Op-Ed: Could Europe's E Coli Outbreak Happen Here?

Fresh fruits and vegetables hold a special space in Marin County’s health-conscious lifestyle. We cherish our farmer’s markets, our community gardens, and our connection to the Earth and to the people who grow the foods we love to eat.

We recognize how the raw ingredients in our fresh salads can hold the key to a long and healthy life, and in Marin County we are among the country’s most avid consumers of fresh produce of all kinds.

But what if our salads could kill us?

That’s what people throughout Germany and other European countries are asking now, as they grapple with an outbreak of E coli bacteria from a new and highly virulent strain.

Reported cases of diarrhea associated with the outbreak have now topped 2,400, with more than 640 cases leading to a serious form of anemia and kidney disease, and at least 15 cases ending in death. Four suspected cases have also been reported in the United States, all from recent travelers to Germany.

The source of the outbreak remains elusive, but investigations so far have centered on the fresh vegetables sold recently in Hamburg’s huge wholesale produce market. Cucumbers were the first alleged culprit. Then tomatoes and lettuce came under suspicion.

Most recently attention has focused on fresh sprouts. Testing continues, but investigators admit that in this mystery a “smoking vegetable” may never be found.

Not surprisingly, salad consumption in Europe has plummeted. Thousands of cartons of unsold produce have been shipped off for compost or to biodiesel plants. A public health disaster is rapidly becoming an economic disaster for European growers, and may even be undermining the public’s confidence in going green with their diets.

Serious outbreaks like this one grab our attention, but unfortunately foodborne illness due to more typical strains of toxin-producing E coli and other familiar microbes is all too common in our county and elsewhere these days. An outbreak like the one occurring in Europe will almost definitely erupt here in the not-so-distant future.

The federal Centers for Disease Control and Prevention has recently estimated that nearly one in six Americans becomes ill from foodborne infections each year. Of those 48 million cases, 128,000 cases lead to hospitalization, and more than 3,000 result in death.

That’s more deaths each year from germs in our food than all the deaths resulting from the terrorist attacks of September 11, 2001.

Increasingly, when a source for foodborne outbreaks is now identified, fresh fruits and vegetables are turning up as the cause. In recent years toxin-producing E coli outbreaks have been linked conclusively to tainted spinach, lettuce, cabbage and sprouts.

One big reason for this trend is the shifting American diet. We’re eating more fresh produce today, and the higher demand is driving up the production of fruits and vegetables on an industrial scale, both locally and around the world.

Overall, the greater availability of fresh produce is good for our health, but it means that when contamination occurs it can happen on a much larger scale. For example, the mere dropping of feces by feral pigs traversing a large ranch by night about 100 miles south of Marin was probably responsible for up to 199 cases of serious E coli disease in 26 states during 2006 through the widespread distribution of bagged fresh spinach.

New federal funding is now stepping up inspection of food production and processing sites, both domestically and internationally, in response to growing public concern about food safety. Strict adherence to accepted hygienic practices in food production will eventually reduce the risk of disease to consumers.

But a few simple precautions taken now at home can bring the risk of getting sick from your produce nearly to zero:

• Most importantly, wash your produce thoroughly. Rinse fresh fruits and vegetables under the tap to remove any visible dirt or grime.
• Remove and discard the outermost leaves of a head of lettuce or cabbage.
• Avoid cross-contamination in your kitchen by washing your hands, utensils and cutting boards after contact with raw meat or poultry. Make sure your cutting board is absolutely clean before you cut your fruits and vegetables. If your cutting board is worn or heavily grooved, replace it.
• Avoid leaving cut produce at room temperature for many hours.
• And always remember to wash your hands before you eat or before you prepare foods for yourself or others.

The European outbreak is unfortunate, but it can serve as a reminder to us on this side of the Atlantic of the need to take food safety seriously every day.

Dr. Eberhart-Phillips is the Marin County Public Health Officer. He can be reached at jeberhart-phillips@co.marin.ca.us.