Treat the water; then mitigate other romaine problems

Stephen Ostroff — Tue, 03 Dec 2019 00:36:11 +0000

Opinion

Stephen M. Ostroff is a former deputy commissioner for foods at the Food and Drug Administration. He wrote this column recently.

Exactly a year ago, during Thanksgiving week, I was involved in the government’s decision to recommend removing romaine lettuce from grocery store shelves and restaurants. We also advised people not to eat any romaine they had purchased and to throw it away instead.

Now, right before Thanksgiving, it’s happening again.

Nobody wants to scratch romaine off the nation’s Thanksgiving menu. But these recommendations were easy ones to make.

Last year, an outbreak of E. coli bacteria linked to romaine was sweeping the country. Contaminated romaine was likely still on the market. We were unsure where the contaminated product came from, so all of it had to be removed. Even if we knew its origin, romaine wasn’t labeled to allow consumers to determine where it was grown. At least the labeling has improved since last year. But more needs to change.

During the 2018 Thanksgiving outbreak, the government’s actions clearly prevented additional illnesses. But, unfortunately, 62 people still became ill. Symptoms of an E. coli infection can include severe stomach cramps, bloody diarrhea, vomiting and fever. Some people experience only mild symptoms, but for others a severe infection can be life-threatening.

Fast forward to now, and there’s another outbreak of the same strain of E. coli linked to romaine, likely from California’s central coast. As of Nov. 22, 40 cases had been reported across 16 states, with 28 hospitalizations but no deaths. The Food and Drug Administration and Centers for Disease Control and Prevention are recommending that consumers avoid romaine from the Salinas region.

Remarkably, the specific E. coli strain (O157:H7) causing the new outbreak is genetically indistinguishable from last year’s and another one in late 2017. Last month, the FDA retroactively identified an outbreak involving romaine lettuce that occurred in late summer, causing 23 illnesses. The CDC has not posted information about that outbreak, so the epidemiologic patterns of illness and causative strain are unknown.

Notably, the 2018 Thanksgiving outbreak was not the first one that year either. It was preceded by the biggest outbreak in the United States of E. coli illness in more than a decade, with 210 illnesses, including five deaths, linked to romaine from the winter growing region around Yuma, Ariz.

With five multistate outbreaks in less than two years, it’s clear there’s a serious continuing problem with E. coli O157:H7 and romaine lettuce. The natural reservoir for this pathogen is ruminant animals, especially cattle. Moreover, one particular strain of E. coli seems to have found a home in the growing regions of central coastal California, returning each fall near the end of the growing season.

It’s not clear where this strain is hiding. Cattle? Water sources? Elsewhere? What is clear is that additional steps must be taken to make romaine safer.

Other commodities such as meat and flour also cause foodborne illness. But at least with these, cooking and baking eliminate the risk. That isn’t the case with romaine. Washing the lettuce may remove surface contamination, but the crinkly leaves make eliminating all of it almost impossible.

The Food Safety Modernization Act, signed into law in 2011, places the responsibility on food producers to prevent contamination from occurring and to assure their product is safe. The leafy greens industry, with input from the FDA, the CDC and others, has recently taken steps to meet this obligation. In September, an industry-led task force issued a set of recommendations to address the problem.

One of the most significant recommendations is that any open-source water in contact with edible lettuce in the three weeks before harvest should be treated to remove contamination. E. coli O157:H7 was found in untreated surface water in both the Yuma and 2018 Thanksgiving outbreaks.

The task force recommendations should be immediately adopted and implemented. But even more should be done. Surface water used for romaine irrigation should be treated throughout the growing cycle, not just in the three weeks before harvest. The FDA should also quickly issue agricultural water standards that have been postponed but are required by FSMA’s produce-safety rules.

Another concern that must be addressed: concentrated animal feeding operations, where tens of thousands of cattle potentially carrying E. coli O157:H7 are housed, if they are located near leafy green growing areas. Buffers between the cattle operations and growing fields are required, but bigger ones may be needed.

E. coli can cause terrible illness. Just ask any of the victims of the five most recent outbreaks. The romaine lettuce market has managed to rebound from outbreak after outbreak. But consumer loyalty is unlikely to be limitless. The industry should not take this resilience as a given.

Editor’s note: Stephen M. Ostroff originally wrote this column for The Washington Post. It is republished here with his permission.

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Editor’s note: Stephen Ostroff is FDA’s Deputy Commissioner for Foods and Veterinary Medicine. He wrote this column as an FDA blog post Nov. 10.

Most people, even if they live in cities or suburbs, understand that there are many types of farms. But to really appreciate how different farms can be, you have to get out there and see it for yourself. By visiting farms in different parts of the country, you see first-hand the food safety challenges that are unique to a region. Farms are different sizes, grow a variety of crops and don’t follow the same growing and harvesting practices. There’s a varied amount of rainfall by region and season, and irrigation methods differ by crop and location. And so, while farmers confront some of the same issues, there can be real differences in the challenges they face.

Wenatchee (WA) Reclamation District Manager Rick Smith, center, shows FDA’s Stephen Ostroff, right, and colleagues an open irrigation canal system. (Photo courtesy of FDA)

What produce farmers and other food producers have in common is that they face new federal standards for the production of safe food. Seven foundational rules to implement the FDA Food Safety Modernization Act (FSMA) were finalized by May of this year. These include the produce safety rule, which establishes enforceable safety standards for the production and harvesting of most fruits and vegetables on farms in the United States and foreign farms that produce these commodities for the United States. They also include the preventive controls for human food rule, which establishes safety standards applicable to food facilities, including those that process fruits and vegetables.

I, along with my colleagues at FDA and state counterparts, visited the farmlands of the Pacific Northwest and California earlier this fall to get a sense of how growers, packers, processors and other stakeholders are getting ready to meet the new standards that apply to them. In September, we visited apple orchards and packing houses in Washington and berry growers in Oregon. We toured irrigation systems and met with stakeholders who included growers, water resources groups and tribal representatives.

In October, we visited stone fruit, table grape, citrus, and lettuce and strawberry fields in northern California. We toured an almond hulling and shelling operation in a visit coordinated by the Almond Alliance of California, and held a roundtable discussion about California’s water supply with farmers, representatives of industry associations and others. We visited a major processor of salad items. We finished the trip with an early-morning visit to the Golden Gate Produce Terminal in San Francisco, a trove of organic and conventional produce, as well as specialty and ethnic foods.

Produce farms have not been regulated like this before – it’s new territory for both the farming community and for FDA. We were asked many questions and received a great deal of feedback about the new regulations. But we found a strong commitment to providing consumers with safe fruits and vegetables and to moving forward in a collaborative fashion. For our part, I think it’s incumbent on FDA to protect public health without requiring a lot of unnecessary steps or measures that don’t achieve that goal.

These trips also highlighted the fact that that many food producers and industry associations have already invested a lot of time and effort in food safety measures. In some instances, what they have put in place goes beyond what is required under FSMA. In both trips, we saw farmers, other food producers, and industry associations stepping up to address past safety issues, including by developing their own on-farm standards and implementing audits to verify that those standards are met. Some developed treatment protocols and funded research to fill data gaps. These efforts will make it much easier to meet the new federal standards.

The big challenge for the growers in the drought-stricken Western states is water. The drought makes it difficult for growers to predict from month to month and season to season how much water will be available, where it will come from, and what it will cost. Therefore, many had questions regarding the produce safety rule’s water quality standards.

Our state regulatory partners in Washington, Oregon, Idaho and California brought members of the produce community together to meet us and discuss these issues. I am so grateful for their active involvement in making FSMA a success. Karen Ross, secretary of the California Department of Food and Agriculture, Lisa Hanson, interim director of the Oregon Department of Agriculture, Derek Sandison, director of the Washington State Department of Agriculture, and Pamela Juker, representing the director of the Idaho State Department of Agriculture, are strong voices for agriculture and food safety in the West, and we value their partnership and continued input. Both they and their staffs understand the farmers and have long-standing relationships with them. Through recently announced produce safety cooperative agreements with FDA, we will be partnering with each of these states and 38 others to implement the new produce safety rule.

We also had the opportunity to visit farms that have been in families for generations. These farmers take great pride in their work and are determined to keep their food safe but still have questions about how to they can comply with the new requirements. The take-home lesson for us was the need to provide adequate education and training and clear guidance that will help these farmers comply with FSMA. Farmers are looking for this and we’re making sure that we can fill these needs.

There was also a lot of discussion about making sure that the information we provide can be understood by people working on farms who are not native English speakers. There is a great deal of diversity in these regions, including the Hmong-American farmers of California’s Central Valley.

So there’s a lot of work ahead of us, and together we will roll up our sleeves to get it done. We went to see farmers and other food producers, and met a lot of talented people who grow and process the food we eat. We found an incredible diversity in the food that is produced, but a shared commitment to having the safest possible food supply.

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Stephen Ostroff | Food Safety News

Treat the water; then mitigate other romaine problems

Opinion

Western farmers, processors share commitment to food safety