that they're struggling. It's always of concern as a public health person, and you're faced with a devastating outbreak, you want to tell consumers what to do. But - and it's fine to put out word - don't need such and such a food product - that's often what it's about. But there's nothing worse than coming out with one, then adding a second and a third and a fourth, and then going back and saying, oops, we may have made a mistake - as happened with the Spanish cucumbers.

And now I saw something just as recently as today saying, well, you know, maybe it was cucumbers after all. They apparently found a positive in somebody's garbage that's 10 days old. It seems like they're all over the map, which is obviously providing very confusing information to consumers. And we know from experience that when you go out to consumers and say don't eat a certain commodity, it's devastating to that industry.

BLOCK: What do you think the German authorities or investigators are doing wrong here?

Dr. ACHESON: Well, without the inside track, it's really hard to know. But if anything, Melissa, what I would guess is that they are relying too heavily on looking for a positive sample. They want the confirmed evidence that we found the outbreak strain in a sample of whatever - tomatoes or lettuce or cucumbers. And this far out in the outbreak that could be almost impossible to find, because the food has either been consumed or spoiled and has been thrown away.

We, in the U.S., reacted many times appropriately to solid epidemiology without actually having a positive sample, like spinach in 2006 which was obviously a massive E. coli outbreak. And it was very evident from the epidemiology that it was spinach.

If you're relying on waiting for the sample, the further you are away from the start of the outbreak the harder it's going to be to do that, and so you continue to struggle.

BLOCK: Dr. Acheson, are there lessons here not just for tracing the source of an outbreak, like this one, but for preventing that outbreak in the first place?

Dr. ACHESON: Oh, absolutely. The critical importance of preventive controls is paramount. And assuming that this is fresh produce, you start those on the farm with a number of preventive controls, you work it through the processing environment, through transportation with adequate refrigeration at transport and retail. And you extend it right through to consumers' homes to avoid cross-contamination between raw meat and poultry and fresh produce.

So, multiple layers of preventive controls combined with rapid response.

BLOCK: Dr. David Acheson is in charge of the food and import safety practice with the consulting firm Leavitt Partners. Dr. Acheson, thanks so much.

Dr. ACHESON: A great pleasure. Thank you.

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