July 1, 2008 -- Move over, tomatoes, the FDA now has other produce items on its list of suspects in the salmonella outbreak that has sickened at least 869 people -- including 107 who have been hospitalized -- in 36 states and Washington, D.C.
But FDA officials aren't letting tomatoes off the hook -- and they refuse to say what other types of produce they're probing, except that those items are often served with tomatoes.
Tomatoes continue to be the lead suspect in the salmonella investigation, notes David Acheson, MD, the FDA's associate commissioner for foods.
Tomatoes are "our major focus," says Acheson, adding that the FDA has asked labs across the U.S. to help run tests on domestic and imported produce to find the salmonella source.
The CDC is also questioning people with salmonella infection and their healthy friends and relatives to find out if those unnamed produce items might be to blame.
Meanwhile, the government's advice to consumers hasn't changed -- for now.
A recap of that advice: Cherry tomatoes, grape tomatoes, tomatoes sold on the vine, and homegrown tomatoes are in the clear, along with red Roma, red plum, and red round tomatoes grown and harvested in certain states and countries listed on the FDA's web site.
Salmonella Outbreak Is Ongoing
The salmonella outbreak is ongoing, Robert Tauxe, MD, MPH, deputy director of the CDC's Division of Foodborne, Bacterial, and Mycotic Diseases, said today at a news conference.
The CDC has gotten reports of people sickened as recently as June 20, and at least 179 people have come down with Salmonella saintpaul, the rare strain in the outbreak, on or after June 1, says Tauxe.
More than half of the salmonella cases have happened in Texas, Arizona, and New Mexico, notes Tauxe. The CDC has launched a new, multi-state study to compare where ill and well people remember eating and what they ate, says Tauxe.
Last week, CDC officials said that while tomatoes are strongly associated with the salmonella outbreak, other possible sources, including guacamole and salsa containing raw red tomatoes, are on the suspect list. Many of the people who came down with salmonella infection had eaten tomatoes in dishes such as guacamole and salsa, CDC officials said in a June 27 news conference.
Today, Tauxe said that the outbreak is "very strongly" associated with tomatoes, with more than 80% of the ill people interviewed by the CDC earlier in the outbreak saying they had consumed fresh, raw tomatoes before getting sick -- about twice as many as healthy people also interviewed. "It was extremely unlikely that we observed that by chance alone," says Tauxe.
How Safe Are 'Safe' Tomatoes?
The FDA's recommendations about what types of tomatoes to eat are all about where those tomatoes are grown and harvested.
But if safe tomatoes got washed, packed, or repacked in a facility tainted with Salmonella saintpaul, they could be contaminated -- and not so safe after all.
Some of the packing and redistribution centers that handled tomatoes from southern and central Florida and Mexico when the outbreak began are still handling tomatoes, including tomatoes from safe areas. If those facilities are tainted -- and there's no sign that they are -- FDA officials say they would take immediate action.
Path From Plant to Plate
Al Wagner, a professor of food safety at Texas A&M University, says he's not scared to eat tomatoes. But he also says it's "amazing" that such problems don't happen more often, given the complexity of the produce pipeline.
For instance, a tomato might go from the farm to a packer, then be repacked with other tomatoes of the same size and ripeness from other farms, then go to a distribution center, then go to a major supermarket or wholesaler -- all in "a matter of days, weeks at the most," says Kathy Means, vice president of governmental relations and public affairs for the Produce Marketing Association, a Delaware-based industry group.
All of those places are potential sources of contamination. That's why the FDA isn't just hunting for the source of the salmonella outbreak on certain tomato farms in Florida and Mexico, but in all the places where those tomatoes traveled after being harvested.
Sanitation a Key
"Packing sheds -- and how well they sanitize and monitor the water they wash produce in -- are a key point in tomato safety, notes Wagner.
"If you do have some products come through that maybe have some contamination, if the water is sanitized properly, it's going to kill whatever organisms are there, so that subsequent fruit coming through there is not going to be inoculated," says Wagner.
Wagner's not blaming the packing sheds. "There are some that are doing an excellent job of taking care of that," he says.
But if packing sheds get lax about sanitation, that opens the door to problems.
"If the problem is at the packing house and if they are still packing tomatoes, then you could still have a problem," says Means.
"Say a load comes in that does have some salmonella in it, and it goes into the wash water. Then it's there and everything that comes afterwards" gets exposed, Wagner explains. "Proper sanitation would take care of that."
The risk of getting a tomato tainted with Salmonella saintpaul is "minimal," says Means. But she admits that the system isn't perfect.
The industry should use a tracking system, says Means, to trace where produce goes every step of the way from farm to table -- and to quickly pinpoint contamination sources when outbreaks arise.
Acheson agrees. Calling the salmonella investigation's pace "frustratingly slow," he said FDA investigators have been bogged down by industry records kept on paper. There is a "critical need," says Acheson, for industry to modernize its record-keeping practices.
Means predicts that the current outbreak will boil down to one farm, packing shed, or other source, since Salmonella saintpaul is such a rare strain that it's unlikely to appear in two places at the same time.
"It's going to come down to one thing, ultimately," says Means. "The faster we get to that one thing, the faster everybody can put the specter of bad tomatoes behind them."